The effects of low-intensity narrow-band blue-light treatment compared to bright white-light treatment in sub-syndromal seasonal affective disorder

Abstract

BackgroundThe discovery of a novel photoreceptor in the retinal ganglion cells with a highest sensitivity of 470-490 nm blue light has led to research on the effects of short-wavelength light in humans. Several studies have explored the efficacy of monochromatic blue or blue-enriched light in the treatment of SAD. In this study, a comparison has been made between the effects of broad-wavelength light without ultraviolet (UV) wavelengths compared to narrow-band blue light in the treatment of sub-syndromal seasonal affective disorder (Sub-SAD).MethodIn a 15-day design, 48 participants suffering from Sub-SAD completed 20-minute sessions of light treatment on five consecutive days.22 participants were given bright white-light treatment (BLT, broad-wavelength light without UV 10 000 lux, irradiance 31.7 Watt/m2) and 26 participants received narrow-band blue light (BLUE, 100 lux, irradiance 1.0 Watt/m2). All participants completed daily and weekly questionnaires concerning mood, activation, sleep quality, sleepiness and energy. Also, mood and energy levels were assessed by means of the SIGH-SAD, the primary outcome measure.ResultsOn day 15, SIGH-SAD ratings were significantly lower than on day 1 (BLT 54.8 %, effect size 1.7 and BLUE 50.7 %, effect size 1.9). No statistically significant differences were found on the main outcome measures.ConclusionLight treatment is an effective treatment for Sub-SAD. The use of narrow-band blue-light treatment is equally effective as bright white-light treatment.Trial registrationThis study was registered in the Dutch Trial Register (Nederlands Trial Register TC = 4342) (20-12-2013).

Seasonal affective disorder, winter type: current insights and treatment options

“…The therapeutic outcomes of exposure to blue light were found to be superior to those of red light;87,88 blue-enriched LED light was superior to placebo,40 but similar to blue light 89. In studies comparing the therapeutic outcomes after exposure to low-intensity narrow-band blue light with that of bright white light, no differences were found in the treatment effects in SAD90 or subsyndromal SAD (winter blues) 60. In a recent study comparing the therapeutic results after exposure to blue light (~465 nm) vs exposure to blue-free light (595–612 nm) no difference in treatment outcome was found 91.…”

“…The existence of seasonal complaints, their severity, and a certain global seasonality score enable this instrument used in epidemiological studies to estimate SAD prevalence. Although the SPAQ is widely used, its validity has been criticized 55–60. A number of new self-rating instruments have been developed for the assessment of seasonal depression, such as the Seasonal Health Questionnaire (SHQ)61 or more recently, the Seasonality Assessment Form 62.…”

“…In addition to fixed light equipment, portable light fixtures have become available, such as head-mounted devices (light visors),92 and since the introduction of LEDs other portable devices 40,60. The commonality among all these light therapies is that patients are awake and exposed to light at the retina by sitting in front of a light fixture or via a head-mounted light device.…”

Depressive disorders: Processes leading to neurogeneration and potential novel treatments

“…Bright light therapy is the most common procedure in this category. It has been used especially for the treatment of seasonal affective disorder(Danilenko and Ivanova, 2015; Gordijn et al, 2012;Meesters et al, 2016Meesters et al, , 2011Oldham and Ciraulo, 2014;Pail et al, 2011;Prasko, 2008;Rastad et al, 2011) , but also in bipolar disorder (Pail et al, 2011;Prasko, 2008;Schwartz and Olds, 2015;Suzuki et al, 2016) and MDD (Al-Karawi and Jubair, 2016;Bais et al, 2016;Dridi et al, n.d.;Eniola et al, 2016;Oldham and Ciraulo, 2014;Pail et al, 2011;Schwartz and Olds, 2015), reportedly with a variable degree of therapeutic success. Light therapy as a nonpharmaceutical treatment has been recommended and is being tested as a method avoiding any pharmacological load during pregnancy and in perinatal depression (Bais et al, 2016;Crowley and Youngstedt, 2012).…”

Psychiatric Research and Clinical Practice

“…Placebo-controlled trials of LED devices for patients with the disorder have shown efficacy for 398-lux narrow-band blue light (19), for 200-lux narrow-band blue light (20), and for 1,350-lux blueenriched white light (21). A trial comparing 98-lux narrowband blue light with 711-lux blue-enriched white light found similar therapeutic effect in patients with seasonal affective disorder (22), and a trial of 100-lux narrow-band blue light versus 10,000-lux bright white light found similar effect in patients with subsyndromal seasonal affective disorder (23). Given the absence of a placebo condition in the latter two studies, these findings should be considered preliminary.…”