Lam R W, Tam E M, Shiah I S, Yatham L N, Zis A P
Department of Psychiatry, University of British Columbia, and the University of British Columbia Hospital, Vancouver, Canada.
J Clin Psychiatry. 2000 Jan;61(1):30-2. doi: 10.4088/jcp.v61n0108.
Recent case reports suggest that some patients with seasonal affective disorder (SAD) may become suicidal after initial treatment with light therapy. This retrospective study sought to determine the effects of light therapy on suicidal ideation in patients with SAD.
The cases of 191 depressed patients with SAD by DSM-III-R or DSM-IV criteria treated with an open trial of morning light therapy using cool white fluorescent light boxes (2500 lux for 2 hours per day or 10,000 lux for 30 minutes per day) for 2 weeks were retrospectively analyzed. Patients had been rated before and after treatment with the expanded Hamilton Depression Rating Scale (SIGH-SAD).
Sixty-seven percent of patients were rated as clinical responders to light therapy. There was significant improvement in the SIGH-SAD suicide item score, with 45% of patients showing a reduction in score. Only 6 patients (3%) had slight worsening of suicide scores. No patients attempted suicide or discontinued light therapy because of emergent suicidality.
Light therapy relieves suicidal ideation in patients with SAD consistent with overall clinical improvement. Emergence of suicidal ideas or behaviors is very uncommon with light therapy.
近期的病例报告表明，一些季节性情感障碍（SAD）患者在接受光疗初始治疗后可能会出现自杀行为。这项回顾性研究旨在确定光疗对SAD患者自杀意念的影响。
对191例符合DSM-III-R或DSM-IV标准的SAD抑郁症患者进行回顾性分析，这些患者接受了为期2周的开放试验，使用冷白色荧光灯箱进行晨光照疗（每天2500勒克斯，持续2小时或每天10000勒克斯，持续30分钟）。患者在治疗前后使用扩展的汉密尔顿抑郁量表（SIGH-SAD）进行评分。
67%的患者被评为对光疗有临床反应。SIGH-SAD自杀项目评分有显著改善，45%的患者评分降低。只有6名患者（3%）的自杀评分略有恶化。没有患者因紧急自杀倾向而试图自杀或停止光疗。
光疗可缓解SAD患者的自杀意念，与整体临床改善情况一致。光疗很少出现自杀想法或行为。
