Sit Dorothy, Wisner Katherine L, Hanusa Barbara H, Stull Stacy, Terman Michael
Women's Behavioral HealthCARE, Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
Bipolar Disord. 2007 Dec;9(8):918-27. doi: 10.1111/j.1399-5618.2007.00451.x.
To perform a dose-ranging safety and efficacy study of bright light therapy for depression in women with bipolar disorder (BD).
Nine women with DSM-IV BD I or II in the depressed phase were exposed to 50 lux (illuminance at the receiving surface) red light for two weeks, after which they received 7,000 lux light therapy for two-week epochs of 15, 30 and 45 min daily. The Structured Interview Guide for the Hamilton Depression Rating Scale with Atypical Depression Supplement and the Mania Rating Scale were used to assess mood symptoms. Four patients received morning light and five patients received midday light.
Three of the four subjects treated with morning light developed mixed states. The fourth subject achieved a full, sustained response. To decrease the risk of inducing mixed episodes, we changed the time of light exposure to midday. Of the five women who received midday light therapy, two achieved full response and two showed early improvement but required a dose increase to sustain response. One woman remained depressed with 45 min of midday light but responded fully to a switch to morning light, 30 min daily.
Women with bipolar illness are highly sensitive to morning bright light treatment; the induction of mixed states is a substantial risk. Initiating treatment with a brief duration (15 min) of midday light for bipolar depression is advisable.
开展一项关于明亮光疗法治疗双相情感障碍（BD）女性患者抑郁症的剂量范围安全性和疗效研究。
9名处于抑郁发作期的DSM-IV BD I型或II型女性患者先接受两周50勒克斯（接受表面照度）的红光照射，之后她们接受每天15、30和45分钟、为期两周的7000勒克斯光疗法。采用汉密尔顿抑郁量表（含非典型抑郁补充版）结构化访谈指南和躁狂量表评估情绪症状。4名患者接受晨光照，5名患者接受午光照。
接受晨光照治疗的4名受试者中有3名出现混合状态。第四名受试者实现了完全、持续的缓解。为降低诱发混合发作的风险，我们将光照时间改为中午。接受午光照疗法的5名女性中，2名实现了完全缓解，2名早期有改善，但需要增加剂量以维持缓解。一名女性在每天45分钟午光照的情况下仍处于抑郁状态，但改为每天30分钟晨光照后完全缓解。
双相情感障碍女性对晨光照治疗高度敏感；诱发混合状态是一个重大风险。对于双相抑郁症，建议以短暂（15分钟）的午光照开始治疗。
