Centre for Chronobiology, Psychiatric Hospitals of the University of Basel, Wilhelm Klein Strasse 27, CH-4012 Basel, Switzerland.
J Clin Psychiatry. 2011 Jul;72(7):986-93. doi: 10.4088/JCP.10m06188blu. Epub 2011 Apr 5.
Affective disorder during pregnancy is a common condition requiring careful judgment to treat the depression while minimizing risk to the fetus. Following up on promising pilot trials, we studied the efficacy of light therapy.
Twenty-seven pregnant women with nonseasonal major depressive disorder according to DSM-IV (outpatients, university polyclinic) were randomly assigned to 7,000 lux fluorescent bright white or 70 lux dim red (placebo) light administered at home in the morning upon awakening for 1 h/d in a 5-week double-blind trial carried out between October 2004 and October 2008. Clinical state was monitored weekly with the 29-item Structured Interview Guide for the Hamilton Depression Rating Scale (HDRS) with Atypical Depression Supplement (SIGH-ADS). Changes of rating scale scores over time were analyzed with the general linear model. Differences from baseline of SIGH-ADS and 17-item HDRS scores at every time point were the dependent variables, time was the within-subjects factor, and treatment was the between-subjects factor. The model also included baseline score of depression and gestational age at intervention start.
The superiority of bright light over dim light placebo was shown for both SIGH-ADS (R² = 0.251; F(3,23) = 3.91; P < .05) and HDRS (R² = 0.338; F(3,23) = 5.42; P < .01) when analyzing the week-by-week change from baseline, and HDRS scores showed a significant interaction of treatment with time (F(4,92) = 2.91; P < .05). Categorical analysis revealed that the response rate (HDRS ≥ 50% improvement) at week 5 was significantly greater for bright light (81.3%, n = 16) than for placebo light (45.5%, n = 11) (P < .05). Remission (final score ≤ 8) was attained by 68.6% versus 36.4%, respectively (P < .05). Expectation ratings did not differ significantly between groups.
Bright white light treatment for 5 weeks improved depression during pregnancy significantly more than placebo dim red light. The study provides evidence that light therapy, a simple, cost-effective antidepressant modality with minimal side effects for the mother and no known risk for the unborn child, may be a useful nonpharmacologic approach in this difficult situation.
clinicaltrials.gov Identifier: NCT01043289.
孕期情绪障碍是一种常见病症，需要谨慎判断以治疗抑郁，同时将对胎儿的风险降到最低。在有前景的试点试验之后，我们研究了光疗的疗效。
27 名符合 DSM-IV 标准的非季节性重度抑郁症孕妇（门诊患者，大学综合医院）被随机分配至 7,000 勒克斯荧光白光灯或 70 勒克斯暗红光（安慰剂），在 2004 年 10 月至 2008 年 10 月进行的为期 5 周的双盲试验中，每天早上醒来后在家中使用 1 小时。每周使用 29 项汉密尔顿抑郁评定量表（HDRS）与非典型抑郁补充量表（SIGH-ADS）进行临床状态监测。使用一般线性模型分析评分随时间的变化。时间点的 SIGH-ADS 和 17 项 HDRS 评分与基线的差异是因变量，时间是被试内因素，治疗是被试间因素。该模型还包括抑郁的基线评分和干预开始时的孕龄。
与暗红光安慰剂相比，明亮光在 SIGH-ADS（R² = 0.251；F(3,23) = 3.91；P <.05）和 HDRS（R² = 0.338；F(3,23) = 5.42；P <.01）方面均显示出优越性，当分析从基线的每周变化时，HDRS 评分显示出治疗与时间的显著交互作用（F(4,92) = 2.91；P <.05）。分类分析显示，第 5 周时明亮光的反应率（HDRS 改善≥50%）明显高于安慰剂光（81.3%，n = 16）（P <.05）。分别为 68.6%和 36.4%（P <.05）达到缓解（最终评分≤8）。两组之间的期望评分无显著差异。
5 周的明亮白光治疗显著优于安慰剂暗红光，改善了孕期抑郁。该研究提供了证据表明，光疗作为一种简单、经济有效的抗抑郁方法，对母亲的副作用最小，对未出生的孩子没有已知的风险，可能是这种困难情况下有用的非药物治疗方法。
clinicaltrials.gov 标识符：NCT01043289。
