Oldham Mark A, Ciraulo Domenic A
Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut (Dr Oldham), and Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts (Drs Oldham and Ciraulo).
Prim Care Companion CNS Disord. 2014;16(3). doi: 10.4088/PCC.14m01637. Epub 2014 Jun 26.
Evidence on the use of bright light therapy for conditions beyond seasonal affective disorder continues to accrue; however, data on the prevalent use of bright light therapy in the community or in hospitals remain limited, particularly in the United States.
We conducted a 5-minute e-mail survey of practicing psychiatrists in Massachusetts using the membership roster through the Massachusetts Psychiatric Society to evaluate prevalent use of bright light therapy as well as to solicit attitudes toward the treatment. Three e-mails were sent out over a 2-week period, and responses were obtained from March 2-24, 2013. An iPad raffle was used to incentivize survey completion.
Of the 1,366 delivered e-mails, 197 responses were obtained. Of respondents, 72% indicated that they used bright light therapy in their practice, and, among these, all but 1 used bright light therapy for seasonal affective disorder. Only 55% of responding psychiatrists who use bright light therapy consider it to treat nonseasonal depression, and 11% of respondents who recommend bright light therapy would consider its use in inpatient settings. Lack of insurance coverage for light-delivery devices was identified as the largest barrier to using bright light therapy, being cited by 55% of respondents. Survey results suggest that limitations in practitioner knowledge of bright light therapy and the absence of bright light therapy in treatment algorithms are the 2 leading modifiable factors to encourage broader implementation.
The principal limitation of our survey was the low response rate. As such, we consider these data preliminary.
Response bias very likely led to an overestimation in prevalent use of bright light therapy; however, this bias notwithstanding, it appears that bright light therapy is used significantly less often for nonseasonal depression than for seasonal affective disorder. Further, its use in inpatient settings is significantly less than in outpatient settings. We expect that efforts to educate practitioners on the use and efficacy of bright light therapy for various psychiatric disorders combined with its inclusion on treatment algorithms may foster greater prevalent use.
关于将强光疗法用于季节性情感障碍以外病症的证据不断积累；然而，关于强光疗法在社区或医院中的普遍使用数据仍然有限，尤其是在美国。
我们通过马萨诸塞州精神病学会的会员名册，对马萨诸塞州的执业精神科医生进行了一项为期5分钟的电子邮件调查，以评估强光疗法的普遍使用情况，并征求他们对该疗法的态度。在两周内发送了三封电子邮件，并于2013年3月2日至24日收到回复。通过抽奖送iPad激励完成调查。
在发送的1366封电子邮件中，收到了197份回复。在受访者中，72%表示他们在临床实践中使用强光疗法，其中除1人外，所有人都将强光疗法用于季节性情感障碍。在使用强光疗法的精神科医生受访者中，只有55%认为它可用于治疗非季节性抑郁症，而在推荐强光疗法的受访者中，只有11%会考虑在住院环境中使用。55%的受访者认为光疗设备缺乏保险覆盖是使用强光疗法的最大障碍。调查结果表明，从业者对强光疗法知识的局限性以及治疗算法中缺乏强光疗法是鼓励更广泛应用的两个主要可改变因素。
我们调查的主要局限性是回复率低。因此，我们认为这些数据是初步的。
回复偏差很可能导致对强光疗法普遍使用率的高估；然而，尽管存在这种偏差，但似乎强光疗法用于非季节性抑郁症的频率明显低于季节性情感障碍。此外，其在住院环境中的使用明显少于门诊环境。我们预计，努力让从业者了解强光疗法对各种精神疾病的使用和疗效，并将其纳入治疗算法，可能会促进更广泛的应用。
