Kopp Benjamin T, Hayes Don, Ghera Princy, Patel Alpa, Kirkby Stephen, Kowatch Robert A, Splaingard Mark
Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, OH, United States; Department of Pediatrics, The Ohio State University Wexner Medical Center, Columbus, OH, United States; Center for Microbial Pathogenesis, Nationwide Children's Hospital, Columbus, OH, United States.
Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, OH, United States; Department of Pediatrics, The Ohio State University Wexner Medical Center, Columbus, OH, United States.
J Affect Disord. 2016 Jan 1;189:164-8. doi: 10.1016/j.jad.2015.08.056. Epub 2015 Sep 28.
Depression is common in cystic fibrosis (CF) and linked with worse outcomes during hospitalization. Bright-light therapy during hospitalizations augments antidepressant regimens and reduces length of stay (LOS) in depressed non-CF patients, but has not been examined in CF METHODS: Thirty subjects used a light box emitting 10,000lx for 30min each day for 7 straight days following hospital admission for pulmonary exacerbation. Depressive symptom severity (QIDS-C) and quality of life factors (CFQ-R) were recorded pre/post light therapy.
Eighty percent of subjects had at least mild depressive symptoms upon admission. Hospitalized CF patients had a significantly lower mean LOS of 11.0±3.6 days compared to a historical cohort from the year prior (13.3±4.4 days, p value=0.038). There was a significant decrease in depressive symptoms for all subjects receiving light therapy (p value<0.0001). There was no relation between depressive symptoms and lung function or vitamin D. Six out of twelve quality of life indicators improved with light therapy including the domains of vitality, emotion, and health perceptions. There were no adverse events reported.
As a pilot study, the design was limited by a lack of a control group and possible confounding effects of hospitalization treatment on systemic symptoms.
Light therapy was well tolerated by hospitalized CF patients and resulted in improved depressive symptoms and quality of life. Light therapy was associated with a reduced length of stay. Large, randomized trials of light therapy may be indicated for hospitalized CF patients.
抑郁症在囊性纤维化（CF）患者中很常见，且与住院期间较差的预后相关。住院期间的强光疗法可增强抗抑郁治疗方案，并缩短非CF抑郁症患者的住院时间（LOS），但尚未在CF患者中进行过研究。
30名受试者在因肺部病情加重入院后，连续7天每天使用发射10000勒克斯的灯箱30分钟。在光疗前后记录抑郁症状严重程度（QIDS-C）和生活质量因素（CFQ-R）。
80%的受试者入院时至少有轻度抑郁症状。与上一年的历史队列相比，住院的CF患者平均住院时间显著缩短，为11.0±3.6天（上一年为13.3±4.4天，p值=0.038）。所有接受光疗的受试者抑郁症状均显著减轻（p值<0.0001）。抑郁症状与肺功能或维生素D之间无关联。12项生活质量指标中有6项在光疗后得到改善，包括活力、情绪和健康认知等领域。未报告不良事件。
作为一项试点研究，该设计受到缺乏对照组以及住院治疗对全身症状可能产生的混杂效应的限制。
住院的CF患者对光疗耐受性良好，抑郁症状和生活质量得到改善。光疗与住院时间缩短相关。可能需要对住院的CF患者进行大规模、随机的光疗试验。
