Perera Stefan, Eisen Rebecca, Bhatt Meha, Bhatnagar Neera, de Souza Russell, Thabane Lehana, Samaan Zainab
, BSc, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada.
, BHSc, MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, Canada.
BJPsych Open. 2016 Mar 4;2(2):116-126. doi: 10.1192/bjpo.bp.115.001610. eCollection 2016 Mar.
Light therapy is a known treatment for patients with seasonal affective disorder. However, the efficacy of light therapy in treating patients with non-seasonal depression remains inconclusive.
To provide the current state of evidence for efficacy of light therapy in non-seasonal depressive disorders.
Systematic review of randomised controlled trials (RCTs) was conducted by searching MEDLINE, EMBASE, PsycINFO, CINAHL, and CENTRAL from their inception to September 2015. Study selection, data abstraction and risk of bias assessment were independently conducted in duplicate. Meta-analyses were performed to provide a summary statistic for the included RCTs. The reporting of this systematic review follows the PRISMA guidelines.
A meta-analysis including 881 participants from 20 RCTs demonstrated a beneficial effect of light therapy in non-seasonal depression (standardised mean difference in depression score -0.41 (95% CI -0.64 to -0.18)). This estimate was associated with significant heterogeneity (=60%, =0.0003) that was not sufficiently explained by subgroup analyses. There was also high risk of bias in the included trials limiting the study interpretation.
The overall quality of evidence is poor due to high risk of bias and inconsistency. However, considering that light therapy has minimal side-effects and our meta-analysis demonstrated that a significant proportion of patients achieved a clinically significant response, light therapy may be effective for patients with non-seasonal depression and can be a helpful additional therapeutic intervention for depression.
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© The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.
光疗法是治疗季节性情感障碍患者的一种已知疗法。然而,光疗法在治疗非季节性抑郁症患者中的疗效仍无定论。
提供光疗法治疗非季节性抑郁症疗效的当前证据状况。
通过检索MEDLINE、EMBASE、PsycINFO、CINAHL和CENTRAL数据库,对从建库至2015年9月的随机对照试验(RCT)进行系统评价。研究选择、数据提取和偏倚风险评估由两人独立重复进行。进行荟萃分析以提供纳入RCT的汇总统计量。本系统评价的报告遵循PRISMA指南。
一项纳入20项RCT共881名参与者的荟萃分析表明,光疗法对非季节性抑郁症有有益影响(抑郁评分的标准化均值差为-0.41(95%CI -0.64至-0.18))。该估计值与显著异质性(I²=60%,P=0.0003)相关,亚组分析未能充分解释这种异质性。纳入试验中还存在较高的偏倚风险,限制了研究的解释。
由于偏倚风险高和不一致性,证据的总体质量较差。然而,考虑到光疗法副作用极小,且我们的荟萃分析表明相当一部分患者取得了具有临床意义的反应,光疗法可能对非季节性抑郁症患者有效,可作为抑郁症一种有益的辅助治疗干预措施。
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©皇家精神科医学院2016年。本文是一篇开放获取文章,根据知识共享非商业性、无衍生作品(CC BY-NC-ND)许可协议分发。