Chang Chun-Hung, Liu Chieh-Yu, Chen Shaw-Ji, Tsai Hsin-Chi
Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.
Department of Psychiatry & Brain Disease Research Center, China Medical University Hospital, Taichung, Taiwan.
Neuropsychiatr Dis Treat. 2018 Nov 14;14:3091-3102. doi: 10.2147/NDT.S180321. eCollection 2018.
The aim of this study was to examine the effectiveness of light therapy in the treatment of geriatric depression.
A systematic review and meta-analysis were carried out. Data sources for the literature search were PubMed, Cochrane Collaboration's Central Register of Controlled Clinical Trials, Cochrane Systematic Reviews, and ClinicalTrials.gov. Controlled trials of light therapy on older patients with nonseasonal depression and depression rating scales were eligible. Studies were pooled using a random-effect model for comparisons with light therapy. We used effect size (ES), which expresses changes in depression severity, in each selected meta-analysis to calculate the standardized mean difference on the basis of Hedges' adjusted g; positive values indicated that the depression severity improved after light therapy. All results were presented with 95% CIs. Statistical heterogeneity was explored through visual inspection of funnel plots and the I2 statistic. Moderators of effects were explored using meta-regression.
We identified eight trials involving 395 participants that met the inclusion criteria. Light therapy was significantly more effective than comparative treatments, including placebo or dim light, with an ES of 0.422 (95% CI: 0.174-0.709, =0.001). In addition, six of the eight trials used bright (white) light, resulting in significantly reduced severity of geriatric depression (N=273, ES: 0.460, 95% CI: 0.085-0.836, =0.016). Furthermore, pale blue light therapy reduced the severity of geriatric depression (N=89, ES: 0.464, 95% CI: 0.046-0.882, =0.030).
Our results highlighted the significant efficacy of light therapy in the treatment of geriatric depression. Additional well-designed, controlled studies are necessary to adopt standard parameters, adequate group sizes, and randomized assignment to evaluate more thoroughly the efficacy of light therapy for treating geriatric depression.
本研究旨在探讨光照疗法治疗老年抑郁症的有效性。
进行了一项系统评价和荟萃分析。文献检索的数据来源为PubMed、Cochrane协作网临床对照试验中央注册库、Cochrane系统评价及ClinicalTrials.gov。符合条件的是关于非季节性抑郁症老年患者的光照疗法对照试验以及抑郁评定量表。采用随机效应模型汇总研究以与光照疗法进行比较。在每项选定的荟萃分析中，我们使用表示抑郁严重程度变化的效应量（ES），基于Hedges调整后的g计算标准化均数差；正值表明光照疗法后抑郁严重程度有所改善。所有结果均给出95%置信区间。通过漏斗图的视觉检查和I²统计量探讨统计异质性。使用Meta回归探索效应的调节因素。
我们确定了8项试验，涉及395名符合纳入标准的参与者。光照疗法显著优于包括安慰剂或暗光在内的对照治疗，效应量为0.422（95%置信区间：0.174 - 0.709，P = 0.001）。此外，8项试验中的6项使用了明亮（白色）光，导致老年抑郁症严重程度显著降低（N = 273，效应量：0.460，95%置信区间：0.085 - 0.836，P = 0.016）。此外，淡蓝色光疗法降低了老年抑郁症的严重程度（N = 89，效应量：0.464，95%置信区间：0.046 - 0.882，P = 0.030）。
我们的结果突出了光照疗法治疗老年抑郁症的显著疗效。需要更多精心设计的对照研究，采用标准参数、足够的样本量和随机分组，以更全面地评估光照疗法治疗老年抑郁症的疗效。
