Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
Competence Center for Eating Behavior, Obesity and the Psyche, Zofingen Hospital, Zofingen, Switzerland.
Psychother Psychosom. 2020;89(1):17-24. doi: 10.1159/000502891. Epub 2019 Oct 1.
Bright light therapy (BLT) has been used as a treatment for seasonal affective disorder (SAD) for over 30 years. This meta-analysis was aimed to assess the efficacy of BLT in the treatment of SAD in adults.
We performed a systematic literature search including randomized, single- or double-blind clinical trials investigating BLT (≥1,000 lx, light box or light visor) against dim light (≤400 lx) or sham/low-density negative ion generators as placebo. Only first-period data were used from crossover trials. The primary outcome was the post-treatment depression score measured by validated scales, and the secondary outcome was the rate of response to treatment.
A total of 19 studies finally met our predefined inclusion criteria. BLT was superior over placebo with a standardized mean difference of -0.37 (95% CI: -0.63 to -0.12) for depression ratings (18 studies, 610 patients) and a risk ratio of 1.42 (95% CI: 1.08-1.85) for response to active treatment (16 studies, 559 patients). We found no evidence for a publication bias, but moderate heterogeneity of the studies and a moderate-to-high risk of bias.
BLT can be regarded as an effective treatment for SAD, but the available evidence stems from methodologically heterogeneous studies with small-to-medium sample sizes, necessitating larger high-quality clinical trials.
光疗（BLT）已被用作治疗季节性情感障碍（SAD）超过 30 年。本荟萃分析旨在评估 BLT 治疗成人 SAD 的疗效。
我们进行了系统的文献检索，包括随机、单盲或双盲临床试验，研究 BLT（≥1000 lx，光箱或光面罩）与暗光灯（≤400 lx）或假/低浓度负离子发生器作为安慰剂的比较。仅从交叉试验中使用第一期数据。主要结局是使用经过验证的量表测量治疗后的抑郁评分，次要结局是治疗反应率。
共有 19 项研究最终符合我们预先设定的纳入标准。BLT 在治疗 SAD 方面优于安慰剂，抑郁评分的标准化均数差为-0.37（95%CI：-0.63 至-0.12）（18 项研究，610 名患者），对活性治疗的反应率风险比为 1.42（95%CI：1.08-1.85）（16 项研究，559 名患者）。我们没有发现发表偏倚的证据，但研究存在中度异质性和中度至高度偏倚风险。
BLT 可以被视为治疗 SAD 的有效方法，但现有证据来自方法学上存在差异、样本量较小的研究，需要更大规模、高质量的临床试验来进一步验证。
