Chen Zuo-Wei, Zhang Xin-Feng, Tu Zhe-Ming
Yangtze University Medical School, Jingzhou, Hubei 434000, China.
Jingzhou Mental Health Center, Jingzhou, Hubei 434000, China; Institute of Mental Health of Yangtze University, Jingzhou, Hubei 434000, China.
J Affect Disord. 2024 Apr 1;350:531-536. doi: 10.1016/j.jad.2024.01.028. Epub 2024 Jan 12.
The purpose of this study was to assess the potential effectiveness of several mainstream therapies, including phototherapy, antidepressants, cognitive-behavioral therapy, and negative ion generators, in the treatment of Seasonal Affective Disorder (SAD).
A systematic search of PubMed, Embase, Cochrane, and WOS databases was conducted from January 1975 to December 3, 2022. Randomized controlled trials meeting predefined selection criteria for the treatment of SAD using mainstream therapeutic approaches were identified. After reviewing abstracts, data were synthesized and categorized based on the type of intervention and the targeted disorder.
A total of 21 randomized controlled trials, involving 1037 participants, were included. The standardized mean difference of depression scores and corresponding 95 % confidence intervals were calculated to assess the efficacy of phototherapy for Seasonal Affective Disorder. The meta-analysis revealed that phototherapy was significantly more effective than other intervention groups or control therapies, with an effect size of 4.64(2.38,7.03). Subgroup analysis demonstrated that no factors could explain the significant heterogeneity observed. Phototherapy exhibited statistically significant mild to moderate therapeutic effects in alleviating depressive symptoms and can be considered as a clinical therapy for treating Seasonal Affective Disorder. However, the quality of evidence remains low, and further well-designed, larger sample size, and high-quality studies are needed to confirm the efficacy of phototherapy in treating Seasonal Affective Disorder.
In conclusion, our systematic review and meta-analysis indicate that bright light therapy is a promising first-line non-pharmacological treatment for Seasonal Affective Disorder (SAD), showing significant improvement in mood symptoms compared to placebo. The findings support the use of bright light therapy as an effective and well-tolerated intervention for SAD. However, further large-scale, multicenter randomized controlled trials with long-term follow-up are needed to assess the long-term efficacy and safety of different treatment approaches for SAD.
本研究旨在评估几种主流疗法,包括光疗法、抗抑郁药、认知行为疗法和负离子发生器,在治疗季节性情感障碍(SAD)方面的潜在效果。
对1975年1月至2022年12月3日的PubMed、Embase、Cochrane和WOS数据库进行系统检索。确定了符合使用主流治疗方法治疗SAD的预定义选择标准的随机对照试验。在审查摘要后,根据干预类型和目标疾病对数据进行了综合和分类。
共纳入21项随机对照试验,涉及1037名参与者。计算了抑郁评分的标准化平均差和相应的95%置信区间,以评估光疗法治疗季节性情感障碍的疗效。荟萃分析显示,光疗法比其他干预组或对照疗法显著更有效,效应大小为4.64(2.38,7.03)。亚组分析表明,没有因素可以解释观察到的显著异质性。光疗法在减轻抑郁症状方面表现出具有统计学意义的轻度至中度治疗效果,可被视为治疗季节性情感障碍的临床疗法。然而,证据质量仍然较低,需要进一步设计良好、样本量更大和高质量的研究来证实光疗法治疗季节性情感障碍的疗效。
总之,我们的系统评价和荟萃分析表明,强光疗法是一种有前景的季节性情感障碍(SAD)一线非药物治疗方法,与安慰剂相比,情绪症状有显著改善。这些发现支持将强光疗法作为SAD的一种有效且耐受性良好的干预措施。然而,需要进一步进行大规模、多中心的随机对照试验,并进行长期随访,以评估不同治疗方法对SAD的长期疗效和安全性。