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光照疗法对围产期抑郁症的影响:系统评价和荟萃分析

Effect of Bright Light Therapy on Perinatal Depression: A Systematic Review and Meta-Analysis: Effet de la luminothérapie sur la dépression périnatale: une revue systématique et une méta-analyse.

机构信息

School of Nursing, Wuhan University, Wuhan, Hubei, China.

Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.

出版信息

Can J Psychiatry. 2024 Oct;69(10):737-748. doi: 10.1177/07067437241248051. Epub 2024 Jun 11.

Abstract

OBJECTIVE

This study represents the inaugural attempt to systematically review and analyse the efficacy of bright light therapy on depression among women experiencing major depressive disorder or depressive symptoms during the perinatal period, encompassing its efficacy on depression scores, remission rates, and response rates.

METHODS

We searched 10 databases for randomized controlled trials examining bright light therapy's efficacy on perinatal depression up to January 2024. Data extraction was performed independently by 2 investigators. The Cochrane Handbook guidelines appraised the study quality, and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach assessed evidence certainty.

RESULTS

We incorporated 6 studies, encompassing 151 participants. When contrasted with dim light therapy, bright light therapy did not significantly alter depression scores (standard mean difference = -0.29, 95% confidence interval [CI], -0.62 to 0.04,  = 0.08, ² = 34%) or response rates (risk ratio [RR] = 1.56, 95% CI, 0.98 to 2.49,  = 0.06, ² = 0%) in women experiencing perinatal depression. Conversely, bright light therapy was associated with a substantial increase in remission rates (RR = 2.63, 95% CI, 1.29 to 5.38,  = 0.008, ² = 2%).

CONCLUSION

Bright light therapy did not show efficacy in treating perinatal depression in terms of depression scores and response rates. However, regarding the remission rate, bright light did show efficacy compared to control conditions. Due to the limited sample size in the included studies, type II err or may occur. To obtain more conclusive evidence, future studies must employ larger sample sizes.

摘要

目的

本研究首次系统地回顾和分析了在围产期经历重性抑郁障碍或抑郁症状的女性中,强光疗法对抑郁症的疗效,包括其对抑郁评分、缓解率和反应率的影响。

方法

我们检索了 10 个数据库,以查找截至 2024 年 1 月评估强光疗法对围产期抑郁症疗效的随机对照试验。两名研究人员独立进行数据提取。使用 Cochrane 手册指南评估研究质量,并使用推荐评估、制定与评价分级(GRADE)方法评估证据确定性。

结果

我们纳入了 6 项研究,共 151 名参与者。与暗光照疗法相比,强光疗法并未显著改变抑郁评分(标准均数差=−0.29,95%置信区间[CI]:−0.62 至 0.04,=0.08,²=34%)或反应率(风险比[RR]=1.56,95%CI:0.98 至 2.49,=0.06,²=0%)在经历围产期抑郁症的女性中。相反,强光疗法与缓解率的显著增加相关(RR=2.63,95%CI:1.29 至 5.38,=0.008,²=2%)。

结论

强光疗法在改善围产期抑郁症的抑郁评分和反应率方面没有显示出疗效。然而,在缓解率方面,与对照条件相比,强光疗法显示出了疗效。由于纳入研究的样本量有限,可能存在第二类错误。为了获得更具结论性的证据,未来的研究必须采用更大的样本量。

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本文引用的文献

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