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一项关于神经性贪食症光疗法的对照研究。

A controlled study of light therapy for bulimia nervosa.

作者信息

Lam R W, Goldner E M, Solyom L, Remick R A

机构信息

Department of Psychiatry, University of British Columbia, Vancouver, Canada.

出版信息

Am J Psychiatry. 1994 May;151(5):744-50. doi: 10.1176/ajp.151.5.744.

Abstract

OBJECTIVE

Winter worsening of mood and eating symptoms, similar to that of seasonal affective disorder, has recently been reported in patients with bulimia nervosa. To assess the effectiveness of light therapy for treatment of bulimia nervosa, the authors conducted a study of light therapy during winter comparing an active (bright white light) condition to a control (dim red light) condition in bulimic patients who were not selected for a seasonal pattern of bulimia.

METHOD

After a 2-week baseline assessment, 17 female patients with a DSM-III-R diagnosis of bulimia nervosa underwent early morning light treatment with 2 weeks of bright white light exposure (10,000 lux for 30 min/day) and 2 weeks of dim red light exposure (500 lux for 30 min/day) in a counterbalanced, crossover design. Outcome measures included daily binge/purge diaries, objective and subjective measures of mood, and the Eating Attitudes Test. Expectation of response for each condition was also assessed before treatment.

RESULTS

Although pretreatment expectation ratings were similar for each condition, the bright white light condition was superior to the dim red light condition for all mood and eating outcome measures. Patients with "seasonal" bulimia (N = 7) had significantly greater improvement after the bright white light treatment than patients with nonseasonal bulimia (N = 10). No significant order effects were noted, nor differential effects for patients taking concurrent antidepressant medications (N = 4).

CONCLUSIONS

These data suggest that bright white light therapy is an effective short-term treatment for both mood and eating disturbances associated with bulimia nervosa, although the therapeutic effect may be greater in those patients with a seasonal pattern.

摘要

目的

最近有报道称,神经性贪食症患者会出现与季节性情感障碍类似的冬季情绪和饮食症状加重的情况。为评估光疗法对治疗神经性贪食症的有效性,作者对冬季光疗法进行了一项研究,在未按神经性贪食季节性模式挑选的贪食症患者中,将主动(亮白光)条件与对照(暗红光)条件进行比较。

方法

在进行为期2周的基线评估后,17名符合DSM-III-R神经性贪食症诊断标准的女性患者,采用平衡交叉设计,接受为期2周的亮白光照射(10000勒克斯,每天30分钟)和2周的暗红光照射(500勒克斯,每天30分钟)的清晨光疗。结果测量包括每日暴饮暴食/清除日记、情绪的客观和主观测量以及饮食态度测试。在治疗前还评估了对每种条件的反应预期。

结果

尽管每种条件下治疗前的预期评分相似,但在所有情绪和饮食结果测量方面,亮白光条件均优于暗红光条件。“季节性”贪食症患者(N = 7)在亮白光治疗后的改善明显大于非季节性贪食症患者(N = 10)。未观察到显著的顺序效应,同时服用抗抑郁药物的患者(N = 4)也未观察到差异效应。

结论

这些数据表明,亮白光疗法是治疗与神经性贪食症相关的情绪和饮食障碍的一种有效的短期治疗方法,尽管对于有季节性模式的患者,治疗效果可能更大。

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