Swedo S E, Allen A J, Glod C A, Clark C H, Teicher M H, Richter D, Hoffman C, Hamburger S D, Dow S, Brown C, Rosenthal N E
Department of Psychiatry, McLean Hospital, Belmont, MA, USA.
J Am Acad Child Adolesc Psychiatry. 1997 Jun;36(6):816-21. doi: 10.1097/00004583-199706000-00019.
To evaluate the efficacy of light therapy for the treatment of pediatric seasonal affective disorder (SAD).
28 children (aged 7 to 17 years) at two geographically distinct sites were enrolled in a double-blind, placebo-controlled, crossover trial of bright-light treatment. Subjects initially entered a week-long baseline period during which they wore dark glasses for an hour a day. They were then randomly assigned to receive either active treatment (1 hour of bright-light therapy plus 2 hours of dawn simulation) or placebo (1 hour of clear goggles plus 5 minutes of low-intensity dawn simulation) for 1 week. The treatment phase was followed by a second dark-glasses phase lasting 1 to 2 weeks. After this phase, the children received the alternate treatment. Response was measured using the parent and child versions of the Structured Interview Guide for the Hamilton Depression Rating Scale, Seasonal Affective Disorders version (SIGH-SAD).
Data were analyzed as change from baseline. SIGH-SAD-P total depression scores were significantly decreased from baseline during light therapy compared with placebo (one-way analysis of variance, rho = .009), and no differences were found between the placebo and control phases. Subscores of atypical and typical depression were also significantly decreased during the active treatment (rho = .004 and .028, respectively). A similar trend was noted with the SIGH-SAD-C, but this did not reach significance. At the end of the study, 78% of the parents questioned and 80% of the children questioned rated light therapy as the phase during which the child "felt best."
Light therapy appears to be an effective treatment for pediatric SAD.
评估光疗法治疗儿童季节性情感障碍(SAD)的疗效。
在两个地理位置不同的地点,28名7至17岁的儿童参与了一项关于强光治疗的双盲、安慰剂对照、交叉试验。受试者最初进入为期一周的基线期,在此期间他们每天戴一小时墨镜。然后他们被随机分配接受为期1周的积极治疗(1小时强光疗法加2小时黎明模拟)或安慰剂治疗(1小时透明护目镜加5分钟低强度黎明模拟)。治疗阶段之后是持续1至2周的第二个戴墨镜阶段。在此阶段之后,儿童接受交替治疗。使用汉密尔顿抑郁量表季节性情感障碍版(SIGH - SAD)的结构化访谈指南的家长版和儿童版来测量反应。
数据按与基线的变化进行分析。与安慰剂相比,在光疗期间,SIGH - SAD - P总抑郁评分从基线显著降低(单因素方差分析,rho = .009),并且在安慰剂阶段和对照阶段之间未发现差异。在积极治疗期间,非典型和典型抑郁的子评分也显著降低(分别为rho = .004和.028)。SIGH - SAD - C也观察到类似趋势,但未达到显著水平。在研究结束时,78%接受询问的家长和80%接受询问的儿童将光疗阶段评为孩子“感觉最好”的阶段。
光疗法似乎是治疗儿童SAD的有效方法。