Light Therapy for Patients With Bipolar Depression: Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Autor: | Lam RW; Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, Canada., Teng MY; Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, Canada., Jung YE; Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, Canada.; Department of Psychiatry, Faculty of Medicine, Jeju National University, Korea., Evans VC; Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, Canada., Gottlieb JF; Department of Psychiatry and Behavioral Sciences, Feinberg Faculty of Medicine, Northwestern University, Chicago, CA, USA., Chakrabarty T; Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, Canada., Michalak EE; Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, Canada., Murphy JK; Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, Canada., Yatham LN; Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, Canada., Sit DK; Department of Psychiatry and Behavioral Sciences, Feinberg Faculty of Medicine, Northwestern University, Chicago, CA, USA. |
---|---|
Jazyk: | angličtina |
Zdroj: | Canadian journal of psychiatry. Revue canadienne de psychiatrie [Can J Psychiatry] 2020 May; Vol. 65 (5), pp. 290-300. Date of Electronic Publication: 2019 Dec 12. |
DOI: | 10.1177/0706743719892471 |
Abstrakt: | Objective: Bipolar disorder (BD) is challenging to treat, and fewer treatments are available for depressive episodes compared to mania. Light therapy is an evidence-based nonpharmacological treatment for seasonal and nonseasonal major depression, but fewer studies have examined its efficacy for patients with BD. Hence, we reviewed the evidence for adjunctive light therapy as a treatment for bipolar depression. Methods: We conducted a systematic review of databases from inception to June 30, 2019, for randomized, double-blind, placebo-controlled trials of light therapy in patients with BD (CRD42019128996). The primary outcome was change in clinician-rated depressive symptom score; secondary outcomes included clinical response, remission, acceptability, and treatment-emergent mood switches. We quantitatively pooled outcomes using meta-analysis with random-effects models. Results: We identified seven trials representing 259 patients with BD. Light therapy was associated with a significant improvement in Hamilton Depression Rating Scale score (standardized mean difference = 0.43, 95% confidence interval [CI], 0.04 to 0.82, P = 0.03). There was also a significant difference in favor of light therapy for clinical response (odds ratio [ OR ] = 2.32; 95% CI, 1.12 to 4.81; P = 0.024) but not for remission. There was no difference in affective switches between active light and control conditions ( OR = 1.30; 95% CI, 0.38 to 4.44; P = 0.67). Study limitations included different light treatment parameters, small sample sizes, short treatment durations, and variable quality across trials. Conclusion: There is positive but nonconclusive evidence that adjunctive light therapy reduces symptoms of bipolar depression and increases clinical response. Light therapy is well tolerated with no increased risk of affective switch. |
Databáze: | MEDLINE |
Externí odkaz: |