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A Randomized, Double-Blind, Placebo-Controlled Study of Light Therapy for Antepartum Depression

Wirz-Justice, Anna and Bader, Anja and Frisch, Ulrike and Stieglitz, Rolf-Dieter and Alder, Judith and Bitzer, Johannes and Hösli, Irene and Jazbec, Sandra and Benedetti, Francesco and Terman, Michael and Wisner, Katherine L. and Riecher-Rössler, Anita. (2011) A Randomized, Double-Blind, Placebo-Controlled Study of Light Therapy for Antepartum Depression. Journal of clinical psychiatry, 72 (7). pp. 986-993.

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Abstract

Objective: Affective disorder during pregnancy is a common condition requiring careful judgment to treat the depression while minimizing risk to the fetus. Following up on promising pilot trials, we studied the efficacy of light therapy.
Method: Twenty-seven pregnant women with nonseasonal major depressive disorder according to DSM-IV (outpatients, university polyclinic) were randomly assigned to 7,000 lux fluorescent bright white or 70 lux dim red (placebo) light administered at home in the morning upon awakening for 1 h/d in a 5-week double-blind trial carried out between October 2004 and October 2008. Clinical state was monitored weekly with the 29-item Structured Interview Guide for the Hamilton Depression Rating Scale (HDRS) with Atypical Depression Supplement (SIGH-ADS). Changes of rating scale scores over time were analyzed with the general linear model. Differences from baseline of SIGH-ADS and 17-item HDRS scores at every time point were the dependent variables, time was the within-subjects factor, and treatment was the between-subjects factor. The model also included baseline score of depression and gestational age at intervention start.
Results: The superiority of bright light over dim light placebo was shown for both SIGH-ADS (R-2 = 0.251; F-3,F-23 = 3.91; P < .05) and HDRS (R-2 = 0.338; F-3,F-23 = 5.42; P < .01) when analyzing the week-by-week change from baseline, and HDRS scores showed a significant interaction of treatment with time (F-4,F-92 = 2.91; P < .05). Categorical analysis revealed that the response rate (HDRS >= 50% improvement) at week 5 was significantly greater for bright light (81.3%, n = 16) than for placebo light (45.5%, n = 11) (P < .05). Remission (final score 8) was attained by 68.6% versus 36.4%, respectively (P < .05). Expectation ratings did not differ significantly between groups.
Conclusions: Bright white light treatment for 5 weeks improved depression during pregnancy significantly more than placebo dim red light. The study provides evidence that light therapy, a simple, cost-effective antidepressant modality with minimal side effects for the mother and no known risk for the unborn child, may be a useful non-pharmacologic approach in this difficult situation.
Faculties and Departments:07 Faculty of Psychology > Departement Psychologie > Forschungsbereich Klinische Psychologie und Neurowissenschaften > Klinische Psychologie und Psychiatrie (Stieglitz)
03 Faculty of Medicine > Bereich Psychiatrie (Klinik) > Erwachsenenpsychiatrie UPK > Erwachsenenpsychiatrie (Riecher-Rössler)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Psychiatrie (Klinik) > Erwachsenenpsychiatrie UPK > Erwachsenenpsychiatrie (Riecher-Rössler)
03 Faculty of Medicine > Bereich Spezialfächer (Klinik) > Ehemalige Einheiten Spezialfächer (Klinik) > Geburtshilfliche und Gynäkologische Psychosomatik (Bitzer)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Spezialfächer (Klinik) > Ehemalige Einheiten Spezialfächer (Klinik) > Geburtshilfliche und Gynäkologische Psychosomatik (Bitzer)
03 Faculty of Medicine > Bereich Spezialfächer (Klinik) > Gynäkologie und Geburtshilfe > Geburtshilfe (Hösli-Krais)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Spezialfächer (Klinik) > Gynäkologie und Geburtshilfe > Geburtshilfe (Hösli-Krais)
UniBasel Contributors:Bitzer, Johannes and Riecher-Rössler, Anita and Hösli-Krais, Irene M. and Stieglitz, Rolf Dieter
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Physicians Postgraduate
ISSN:0160-6689
e-ISSN:1555-2101
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
Identification Number:
Last Modified:08 Nov 2016 14:48
Deposited On:08 Jun 2012 06:42

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