Feasibility and Efficacy of Bright Light Therapy in Depressed Adolescent Inpatients

Kirschbaum-Lesch, Inken; Gest, Stephanie; Legenbauer, Tanja; Holtmann, Martin

doi:10.1024/1422-4917/a000603

Cited by 29 publications

(16 citation statements)

References 14 publications

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“…Our findings also suggest that adolescents may not be reliable reporters of their BWL use. Although not unexpected, this has not previously been reported in other BWL studies, as other studies have relied solely on selfreport (Danielsson et al, 2016;Gradisar et al, 2011;Kirschbaum-Lesch et al, 2018;Richardson et al, 2018). Objective verification of BWL use is needed to obtain valid data on adherence.…”

Section: Discussionmentioning

confidence: 73%

A Morning Bright Light Therapy Intervention to Improve Circadian Health in Adolescent Cancer Survivors: Methods and Preliminary Feasibility

Rogers

Mowbray

Rahmaty

et al. 2020

J Pediatr Oncol Nurs

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Circadian rhythm disturbances are common among children with cancer, and are associated with poor health outcomes. Social zeitgeber theory suggests that intervening in the cascade of events that disrupt circadian rhythms may improve health outcomes. Light, most potently sunlight, is a “zeitgeber,” or environmental cue instrumental in maintaining entrainment of circadian rhythms. Bright white light (BWL) therapy, a proxy for sunlight, has been used successfully to prevent deterioration of circadian rhythms in adult cancer patients, and to reentrain these rhythms in adolescents with circadian rhythm disorders. This study aimed to develop and assess preliminary feasibility of a BWL therapy intervention for supporting circadian health of adolescent cancer survivors. We hypothesized that adolescents could independently manage BWL in their home, coordinated by nurses using a mail-, phone- and internet-based format, with minimal side effects. Adolescents were instructed to use BWL for 30 minutes daily on awakening, for 28 days. Actigraphs, measuring the circadian activity rhythms of sleep and wake, were worn for 7 days at baseline and Week 4. Adverse events were screened serially. Analyses were descriptive and nonparametric. Eight adolescents participated. On average, BWL was used on 61% of days, for 15 minutes per day. Adverse events were generally mild, although one participant discontinued BWL due to persistent BWL-related nausea. This nurse-guided remote BWL therapy intervention in adolescent cancer survivors demonstrated preliminary feasibility. Future studies with larger samples are required to verify the feasibility of this study, and to determine its safety and effectiveness in supporting circadian activity rhythms.

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Section: Discussionmentioning

confidence: 73%

A Morning Bright Light Therapy Intervention to Improve Circadian Health in Adolescent Cancer Survivors: Methods and Preliminary Feasibility

Rogers

Mowbray

Rahmaty

et al. 2020

J Pediatr Oncol Nurs

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“…Following feedback from the participants in our pilot studies, light boxes are replaced by light glasses that allow patients to carry on with everyday tasks and fit into their daily routine while giving the same results as a 10,000 lx light box ([ 26 , 27 ]). To ensure an appropriate and constant number of lux administered in each condition, intensities are quantified using a Lux meter (PCE-172).…”

Section: Methodsmentioning

confidence: 99%

“…BLT is promising due to robust evidence in adults, easy application, low side effects, and heightened compliance [ 25 ]. Light glasses have been shown to lead to the same results as a 10,000 lx light box ([ 26 , 27 ]). However, empirical evidence on BLT for youth is scarce and pilot studies suffer from small sample sizes, lack of randomization, shortness of treatment duration, and lack of control settings.…”

Section: Introductionmentioning

confidence: 99%

Adolescent depression: Study protocol for a randomized, controlled, double-blind multicenter parallel group trial of Bright Light Therapy in a naturalistic inpatient setting (DeLight)

Holtmann

Mokros

Kirschbaum-Lesch

et al. 2018

Trials

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BackgroundDepressive disorders are among the most prominent health problems in youth. Even with the best available pharmacological and non-pharmacological treatments, remission rates are low. Without early treatment, depression in youth is associated with a high risk of symptom progression, chronicity, co-morbidity, and suicidal behavior. Thus, adolescent depression is a prime candidate for innovation in treatment. In depressive adults, meta-analytic evidence has proven that bright light therapy (BLT) is a potent low-threshold intervention, promising due to easy application, low side effects, and optimized compliance. In adolescents, studies with small samples show promising effects. This randomized controlled trial will examine the effectiveness of BLT in youth inpatients.Methods/designIn this randomized, controlled, double-blind multicenter parallel group trial, morning BLT is applied for four weeks in addition to treatment as usual (TAU) for depressed youth inpatients (daily morning exposure to bright light via light-emitting glasses, 10,000 lx, for 30 min) and will be compared to a control condition (placebo light treatment, red light, identical light glasses). The primary objective is to assess whether BLT reduces symptoms of depression in youth with greater effect compared to placebo light therapy. Secondary objectives are to examine the impact of BLT on responder status, application of antidepressant medication, and further depression-related symptoms (sleep, activity, quality of life, satisfaction with health, general psychopathology, alertness, and circadian function). N = 224 patients will be recruited in a naturalistic inpatient setting. A follow-up will be carried out after three and six months.DiscussionThe study aims to discuss and evaluate BLT as an additive method supporting standardized clinical procedures dealing with severe to moderate depressive symptoms in youth.Trial registrationGerman Clinical Trials Register, DRKS00013188. Registered on November 30, 2017.Electronic supplementary materialThe online version of this article (10.1186/s13063-018-2949-0) contains supplementary material, which is available to authorized users.

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“…11 Similar evidence in younger individuals is scarce, mostly consists of studies with small sample size/no follow-up, and it is limited to individuals older than 12 years of age. [12][13][14][15][16][17][18] In a randomised controlled trial, CBT for insomnia for 6 weekly sessions and a booster session after 2 months was significantly more effective in decreasing comorbid depression compared with waitlist in 12-19-year-old individuals with DSM-V (Diagnostic Statistical Manual) insomnia and no comorbid psychiatric disorders. The effect was large, was maintained after 12 months and was fully mediated by the reduction of insomnia symptoms.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Do insomnia and/or sleep disturbances predict the onset, relapse or worsening of depression in community and clinical samples of children and youth? Protocol for a systematic review and meta-analysis

et al. 2020

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IntroductionDisturbed sleep represents a potentially important modifiable risk factor for the development of depression in children and youth. This protocol for a systematic review proposes to investigate whether insomnia and/or sleep disturbances predict child and youth depression in community and clinical-based samples.Methods and analysisThe protocol adheres to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. English-written, longitudinal studies that quantitatively estimated the prediction of depression by insomnia and/or sleep disturbances in individuals 5–24 years of age will be included. EMBASE, MEDLINE, PsychINFO, Scopus and Web of Science and grey literature will be searched from 1980 to the present. For the selection of studies, two reviewers will be involved. Data extraction will be conducted by one author and checked independently by a second author. Risk of bias will be appraised using the Research Triangle Institute Item Bank tool. Heterogeneity will be measured using the I2 statistics. Meta-analysis will be carried out if ≥3 results are available and if outcome measures can be pooled. The choice between a random-effect or fixed-effect model will be based both on the I2 statistics and the participant and study characteristics of the combined studies. Results of the meta-analyses will be summarised by a forest plot. Analyses will be performed in subgroups stratified by key variables defined depending on the amount and type of information retrieved.A narrative synthesis will be conducted in place of the meta-analysis should the pooling of data not be possible. Quality of evidence will be rated using the Grading of Recommendations Assessment, Development and Evaluation guidelines.As this is a protocol for systematic review and meta-analysis of published data, ethics review and approval are not required. The findings will be published in a peer-reviewed journal and disseminated at scientific conferences and in patient advocacy organisations.PROSPERO registration numberCRD42019136729.

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Feasibility and Efficacy of Bright Light Therapy in Depressed Adolescent Inpatients

Cited by 29 publications

References 14 publications

A Morning Bright Light Therapy Intervention to Improve Circadian Health in Adolescent Cancer Survivors: Methods and Preliminary Feasibility

A Morning Bright Light Therapy Intervention to Improve Circadian Health in Adolescent Cancer Survivors: Methods and Preliminary Feasibility

Adolescent depression: Study protocol for a randomized, controlled, double-blind multicenter parallel group trial of Bright Light Therapy in a naturalistic inpatient setting (DeLight)

Do insomnia and/or sleep disturbances predict the onset, relapse or worsening of depression in community and clinical samples of children and youth? Protocol for a systematic review and meta-analysis

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