Light Therapy for Patients With Bipolar Depression: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

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.

Preventive effect of morning light exposure on relapse into depressive episode in bipolar disorder

“…A meta-analysis in 259 patients with bipolar disorder showed that light therapy was associated with a significant improvement in clinician-rated depressive symptoms and clinical response compared with control conditions. 6 Our previous cross-sectional study in 181 outpatients with bipolar disorder found that higher average light intensity and longer ≥1000 lux duration in the daytime were significantly associated with reduced depressive symptoms. 9 The present study supported the results of previous studies and indicated that a 1-unit increase in average morning illuminance log lux (eg, from 148 lux to 403 lux) was associated with a 34% decrease in relapse into depressive episodes.…”

Light Therapy Reduces Fatigue in Patients With Cancer: Protocol for a Systematic Review and Meta-analysis

“…Light therapy has many advantages for managing CRF in clinical practice, such as low cost, few side effects, and reduced concurrent symptoms (e.g., depression). pain), and so on [13]. As a result, it is important to determine the effectiveness and acceptability of light therapies for cancer patients.…”

“…Additionally, CBT is labor intensive since it requires professional guidance for several weeks [12]. Light therapy [13], which is another nonpharmacological intervention, has been developed in recent years to treat CRF. It consists of daily exposure to bright, uorescent light delivered via a lightbox or other device for a certain amount of time upon awaking.…”

Incidence rate and clinical characteristics of seasonal affective disorders in senior medical students

“…Практически важным является применение оперативных способов диагностики расстройств настроения в практическом здравоохранении (интеллектуальные системы экспресс-диагностики), что позволяет своевременно выявлять лиц повышенной группы риска и в дальнейшем по отношению к ним проводить интервенционные мероприятия, направленные на повышение качества жизни [19]. Своевременная диагностика всех категорий САР у студентов позволит эффективно использовать имеющийся профилактический и лечебный потенциал [20][21][22].…”