Phototherapy for seasonal major depressive disorder: Effectiveness of bright light of high or low intensity

One‐week light treatment of winter depression near its onset: The time course of relapse

“…Furthermore, in addition to patients who received preventive treatment, Meesters et al (1991) found long-term remissions for patients who were treated when already fully syndromal at baseline (BDI 2 22); such lack of relapse is similar to that found by Yerevanian et al (1986), Wirz-Justice et al (1987), and Grota et al (1989). The present study found no significant correlation between baseline severity and weeks of sustained improvement.…”

“…The present study found no significant correlation between baseline severity and weeks of sustained improvement. Furthermore, in addition to patients who received preventive treatment, Meesters et al (1991) found long-term remissions for patients who were treated when already fully syndromal at baseline (BDI 2 22); such lack of relapse is similar to that found by Yerevanian et al (1986), Wirz-Justice et al (1987), and Grota et al (1989). The starting date of treatment also does not seem to account for the differences in rate of relapse between first and second trials: although the present data show longer-lasting improvement with later treatment onset, the same patients previously showed rapid relapse when treatment began at a later stage of the depressive episode (and later date).…”

“…For example, sev-era1 studies of SAD have reported BDI entry scores of 14 to 15, along with HAM-D scores of 12 to 17 (Yerevanian et al, 1988;Grota et al, 1989;Sack et al, 1990), hardly different from the "early/mild" criterion of Meesters et al (1991Meesters et al ( , 1993b. For example, on average in our data, by separate regression analyses, a BDI score of 13 corresponds to a HAM-D score of 12.54, an ATYP score of 13.68, and a SIGH-SAD score of 24.77, while a BDI score of 22 corresponds to a HAM-D score of 19.83, an ATYP score of 22.86, and a SIGH-SAD score of 40.56.…”

“…A HAM-D score of 12 has often fulfilled baseline entry criteria €or patients already well into an episode, both in studies of SAD and nonseasonal atypical depression. For example, sev-era1 studies of SAD have reported BDI entry scores of 14 to 15, along with HAM-D scores of 12 to 17 (Yerevanian et al, 1988;Grota et al, 1989;Sack et al, 1990), hardly different from the "early/mild" criterion of Meesters et al (1991Meesters et al ( , 1993b. As for their criterion for a "full-blown depression" (BDI of 22 points), our SIGH-SAD equivalent of 40.56 points has been met by only 7 of 144 patients (4.9%) we have studied over the past 8 years [for a representative distribution of baseline scores see Terman (1993) , Fig.…”

“…Upon withdrawal from the lights, relapse typically occurs within about a week in a majority of patients (e.g., Rosenthal et al, 1984Rosenthal et al, , 1985James et al, 1985;Oren et al, 1991). Some studies, however, have observed no relapses within this span of withdrawal (Yerevanian et al, 1986;Wirz-Justice et al, 1987;Grota et al, 1989), leading to a surmise that the course of brief treatment might be sufficient to truncate the current season's depressive episode. However, these studies monitored symptoms only across 2 weeks of withdrawal, and relapses eventually might have occurred.…”