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Article: Adjunctive bright light treatment with gradual advance in unipolar major depressive disorder with evening chronotype – A randomized controlled trial

TitleAdjunctive bright light treatment with gradual advance in unipolar major depressive disorder with evening chronotype – A randomized controlled trial
Authors
KeywordsBright light therapy
nonseasonal depression
evening chronotype
Issue Date2020
PublisherCambridge University Press. The Journal's web site is located at http://journals.cambridge.org/action/displayJournal?jid=PSM
Citation
Psychological Medicine, 2020, Epub 2020-09-14 How to Cite?
AbstractBackground: Unipolar non-seasonal depressed patients with concomitant evening chronotype were associated with poor clinical outcomes and higher non-remission rate. This study aims to examine the efficacy of adjunctive bright light therapy with gradual timing advance in a randomized, assessor and prescriber-blinded controlled trial. Method: Participants were randomly allocated to receive 5 weeks of either bright white light therapy (BLT) or dim red light (DRL) with the same advancement protocol. Participants were followed up till 5 months after treatment. Primary outcomes included (i) remission rate and (ii) the severity of depression. The analysis was conducted using Kaplan-Meier survival analysis, Cox proportional hazard analysis and linear mixed models. Results: A total of 93 participants (46.4 ± 11.7 years old, 80% female) were randomized. The cumulative remission rate for the BLT and the DRL groups was 67.4% and 46.7%, respectively. Time to remission was shorter for the BLT group relative to the DRL group (log-rank test p = 0.024). Cox proportional hazard survival analysis showed that patients in the BLT group had a higher probability of achieving remission relative to patients in the DRL group [hazard ratio = 1.9 (95% CI = 1.1- 3.4), p = 0.026]. Further sensitivity analysis demonstrated greater improvement in 17-Hamilton Depression Score (group × time interaction, p = 0.04) in the BLT group for those who were adherent to light therapy. Conclusions: The use of bright light therapy with gradual advance protocol is an effective adjunctive treatment resulting in quicker and a higher rate of remission of depression in patients with non-seasonal unipolar depression and evening-chronotype.
Persistent Identifierhttp://hdl.handle.net/10722/293238
ISSN
2021 Impact Factor: 10.592
2020 SCImago Journal Rankings: 2.857

 

DC FieldValueLanguage
dc.contributor.authorChan, JWY-
dc.contributor.authorLam, SP-
dc.contributor.authorLi, SX-
dc.contributor.authorChan, SWH-
dc.contributor.authorChan, SY-
dc.contributor.authorCHAN, NY-
dc.contributor.authorZhang, JH-
dc.contributor.authorWing, YK-
dc.date.accessioned2020-11-23T08:13:51Z-
dc.date.available2020-11-23T08:13:51Z-
dc.date.issued2020-
dc.identifier.citationPsychological Medicine, 2020, Epub 2020-09-14-
dc.identifier.issn0033-2917-
dc.identifier.urihttp://hdl.handle.net/10722/293238-
dc.description.abstractBackground: Unipolar non-seasonal depressed patients with concomitant evening chronotype were associated with poor clinical outcomes and higher non-remission rate. This study aims to examine the efficacy of adjunctive bright light therapy with gradual timing advance in a randomized, assessor and prescriber-blinded controlled trial. Method: Participants were randomly allocated to receive 5 weeks of either bright white light therapy (BLT) or dim red light (DRL) with the same advancement protocol. Participants were followed up till 5 months after treatment. Primary outcomes included (i) remission rate and (ii) the severity of depression. The analysis was conducted using Kaplan-Meier survival analysis, Cox proportional hazard analysis and linear mixed models. Results: A total of 93 participants (46.4 ± 11.7 years old, 80% female) were randomized. The cumulative remission rate for the BLT and the DRL groups was 67.4% and 46.7%, respectively. Time to remission was shorter for the BLT group relative to the DRL group (log-rank test p = 0.024). Cox proportional hazard survival analysis showed that patients in the BLT group had a higher probability of achieving remission relative to patients in the DRL group [hazard ratio = 1.9 (95% CI = 1.1- 3.4), p = 0.026]. Further sensitivity analysis demonstrated greater improvement in 17-Hamilton Depression Score (group × time interaction, p = 0.04) in the BLT group for those who were adherent to light therapy. Conclusions: The use of bright light therapy with gradual advance protocol is an effective adjunctive treatment resulting in quicker and a higher rate of remission of depression in patients with non-seasonal unipolar depression and evening-chronotype.-
dc.languageeng-
dc.publisherCambridge University Press. The Journal's web site is located at http://journals.cambridge.org/action/displayJournal?jid=PSM-
dc.relation.ispartofPsychological Medicine-
dc.rightsPsychological Medicine. Copyright © Cambridge University Press.-
dc.rightsThis article has been published in a revised form in [Journal] [http://doi.org/XXX]. This version is free to view and download for private research and study only. Not for re-distribution, re-sale or use in derivative works. © copyright holder.-
dc.subjectBright light therapy-
dc.subjectnonseasonal depression-
dc.subjectevening chronotype-
dc.titleAdjunctive bright light treatment with gradual advance in unipolar major depressive disorder with evening chronotype – A randomized controlled trial-
dc.typeArticle-
dc.identifier.emailLi, SX: shirleyx@hku.hk-
dc.identifier.authorityLi, SX=rp02114-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1017/S0033291720003232-
dc.identifier.scopuseid_2-s2.0-85092157334-
dc.identifier.hkuros319130-
dc.identifier.volumeEpub 2020-09-14-
dc.identifier.spage1-
dc.identifier.epage10-
dc.publisher.placeUnited Kingdom-

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