BACKGROUND: This randomized controlled trial investigates the efficacy of two non-pharmacologic treatments, bright light and high-density negative air ions fornon-seasonal chronic depression. Both methods have shown clinical success for seasonal affective disorder (SAD). METHOD:Patients were 24 (75%) women and 8 (25%) men, ages 22-65 years (mean age +/- S.D., 43.7 +/- 12.4 years), with Major Depressive Disorder, Single Episode (DSM-IV code, 296.2), Chronic (episode duration > or = 2 years). Patients were entered throughout the year and randomly assigned to exposure to bright light (10 000 lux, n = 10), or high-density (4.5 x 10(14) ions/s flow rate, n = 12) or low-density (1.7 x 10(11) ions/s, n = 10, placebo control) negative air ions. Home treatment sessions occurred for 1 h upon awakening for 5 weeks. Blinded raters assessed symptom severity weekly with the Structured Interview Guide for the Hamilton Depression Rating Scale--Seasonal Affective Disorder (SIGH-SAD) version. Evening saliva samples were obtained before and after treatment for ascertainment of circadian melatonin rhythm phase. RESULTS:SIGH-SAD score improvement was 53.7% for bright light and 51.1% for high-density ions v. 17.0% for low-density ions. Remission rates were 50%, 50% and 0% respectively. The presence or severity of atypical symptoms did not predict response to either treatment modality, nor were phase advances to light associated with positive response. CONCLUSIONS: Both bright light and negative air ions are effective for treatment of chronic depression. Remission rates are similar to those for SAD, but without a seasonal dependency or apparent mediation by circadian rhythm phase shifts. Combination treatment with antidepressant drugs may further enhance clinical response.
RCT Entities:
BACKGROUND: This randomized controlled trial investigates the efficacy of two non-pharmacologic treatments, bright light and high-density negative air ions for non-seasonal chronic depression. Both methods have shown clinical success for seasonal affective disorder (SAD). METHOD:Patients were 24 (75%) women and 8 (25%) men, ages 22-65 years (mean age +/- S.D., 43.7 +/- 12.4 years), with Major Depressive Disorder, Single Episode (DSM-IV code, 296.2), Chronic (episode duration > or = 2 years). Patients were entered throughout the year and randomly assigned to exposure to bright light (10 000 lux, n = 10), or high-density (4.5 x 10(14) ions/s flow rate, n = 12) or low-density (1.7 x 10(11) ions/s, n = 10, placebo control) negative air ions. Home treatment sessions occurred for 1 h upon awakening for 5 weeks. Blinded raters assessed symptom severity weekly with the Structured Interview Guide for the Hamilton Depression Rating Scale--Seasonal Affective Disorder (SIGH-SAD) version. Evening saliva samples were obtained before and after treatment for ascertainment of circadian melatonin rhythm phase. RESULTS:SIGH-SAD score improvement was 53.7% for bright light and 51.1% for high-density ions v. 17.0% for low-density ions. Remission rates were 50%, 50% and 0% respectively. The presence or severity of atypical symptoms did not predict response to either treatment modality, nor were phase advances to light associated with positive response. CONCLUSIONS: Both bright light and negative air ions are effective for treatment of chronic depression. Remission rates are similar to those for SAD, but without a seasonal dependency or apparent mediation by circadian rhythm phase shifts. Combination treatment with antidepressant drugs may further enhance clinical response.
Authors: Davide Elia Bertani; Antonella Maria Pia De Novellis; Riccardo Farina; Emanuela Latella; Matteo Meloni; Carmela Scala; Laura Valeo; Gian Maria Galeazzi; Silvia Ferrari Journal: Int J Environ Res Public Health Date: 2021-02-09 Impact factor: 3.390
Authors: Ritsaert Lieverse; Marjan M A Nielen; Dick J Veltman; Bernard M J Uitdehaag; Eus J W van Someren; Jan H Smit; Witte J G Hoogendijk Journal: Trials Date: 2008-07-31 Impact factor: 2.279
Authors: Kim Dekker; Jeroen S Benjamins; Annemieke Van Straten; Winni F Hofman; Eus J W Van Someren Journal: Trials Date: 2015-07-04 Impact factor: 2.279
Authors: Changshun Li; Ziyang Xie; Bo Chen; Kaijin Kuang; Daowei Xu; Jinfu Liu; Zhongsheng He Journal: Int J Environ Res Public Health Date: 2021-05-10 Impact factor: 3.390