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Predicting Effectiveness of Light Treatment for Winter Seasonal Affective Disorder

Completed
Conditions
Depression
Interventions
Device: Bright light
Device: Red light placebo
Registration Number
NCT00742365
Lead Sponsor
University of Maryland, Baltimore
Brief Summary

This study will evaluate a possible tool for predicting future effectiveness of bright light in treating seasonal affective disorder, winter subtype, and will examine secondary effects of bright light on cardiovascular risk factors.

Detailed Description

The winter subtype of seasonal affective disorder (SAD) is characterized by episodes of major depression in the fall and winter, with remission of these episodes in the spring and summer. SAD disrupts the lives of millions of Americans, who experience symptoms such as restless agitation, increased appetite and weight gain, and reduced energy and motivation. Bright light treatment, while shown to be effective in improving SAD in 75% of cases, only causes a full remission in 50% of cases. If doctors had a diagnostic tool to determine which patients would respond to bright light therapy, they could make better decisions about whether to prescribe bright light as treatment. This study will examine a possible diagnostic tool-a single, 1-hour bright light session-for predicting improvement in SAD symptoms over an extended course of bright light treatment. Additionally, because many symptoms of SAD (like weight gain and sedentary lifestyle) correspond to cardiovascular risk, this study will examine whether bright light treatment correlates with improved cardiovascular health.

Participants with SAD will be randomly assigned to first receive a 1-hour session of either bright light or the placebo, red light. Then all participants will switch and receive a 1-hour session of the other type of light. Red light has been accepted as a placebo in previous SAD studies because it does not suppress melatonin or shift circadian rhythms. Before and after each light session, participants will have their SAD symptoms evaluated in a clinical interview and self-report measure. After these two light sessions, all participants will receive instructions for administering bright light treatment on their own at home. For the next 6 weeks, participants will administer the bright light to themselves for 1 hour every morning. Every week they will undergo clinical interviews by phone and will mail in self-report measures, some completed daily and some weekly, to the researchers. The participants will have checkups and interviews in person on Weeks 4 and 6. At the two time periods, SAD symptoms and indicators of cardiovascular risk, such as appetite and sleep loss, will be evaluated. The participant responses to bright light and red light at the initial session will be compared with the participant responses to the subsequent 6-week treatment.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
41
Inclusion Criteria
  • Current major depressive disorder, by structured diagnostic interview (SCID), or current bipolar II disorder, if no prior history of rapid cycling, by SCID
  • Prior history of major depressive disorder or bipolar II disorder with seasonal specifier, by SCID
  • Score of 21 or greater on Hamilton Rating Scale for Depression - Seasonal Affective Disorder Version (SIGH-SAD), met at three time points (informed consent session, 24 hours prior to first light therapy session, and at first light therapy session)
Exclusion Criteria
  • Current bipolar I disorder, psychotic disorder, or cognitive disorder, by SCID
  • Illicit drug use in the past year, by self-report, or alcohol abuse by SCID
  • History of systemic lupus erythematosus
  • History of heart attack or stroke
  • No antidepressant, mood stabilizer, or antipsychotic medication treatment 30 days before treatment
  • Current occupation involves shift work
  • Current sensitivity to bright light or vision problems not correctable by glasses, by self-report
  • Inability to distinguish colors or see stars at night because of increased light sensitivity, by self-report
  • Current suicidal ideation, by self-report during SCID interview
  • Women of childbearing potential who are pregnant, nursing, or trying to become pregnant. Female participants of childbearing potential must agree to one of the following types of birth control: oral, transdermal, or implantable hormonal contraceptives; intrauterine device; diaphragm plus spermicide; or female condom plus spermicide.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
ABright lightParticipants will be given a 1-hour lab test of bright light treatment, then the bright light treatment for 6 weeks.
BRed light placeboParticipants will be given a 1-hour treatment of the red light placebo, then the bright light treatment for 6 weeks.
Primary Outcome Measures
NameTimeMethod
Hamilton rating scale for depressional seasonal affective disorder (SIGH SAD)Measured at baseline, 1 hour after light treatment, and weekly for 6 weeks
Secondary Outcome Measures
NameTimeMethod
Food craving questionnaireMeasured daily for 6 weeks
Side effects questionnaireMeasured weekly for 6 weeks
Sleep logMeasured weekly for 6 weeks
Adherence questionnaireMeasured weekly for 6 weeks
Profile of Mood StatesMeasured at baseline, 1 hour after light treatment, and weekly for 6 weeks
Beck Depression Inventory-II (BDI)Measured at baseline, 1 hour after light treatment, and weekly for 6 weeks
Hunger questionnaireMeasured daily for 6 weeks
Three factor eating questionnaireMeasured weekly for 6 weeks
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