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

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Title: Adjunctive bright light treatment with gradual advance in unipolar major depressive disorder with evening chronotype – A randomized controlled trial.
Authors: Chan, Joey WY, Lam, SP, Li, Shirley X, Chau, Steven WH, Chan, SY, Chan, NY, Zhang, JH, Wing, YK
Source: Psychological Medicine. Jun2022, Vol. 52 Issue 8, p1448-1457. 10p.
Subjects: Phototherapy, Chronotype, Randomized controlled trials, Treatment effectiveness, Severity of illness index, Mental depression, Kaplan-Meier estimator, Clinical chronobiology, Bipolar disorder, Disease remission, Proportional hazards models
Abstract: Background: 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. [ABSTRACT FROM AUTHOR]
Copyright of Psychological Medicine is the property of Cambridge University Press and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Label: Title
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  Data: Adjunctive bright light treatment with gradual advance in unipolar major depressive disorder with evening chronotype – A randomized controlled trial.
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  Data: <searchLink fieldCode="AR" term="%22Chan%2C+Joey+WY%22">Chan, Joey WY</searchLink><br /><searchLink fieldCode="AR" term="%22Lam%2C+SP%22">Lam, SP</searchLink><br /><searchLink fieldCode="AR" term="%22Li%2C+Shirley+X%22">Li, Shirley X</searchLink><br /><searchLink fieldCode="AR" term="%22Chau%2C+Steven+WH%22">Chau, Steven WH</searchLink><br /><searchLink fieldCode="AR" term="%22Chan%2C+SY%22">Chan, SY</searchLink><br /><searchLink fieldCode="AR" term="%22Chan%2C+NY%22">Chan, NY</searchLink><br /><searchLink fieldCode="AR" term="%22Zhang%2C+JH%22">Zhang, JH</searchLink><br /><searchLink fieldCode="AR" term="%22Wing%2C+YK%22">Wing, YK</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Psychological+Medicine%22">Psychological Medicine</searchLink>. Jun2022, Vol. 52 Issue 8, p1448-1457. 10p.
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  Label: Subjects
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  Data: <searchLink fieldCode="DE" term="%22Phototherapy%22">Phototherapy</searchLink><br /><searchLink fieldCode="DE" term="%22Chronotype%22">Chronotype</searchLink><br /><searchLink fieldCode="DE" term="%22Randomized+controlled+trials%22">Randomized controlled trials</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+effectiveness%22">Treatment effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Severity+of+illness+index%22">Severity of illness index</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+depression%22">Mental depression</searchLink><br /><searchLink fieldCode="DE" term="%22Kaplan-Meier+estimator%22">Kaplan-Meier estimator</searchLink><br /><searchLink fieldCode="DE" term="%22Clinical+chronobiology%22">Clinical chronobiology</searchLink><br /><searchLink fieldCode="DE" term="%22Bipolar+disorder%22">Bipolar disorder</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+remission%22">Disease remission</searchLink><br /><searchLink fieldCode="DE" term="%22Proportional+hazards+models%22">Proportional hazards models</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: 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. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Psychological Medicine is the property of Cambridge University Press and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=157616677
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      – Type: doi
        Value: 10.1017/S0033291720003232
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      – Code: eng
        Text: English
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        PageCount: 10
        StartPage: 1448
    Subjects:
      – SubjectFull: Phototherapy
        Type: general
      – SubjectFull: Chronotype
        Type: general
      – SubjectFull: Randomized controlled trials
        Type: general
      – SubjectFull: Treatment effectiveness
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      – SubjectFull: Severity of illness index
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      – SubjectFull: Mental depression
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      – SubjectFull: Kaplan-Meier estimator
        Type: general
      – SubjectFull: Clinical chronobiology
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      – SubjectFull: Bipolar disorder
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      – SubjectFull: Disease remission
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      – SubjectFull: Proportional hazards models
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      – TitleFull: Adjunctive bright light treatment with gradual advance in unipolar major depressive disorder with evening chronotype – A randomized controlled trial.
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              M: 06
              Text: Jun2022
              Type: published
              Y: 2022
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