A systematic review of light therapy on mood scores in major depressive disorder: light specification, dose, timing and delivery

  • Authors

    • Mohammad Alotaibi Exercise, Health & Performance Faculty Research Group, Faculty of Health Sciences, The University of Sydney, 75 East Street, Lidcombe, NSW 2141
    • Mark Halaki Exercise, Health & Performance Faculty Research Group, Faculty of Health Sciences, The University of Sydney, 75 East Street, Lidcombe, NSW 2141
    • Chin-Moi Chow Exercise, Health & Performance Faculty Research Group, Faculty of Health Sciences, The University of Sydney, 75 East Street, Lidcombe, NSW 2141
    2015-12-11
    https://doi.org/10.14419/ijbas.v5i1.5456
  • Bright Light, Depression, Natural Light, Non-Seasonal Affective Disorder, Phototherapy.
  • Abstract

    Background: Depression is associated with prolonged disability, mortality, and morbidity. Ninety percent of patients with Major depressive disorder (MDD) have sleep problems. Light therapy has been shown to be effective in treating sleep disorders and MDD. This review aims to assess the characteristics (colour, intensity), exposure dose (duration and timing) and the mode of delivery (light boxes, visor etc) of light in reducing depression, measured by mood scores, in MDD.

    Method: a systematic literature search was performed on 6 major databases. The Physiotherapy Evidence Database (PEDro) Scale was applied to assess study quality.

    Result: Twenty-four articles satisfied the inclusion criteria. Effective light intensities varied from 176 -10,000 lux. Effective modes of delivery included light box, table lamp, visor and light emitting diode (LED) glasses. Effective light colours included white, green, and blue with the white colour being the most commonly used. The duration of light treatment ranged from 30 min to 2 h, and evening light generally improved mood.

    Conclusion: Light therapy, with exposure durations in the range of 30 min to 2 h per day, intensity range of 176 to 10,000 lux, in any of blue, green, or white light colour and exposure during morning mostly demonstrated a positive change in mood effects. Factors other than the light properties, such as anti-depressant medication use, depression episodes and severity, natural light exposure and sleep deprivation may confound the effects of light therapy.

  • References

    1. [1] L. Palagini, C. Baglioni, A. Ciapparelli, A. Gemignani, and D. Riemann, REM sleep dysregulation in depression: State of the art. Sleep Medicine Reviews 17 (2013) 377-390. http://dx.doi.org/10.1016/j.smrv.2012.11.001.

      [2] American, Psychiatric, and Association, Diagnostic and statistical manual of mental disorders: DSM-IV 1994: Washington DC.

      [3] P. Waraich, E. Goldner , J. Somers, and L. Hsu Prevalence and incidence studies of mood disorders: a systematic review of the literature. Canadian Journal of Psychiatry 49 (2004) 124-138.

      [4] Y. Conwell and D. Brent, Suicide and aging 1: patterns of psychiatric diagnoses. International Psychogeriatrics 7 (1995) 149-164. http://dx.doi.org/10.1017/S1041610295001943.

      [5] H. Britt, G. Miller, S. Knox, et al. General practice activity in Australia 2004-05. General Practice Series No. 18 (2005); available online: http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=6442456135 Accessed November 13, 2013.

      [6] Australian Bureau of Statistics. 4326.0 - National Survey of Mental Health and Wellbeing: Summary of Results, 2007 (2008); available online: http://www.abs.gov.au/ausstats/abs@.nsf/Latestproducts/4326.0Main%20Features32007?opendocument&tabname=Summary&prodno=4326.0&issue=2007&num=&view= Accessed November 13 2013.

      [7] H. Britt, G. Miller, J. Charles, et al. General practice activity in Australia 2000-01 to 2009-10: 10 year data tables'. BEACH - Bettering the Evaluation and Care of Health (2010); available online: http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=6442472732 Accessed November 15, 2014.

      [8] S.R. Pandi-Perumal, A. Moscovitch, V. Srinivasan, et al., Bidirectional communication between sleep and circadian rhythms and its implications for depression: lessons from agomelatine. Progress in Neurobiology 88 (2009) 264-271. http://dx.doi.org/10.1016/j.pneurobio.2009.04.007.

      [9] D.F. Kripke, S.C. Risch, and D. Janowsky, Bright white light alleviates depression. Psychiatry Research 10 (1983) 105-12. http://dx.doi.org/10.1016/0165-1781(83)90109-9.

      [10] G.W. McEnany and K.A. Lee, Effects of light therapy on sleep, mood, and temperature in women with nonseasonal major depression. Issues in Mental Health Nursing 26 (2005) 781-94. http://dx.doi.org/10.1080/01612840591008410.

      [11] B.E. Thalen, B.F. Kjellman, L. Morkrid, and L. Wetterberg, Melatonin in light treatment of patients with seasonal and nonseasonal depression. Acta Psychiatrica Scandinavica 92 (1995) 274-84. http://dx.doi.org/10.1111/j.1600-0447.1995.tb09583.x.

      [12] M. Berk, Sleep and depression Theory and practice. Australian Family Physician 38 (2009) 302-304.

      [13] A.J. Lewy, Sack R. L., & Singer, C. M., Treating phase typed chronobiologic sleep and mood disorders using appropriately timed bright artificial light. Psychopharmacology Bulletin 21 (1985) 368-372.

      [14] G. Glickman and J. Hanifin, inferior retinal light exposure is more effective than superior retinal exposure in suppressing melatonin in humans. Journal of Biological Rhythms 18 (2003) 71-79. http://dx.doi.org/10.1177/0748730402239678.

      [15] R.T. Loving, D.F. Kripke, and S.R. Shuchter, Bright light augments antidepressant effects of medication and wake therapy. Depression and Anxiety 16 (2002) 1-3. http://dx.doi.org/10.1002/da.10036.

      [16] J.A. Deltito, M. Moline, C. Pollak, L.Y. Martin, and I. Maremmani, Effects of phototherapy on non-seasonal unipolar and bipolar depressive spectrum disorders. Journal of Affective Disorders 23 (1991) 231-237 available online.

      [17] R.T. Joffe, D.E. Moul, R.W. Lam, et al., Light visor treatment for seasonal affective disorder: A multicenter study. Psychiatry Research 46 (1993) 29-39 available online.

      [18] R. Lieverse, E.J. Van Someren, M.M. Nielen, et al., Bright light treatment in elderly patients with nonseasonal major depressive disorder: a randomized placebo-controlled trial. Archives of General Psychiatry 68 (2011) 61-70. http://dx.doi.org/10.1001/archgenpsychiatry.2010.183.

      [19] M. Terman, J.S. Terman, F.M. Quitkin, et al., Light therapy for seasonal affective disorder: A review of efficacy. Neuropsychopharmacology 2 (1989) 1-22 available online.

      [20] H.P. Volz, A. Mackert, R.D. Stieglitz, and B. Muller-Oerlinghausen, Effect of bright white light therapy on non-seasonal depressive disorder. Preliminary results. Journal of Affective Disorders 19 (1990) 15-21. http://dx.doi.org/10.1016/0165-0327(90)90004-R.

      [21] A. Mackert, H.P. Volz, R.D. Stieglitz, and B. Muller-Oerlinghausen, Phototherapy in nonseasonal depression. Biological Psychiatry 30 (1991) 257-68. http://dx.doi.org/10.1016/0006-3223(91)90110-8.

      [22] D.F. Kripke, D.J. Mullaney, M.R. Klauber, S.C. Risch, and J.C. Gillin, Controlled trial of bright light for nonseasonal major depressive disorders. Biological Psychiatry 31 (1992) 119-34. http://dx.doi.org/10.1016/0006-3223(92)90199-A.

      [23] N. Yamada, M.T. Martin-Iverson, K. Daimon, T. Tsujimoto, and S. Takahashi, Clinical and chronobiological effects of light therapy on nonseasonal affective disorders. Biological Psychiatry 37 (1995) 866-73. http://dx.doi.org/10.1016/0006-3223(94)00221-N.

      [24] K. Beauchemin and P. Hays, Phototherapy is a useful adjunct in the treatment of depressed in-patients. Acta Psychiatrica Scandinavica 95 (1997) 424-427 available online: http://dx.doi.org/10.1111/j.1600-0447.1997.tb09656.x.

      [25] D.F. Kripke, Light treatment for nonseasonal depression: speed, efficacy, and combined treatment. Journal of Affective Disorders 49 (1998) 109-117. http://dx.doi.org/10.1016/S0165-0327(98)00005-6.

      [26] A. Tuunainen, D.F. Kripke, and T. Endo, Light therapy for non-seasonal depression. Cochrane Database of Systematic Reviews (2004). http://dx.doi.org/10.1002/14651858.CD004050.pub2.

      [27] R.N. Golden, B.N. Gaynes, R. Ekstrom, et al., the Efficacy of Light Therapy in the Treatment of Mood Disorders: A Review and Meta-Analysis of the Evidence. The American Journal of Psychiatry 162 (2005) 656-662 available online: http://dx.doi.org/10.1176/appi.ajp.162.4.656.

      [28] C. Even, C.M. Schroder, S. Friedman, and F. Rouillon Efficacy of light therapy in nonseasonal depression: A systematic review. Journal of Affective Disorders 108 (2008) 11-23. http://dx.doi.org/10.1016/j.jad.2007.09.008.

      [29] A.M. Kledzik and M.C. Thorne, The role of melatonin in psychiatric disorders. 2011. 49-55.

      [30] R.T. Loving, D.F. Kripke, J.A. Elliott, N.C. Knickerbocker, and M.A. Grandner, Bright light treatment of depression for older adults [ISRCTN55452501]. BMC Psychiatry 5 (2005) 41. http://dx.doi.org/10.1186/1471-244X-5-41.

      [31] M.L. Rao, B. Muller-Oerlinghausen, A. Mackert, et al., Blood serotonin, serum melatonin and light therapy in healthy subjects and in patients with nonseasonal depression. Acta Psychiatrica Scandinavica 86 (1992) 127-32. http://dx.doi.org/10.1111/j.1600-0447.1992.tb03240.x.

      [32] B.I. Yerevanian, J.L. Anderson, L.J. Grota, and M. Bray, Effects of Bright Incandescent Light on Seasonal and Nonseasonal Major Depressive Disorder. Psychiatry Research 18 (1986) 355-364. http://dx.doi.org/10.1016/0165-1781(86)90020-X.

      [33] The Physiotherapy Evidence Database. PEDro scale. 21 June 1999; available online: http://www.pedro.org.au/english/downloads/pedro-scale/ Accessed January 10 2015.

      [34] R.E. Strong, B.K. Marchant, F.W. Reimherr, et al., Narrow-band blue-light treatment of seasonal affective disorder in adults and the influence of additional nonseasonal symptoms. Depression and Anxiety 26 (2009) 273-8. http://dx.doi.org/10.1002/da.20538.

      [35] K. Martiny, M. Lunde, M. Unden, H. Dam, and P. Bech, The lack of sustained effect of bright light, after discontinuation, in non-seasonal major depression.[Erratum appears in Psychol Med. 2006 Sep;36(9):1336]. Psychological Medicine 36 (2006) 1247-52. http://dx.doi.org/10.1017/S0033291706008105.

      [36] J. Prasko, J. Horacek, J. Klaschka, et al., Bright light therapy and/or imipramine for inpatients with recurrent non-seasonal depression. Neuroendocrinology Letters 23 (2002) 109-13.

      [37] M. Fritzsche, R. Heller, H. Hill, and H. Kick, Sleep deprivation as a predictor of response to light therapy in major depression. Journal of Affective Disorders 62 (2001) 207-15. http://dx.doi.org/10.1016/S0165-0327(00)00154-3.

      [38] A. Baumgartner, H.-P. Volz, A. Campos-Barros, et al., Serum Concentrations of Thyroid Hormones in Patients with Nonseasonal Affective Disorders Treatment with Bright and Dim Light. Society of biological psychiatry 40 (1996) 899-907.

      [39] R. Lieverse, E.J.W. Van Someren, M.M.A. Nielen, et al., Bright light treatment in elderly patients with nonseasonal major depressive disorder: A randomized placebo-controlled trial. Archives of General Psychiatry 68 (2011) 61-70. http://dx.doi.org/10.1001/archgenpsychiatry.2010.183.

      [40] N. Goel, M. Terman, J.S. Terman, M.M. Macchi, and J.W. Stewart, Controlled trial of bright light and negative air ions for chronic depression. Psychological Medicine 35 (2005) 945-55. http://dx.doi.org/10.1017/S0033291705005027.

      [41] F. Benedetti, C. Colombo, A. Pontiggia, et al., Morning light treatment hastens the antidepressant effect of citalopram: a placebo-controlled trial. Journal of Clinical Psychiatry 64 (2003) 648-53. http://dx.doi.org/10.4088/JCP.v64n0605.

      [42] E. Holsboer-Trachsler, U. Hemmeter, M. Hatzinger, et al., Sleep deprivation and bright light as potential augmenters of antidepressant drug treatment: Neurobiological and psychometric assessment of course. Journal of Psychiatric Research 28 (1994) 381-399 available online: http://dx.doi.org/10.1016/0022-3956%2894%2990020-5.

      [43] J.W. Stewart, F.M. Quitkin, M. Terman, and J.S. Terman, Is seasonal affective disorder a variant of atypical depression? Differential response to light therapy. Psychiatry Research 33 (1990) 121-8. http://dx.doi.org/10.1016/0165-1781(90)90065-D.

      [44] K. Martiny, M. Lunde, M. Unden, H. Dam, and P. Bech, Adjunctive bright light in non-seasonal major depression: Results from clinician-rated depression scales. Acta Psychiatrica Scandinavica 112 (2005) 117-125. http://dx.doi.org/10.1111/j.1600-0447.2005.00574.x.

      [45] R.W. Lam, M. Terman, and A. Wirz-Justice, Light therapy for depressive disorders: Indications and efficacy, in Mood disorders: Systematic medication management. 1997, Karger; Switzerland: Basel, Switzerland. 215-234.

      [46] A. Wirz-Justice, P. Graw, K. Krauchi, et al., 'Natural' light treatment of seasonal affective disorder. Journal of Affective Disorders 37 (1996) 109-20. http://dx.doi.org/10.1016/0165-0327(95)00081-X.

      [47] K.A. Roecklein, P.M. Wong, M.A. Miller, et al., Melanopsin, photosensitive ganglion cells, and seasonal affective disorder. Neuroscience and Biobehavioral Reviews 37 (2013) 229-239. http://dx.doi.org/10.1016/j.neubiorev.2012.12.009.

      [48] T.T. Postolache and D.A. Oren, Circadian phase shifting, alerting, and antidepressant effects of bright light treatment. Clinics in Sports Medicine 24 (2005) 381-413, xii. http://dx.doi.org/10.1016/j.csm.2004.12.005.

      [49] M.R. Nelsen and D.L. Dunner, Treatment resistance in unipolar depression and other disorders: Diagnostic concerns and treatment possibilities. Psychiatric Clinics of North America 16 (1993) 541-566.

      [50] N.S. Philip, L.L. Carpenter, A.R. Tyrka, and L.H. Price, Pharmacologic approaches to treatment resistant depression: A re-examination for the modern era. Expert Opinion on Pharmacotherapy 11 (2010) 709-722. http://dx.doi.org/10.1517/14656561003614781.

      [51] A. Wirz-Justice and R.H. Van den Hoofdakker, Sleep deprivation in depression: what do we know, where do we go? Biological Psychiatry 46 (1999) 445-53. http://dx.doi.org/10.1016/S0006-3223(99)00125-0.

  • Downloads

  • How to Cite

    Alotaibi, M., Halaki, M., & Chow, C.-M. (2015). A systematic review of light therapy on mood scores in major depressive disorder: light specification, dose, timing and delivery. International Journal of Basic and Applied Sciences, 5(1), 30-37. https://doi.org/10.14419/ijbas.v5i1.5456

    Received date: 2015-10-20

    Accepted date: 2015-12-05

    Published date: 2015-12-11