“As to efficacy of light therapy for SAD and other non-seasonal depressive mood disorders, this study largely answers the question: The treatment is effective… Comparable to what has been described in the clinical literature for conventional medications.” – Dr. Robert Golden, MD
A study commissioned by the American Psychiatric Association and led by a psychiatrist at the University of North Carolina at Chapel Hill School of Medicine found that light therapy effectively treats mood disorders, including seasonal affective disorder (SAD) and other depressive disorders.
A report of the study, published in the American Journal of Psychiatry,(1) also finds that the effects of light therapy, also known as phototherapy, are comparable to those found in many clinical studies of antidepressant drug therapy for these disorders.
The findings were based on a meta-analysis – a systematic statistical review of 20 randomized, controlled studies previously reported in the scientific literature. These represented only 12 percent of 173 published studies that the authors had originally considered for review.
"We found that many reports on the efficacy of light therapy are not based on rigorous study designs. This has fueled the controversy in the field as to whether or not light therapy is effective for SAD or for non-seasonal forms of mood disorders," said lead author Dr. Robert N. Golden, MD, formerly chairman of psychiatry at UNC and now dean, University of Wisconsin School of Medicine & Public Health.
"But when you throw out all the studies that are methodologically flawed and then conduct a meta-analysis of those that are well-designed, you find that light therapy is an effective treatment not only for SAD but also for depression."
The use of bright artificial light for people with SAD, a recurring depression that develops in the fall or winter and spontaneously disappears during spring or summer, was first described in the Archives of General Psychiatry in 1984. Since then, the treatment has been tried in clinical and research programs for non-seasonal mood disorders, Alzheimer's disease, jet lag, insomnia, eating disorders and other behavioral problems.
A more recent light therapy approach is "dawn simulation," which attempts to simulate an earlier dawn through exposure to artificial light. This follows the theory that SAD is triggered by the reduced period of bright daylight during winter. The method attempts to recreate the increased intensity of sunlight that occurs in nature in the summer when the sun rises earlier in the day. "The logic here is that it might put people with seasonal affective disorder into remission," Golden said.
Still, the exact mechanisms by which light therapy works remain unclear, the researchers said.
The studies selected by the authors for inclusion in their meta-analysis were grouped into four categories:
• Bright light for SAD,
• Bright light for non-seasonal depression,
• Dawn simulation for SAD,
• And bright light as an adjunct therapy combined with conventional antidepressants for non-seasonal affective disorder.
These study groups were limited to adults ages 18 to 65 years who met a criterion-based mood disorder diagnosis.
The meta-analysis demonstrated statistically significant treatment effects of bright light for SAD, dawn simulation for SAD, and bright light treatment of non-seasonal depression.
"The effect size of the light therapy intervention in our meta-analysis was comparable to what has been described in the clinical literature for conventional medications to treat depression," Golden said. "The findings are as strong or as striking."
More research is needed on the safety of light therapy, particularly among children and the elderly, Golden said… “As to efficacy of light therapy for SAD and other non-seasonal depressive mood disorders, this study largely answers the question: The treatment is effective.”
* Citation: “The Efficacy of Light Therapy in the Treatment of Mood Disorders: A Review and Meta-Analysis of the Evidence,” by Golden RN, et al., American Journal of Psychiatry 162:656-662.
Source: University of North Carolina, Chapel Hill news release, Apr 4, 2005