Extraocular light therapy in winter depression: A double-blind placebo-controlled study

Kathelijne M. Koorengevel, Marijke C.M. Gordijn, Domien G.M. Beersma*, Ybe Meesters, Johan den Boer, Rutger H. van den Hoofdakker, Serge Daan

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Background: It has been hypothesized that the circadian pacemaker is phase delayed in seasonal affective disorder, (SAD) winter type, and that the phase advance resulting from morning ocular light accounts for the efficacy of light therapy. Extraocular light has been reported to produce phase-shifts of the human circadian pacemaker. This allows a double-blind, placebo-controlled study of light therapy in SAD.

Methods: Twenty-nine SAD patients participated. Clinical state was measured on days 1, 8, and 15 of the protocol. From days 4 through 8, 15 patients (4 M, 11 F) received extraocular light by fiberoptic illumination, and 14 (4 M, 10 F) placebo (no light) in the popliteal fossae, from 8 AM to 11 AM. In the evenings of days 3 and 8, the salivary dim light melatonin onset (DLMO) was assessed. Patients completed daily self-ratings on mood, alertness, and sleep.

Results: Both conditions showed a progressive improvement of clinical state over time. Between conditions, no significant differences were observed in clinical scores, the self-ratings on mood and alertness, and in timing of the DLMO before and directly after treatment.

Conclusions: The response to extraocular light therapy in SAD patients did not exceed its placebo effect. Extraocular light did not induce a phase shift of the circadian pacemaker. (C) 2001 Society of Biological Psychiatry.

Original languageEnglish
Pages (from-to)691-698
Number of pages8
JournalBiological Psychiatry
Volume50
Issue number9
DOIs
Publication statusPublished - 1-Nov-2001

Keywords

  • seasonal affective disorder
  • extraocular light
  • light therapy
  • phase-delay hypothesis
  • circadian pacemaker
  • dim-light melatonin onset
  • SEASONAL AFFECTIVE-DISORDER
  • CONSTANT ROUTINE
  • BRIGHT LIGHT
  • CIRCADIAN TEMPERATURE
  • MELATONIN SECRETION
  • SLEEP-DEPRIVATION
  • CONTROLLED TRIAL
  • HUMANS
  • PHASE
  • EXPOSURE

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