{"title":"强光疗法对重度抑郁症的影响：随机对照试验的系统回顾和荟萃分析","authors":"","doi":"10.1016/j.ajp.2024.104149","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>The increasing prevalence of major depressive disorder (MDD) has led to increased demand for psychotherapy and pharmacotherapy, yet concerns were raised regarding the cost and accessibility to these therapies. Bright light therapy (BLT) has shown promise in mitigating depressive symptoms of non-seasonal affective disorders. This meta-analysis gathered evidence from randomised controlled trials (RCTs) to assess the effectiveness of BLT on patients with non-seasonal MDD.</p></div><div><h3>Methods</h3><p>Five databases were systematically searched. The primary outcome of the meta-analysis was the endpoint depression score from the BLT and control treatment groups, with the remission and response rates as the secondary outcomes. Results are presented in standardised mean difference (SMD) and log odd ratio. Subgroup analyses compared the effects of trial length and the length of daily exposure.</p></div><div><h3>Results</h3><p>Results on 15 RCTs between 1996 and 2024 with 883 patients showed positive effects of BLT on alleviating depressive symptoms (<em>SMD</em> = 0.48, 95 % <em>CI</em> [0.22, 0.74], <em>p <</em>.001). Trials that lasted two weeks or less or those with 60 minutes or more of daily exposure were associated with higher therapeutic effectiveness. BLT was also associated with a higher response rate at the end of the trial.</p></div><div><h3>Conclusion</h3><p>This meta-analysis offers positive evidence that favours BLT in alleviating depressive symptoms in MDD, suggesting that it could be a convenient and easily accessible treatment modality to augment psychotherapy and pharmacotherapy.</p></div>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":null,"pages":null},"PeriodicalIF":3.8000,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The effect of bright light therapy on major depressive disorder: A systematic review and meta-analysis of randomised controlled trials\",\"authors\":\"\",\"doi\":\"10.1016/j.ajp.2024.104149\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>The increasing prevalence of major depressive disorder (MDD) has led to increased demand for psychotherapy and pharmacotherapy, yet concerns were raised regarding the cost and accessibility to these therapies. Bright light therapy (BLT) has shown promise in mitigating depressive symptoms of non-seasonal affective disorders. This meta-analysis gathered evidence from randomised controlled trials (RCTs) to assess the effectiveness of BLT on patients with non-seasonal MDD.</p></div><div><h3>Methods</h3><p>Five databases were systematically searched. The primary outcome of the meta-analysis was the endpoint depression score from the BLT and control treatment groups, with the remission and response rates as the secondary outcomes. Results are presented in standardised mean difference (SMD) and log odd ratio. Subgroup analyses compared the effects of trial length and the length of daily exposure.</p></div><div><h3>Results</h3><p>Results on 15 RCTs between 1996 and 2024 with 883 patients showed positive effects of BLT on alleviating depressive symptoms (<em>SMD</em> = 0.48, 95 % <em>CI</em> [0.22, 0.74], <em>p <</em>.001). Trials that lasted two weeks or less or those with 60 minutes or more of daily exposure were associated with higher therapeutic effectiveness. BLT was also associated with a higher response rate at the end of the trial.</p></div><div><h3>Conclusion</h3><p>This meta-analysis offers positive evidence that favours BLT in alleviating depressive symptoms in MDD, suggesting that it could be a convenient and easily accessible treatment modality to augment psychotherapy and pharmacotherapy.</p></div>\",\"PeriodicalId\":8543,\"journal\":{\"name\":\"Asian journal of psychiatry\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2024-07-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Asian journal of psychiatry\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1876201824002429\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asian journal of psychiatry","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1876201824002429","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0
摘要
背景重度抑郁障碍（MDD）的发病率不断上升，导致对心理治疗和药物治疗的需求增加，但人们对这些疗法的成本和可及性表示担忧。亮光疗法（BLT）在减轻非季节性情感障碍的抑郁症状方面表现出了良好的前景。这项荟萃分析收集了随机对照试验（RCT）的证据，以评估BLT对非季节性MDD患者的疗效。荟萃分析的主要结果是BLT治疗组和对照治疗组的终点抑郁评分，缓解率和反应率为次要结果。结果以标准化平均差（SMD）和对数奇异比表示。亚组分析比较了试验时间长短和每日暴露时间长短的影响。结果1996年至2024年间的15项RCT研究结果显示，BLT对缓解抑郁症状有积极作用（SMD = 0.48，95 % CI [0.22，0.74]，p <.001）。持续两周或更短时间的试验或每天接触 60 分钟或更长时间的试验具有更高的疗效。结论这项荟萃分析提供了积极的证据，证明BLT在缓解MDD患者的抑郁症状方面更有优势，这表明BLT可以成为一种方便易得的治疗方式，以辅助心理治疗和药物治疗。
The effect of bright light therapy on major depressive disorder: A systematic review and meta-analysis of randomised controlled trials
Background
The increasing prevalence of major depressive disorder (MDD) has led to increased demand for psychotherapy and pharmacotherapy, yet concerns were raised regarding the cost and accessibility to these therapies. Bright light therapy (BLT) has shown promise in mitigating depressive symptoms of non-seasonal affective disorders. This meta-analysis gathered evidence from randomised controlled trials (RCTs) to assess the effectiveness of BLT on patients with non-seasonal MDD.
Methods
Five databases were systematically searched. The primary outcome of the meta-analysis was the endpoint depression score from the BLT and control treatment groups, with the remission and response rates as the secondary outcomes. Results are presented in standardised mean difference (SMD) and log odd ratio. Subgroup analyses compared the effects of trial length and the length of daily exposure.
Results
Results on 15 RCTs between 1996 and 2024 with 883 patients showed positive effects of BLT on alleviating depressive symptoms (SMD = 0.48, 95 % CI [0.22, 0.74], p <.001). Trials that lasted two weeks or less or those with 60 minutes or more of daily exposure were associated with higher therapeutic effectiveness. BLT was also associated with a higher response rate at the end of the trial.
Conclusion
This meta-analysis offers positive evidence that favours BLT in alleviating depressive symptoms in MDD, suggesting that it could be a convenient and easily accessible treatment modality to augment psychotherapy and pharmacotherapy.
期刊介绍：
The Asian Journal of Psychiatry serves as a comprehensive resource for psychiatrists, mental health clinicians, neurologists, physicians, mental health students, and policymakers. Its goal is to facilitate the exchange of research findings and clinical practices between Asia and the global community. The journal focuses on psychiatric research relevant to Asia, covering preclinical, clinical, service system, and policy development topics. It also highlights the socio-cultural diversity of the region in relation to mental health.
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