Low-intensity blue-enriched white light (750 lux) and standard bright light (10 000 lux) are equally effective in treating SAD. A randomized controlled study

<p>Abstract</p> <p>Background</p> <p>Photoreceptor cells containing melanopsin play a role in the phase-shifting effects of short-wavelength light. In a previous study, we compared the standard light treatment (SLT) of SAD with treatment using short-wavelength blue-enriched white light (BLT). Both treatments used the same illuminance (10 000 lux) and were equally highly effective. It is still possible, however, that neither the newly-discovered photoreceptor cells, nor the biological clock play a major role in the therapeutic effects of light on SAD. Alternatively, these effects may at least be partly mediated by these receptor cells, which may have become saturated as a result of the high illuminances used in the therapy. This randomized controlled study compares the effects of low-intensity BLT to those of high-intensity SLT.</p> <p>Method</p> <p>In a 22-day design, 22 patients suffering from a major depression with a seasonal pattern (SAD) were given light treatment (10 000 lux) for two weeks on workdays. Subjects were randomly assigned to either of the two conditions, with gender and age evenly distributed over the groups. Light treatment either consisted of 30 minutes SLT (5000°K) with the EnergyLight^®(Philips, Consumer Lifestyle) with a vertical illuminance of 10 000 lux at eye position or BLT (17 000°K) with a vertical illuminance of 750 lux using a prototype of the EnergyLight^®which emitted a higher proportion of short-wavelengths. All participants completed questionnaires concerning mood, activation and sleep quality on a daily basis. Mood and energy levels were also assessed on a weekly basis by means of the SIGH-SAD and other assessment tools.</p> <p>Results</p> <p>On day 22, SIGH-SAD ratings were significantly lower than on day 1 (SLT 65.2% and BLT 76.4%). On the basis of all assessments no statistically significant differences were found between the two conditions.</p> <p>Conclusion</p> <p>With sample size being small, conclusions can only be preliminary. Both treatment conditions were found to be highly effective. The therapeutic effects of low-intensity blue-enriched light were comparable to those of the standard light treatment. Saturation effects may play a role, even with a light intensity of 750 lux. The therapeutic effects of blue-enriched white light in the treatment of SAD at illuminances as low as 750 lux help bring light treatment for SAD within reach of standard workplace and educational lighting systems.</p

Seasonal affective disorder, winter type: current insights and treatment options

Ybe Meesters,1 Marijke CM Gordijn,2,3 1University Center for Psychiatry, University Medical Center Groningen, 2Department of Chronobiology, GeLifes, University of Groningen, Groningen, the Netherlands; 3Chrono@Work B.V., Groningen, the Netherlands Abstract: Seasonal affective disorder (SAD), winter type, is a seasonal pattern of recurrent major depressive episodes most commonly occurring in autumn or winter and remitting in spring/summer. The syndrome has been well-known for more than three decades, with light treatment being the treatment of first choice. In this paper, an overview is presented of the present insights in SAD. Description of the syndrome, etiology, and treatment options are mentioned. Apart from light treatment, medication and psychotherapy are other treatment options. The predictable, repetitive nature of the syndrome makes it possible to discuss preventive treatment options. Furthermore, critical views on the concept of SAD as a distinct diagnosis are discussed. Keywords: seasonal affective disorder, review, light treatment, medication, psychotherapy, preventio

Gender-specific mechanisms associated with outcome of depression: perception of emotions, coping and interpersonal functioning

We proposed that a negative bias in the perception of facial expressions would affect the way in which deficient coping and interpersonal functioning influenced the risk of persistent depression. Furthermore, we hypothesised that cognitions, coping strategies, and interpersonal functioning would be more likely to contribute to the prediction of outcome of depression among women than among men. At admission, 60 in-patients with major depression judged 12 schematic faces with respect to the emotions that they expressed (fear, happiness, anger, sadness, disgust, surprise, rejection and invitation). In addition, difficulty in assertiveness and social distress, and coping strategies for dealing with stressful events were measured with self-report questionnaires. At admission and 6 weeks later, the severity of depression was evaluated with the Beck Depression Inventory. Women who were inclined to perceive high levels of negative emotions from facial expressions and who reported high levels of social distress at admission were less likely to be improved after 6 weeks. Among women, these high levels of perception of negative emotions and high levels of social distress tended to predict the persistence of depression independently. A propensity to perceive negative facial expressions may underlie the unfavourable course of depression, especially among women, (C) 1999 Elsevier Science Ireland Ltd. All rights reserved

PREDICTION OF THE ANTIDEPRESSANT RESPONSE TO TOTAL SLEEP-DEPRIVATION OF DEPRESSED-PATIENTS - LONGITUDINAL VERSUS SINGLE DAY ASSESSMENT OF DIURNAL MOOD VARIATION

The relationship between diurnal variation of mood and the clinical response to total sleep deprivation (TSD) was investigated in 43 depressed patients. The question asked was whether the propensity to produce diurnal variations of mood or the actual mood course on the day before TSD determines the clinical response to TSD. Patients rated their mood three times daily during an experimental period of 56 days. The frequency as well as the amplitude of daily mood changes were assessed during this period. For each patient six TSDs were scheduled: two after days with a positive mood course, two after a negative mood course, and two after days without a diurnal change of mood. This strategy allowed comparisons of TSD responses within patients. Moreover, longitudinally and retrospectively assessed diurnal variation were compared with each other. It was found that patients vary largely in the occurrence of diurnal variations of mood. The propensity to produce diurnal variations either in terms of frequency or amplitude was positively correlated with the response to TSD. Within patients no differences were found in responses to TSDs applied after days with diurnal variations (positive or negative) or without diurnal variations. A second aim was to get more insight into the mechanism relating diurnal variations of mood and the TSD response. Therefore, the interrelatedness of various measures of diurnal variations, such as amplitudes and frequencies of positive or negative diurnal mood changes, was studied, as well as the relationships of these variables with TSD responses. On the basis of the strong interrelatedness it is suggested that they all reflect the same underlying mechanism, to be symbolized by an oscillator, producing positive daily fluctuations of mood

Clarinet recital

Libby LarsenShulamit RanRobert SchumannJoan TowerFrancis Poulen