Bright light treatment of depression for older adults [ISRCTN55452501].
Bright light treatment of depression for older adults [ISRCTN55452501].
复制标题
老年人的抑郁症的明亮光治疗[ISRCTN55452501]。
DOI：
10.1186/1471-244x-5-41
复制
发表时间：
2005-11-09
期刊：
影响因子：
4.4
通讯作者：
Grandner, Michael A.
中科院分区：
文献类型：
--
作者：
Loving, Richard T.;Kripke, Daniel F.;Elliott, Jeffrey A.;Knickerbocker, Nancy C.;Grandner, Michael A.
老年人群失眠和抑郁的发生率较高。希望对这一群体使用光治疗可以提供安全，经济和有效的快速恢复。在这项以家庭为基础的试验中，我们用明亮的白色（8,500勒克斯）和昏暗的红色（<10勒克斯）光治疗抑郁的老年受试者，每天在三个不同的时间（早上，中间醒来和晚上）进行一小时的治疗。第一周使用安慰剂应答洗脱期。在治疗开始前进行唤醒治疗，以探索抗抑郁反应和与光治疗的相互作用。在治疗前和治疗后的24小时期间收集尿液和唾液样品，并分别测定aMT 6 s和褪黑激素，以观察昼夜节律定时的任何变化。受试者佩戴手腕监测器以记录光暴露和手腕活动。每日记录表和每周情绪（GDS）和身体症状（SAFTEE）量表进行管理。在治疗前后对每位受试者进行了SCID访谈，并完成了情绪问卷（SIGH-SAD-SR）。此外，汉密尔顿抑郁评分（SIGH-SAD版）访谈由一名对治疗条件不知情的研究人员进行。对年龄匹配的健康志愿者对照组进行为期一天的研究，以获得用于比较体动记录仪和激素水平的基线数据。81名年龄在60至79岁之间的志愿者完成了这项研究。治疗组和安慰剂组都经历了情绪改善。GDS评分平均提高5分，汉密尔顿抑郁量表（HDRS）17分（提取自SIGH-SAD-SR）提高6分。无显著的给药效应或时间-给药相互作用。两个治疗组均未观察到显著不良反应。尿液和唾液分析显示治疗组和安慰剂组之间无显著差异。健康对照组比抑郁组活动更早，睡眠更早，但在基线时接受的光照更少。在这个年龄组中，对强光治疗的抗过敏反应在统计学上并不上级安慰剂。治疗组和安慰剂组的总体改善率均达到16%，具有临床意义。
The incidence of insomnia and depression in the elder population is significant. It is hoped that use of light treatment for this group could provide safe, economic, and effective rapid recovery. In this home-based trial we treated depressed elderly subjects with bright white (8,500 Lux) and dim red (<10 Lux) light for one hour a day at three different times (morning, mid-wake and evening). A placebo response washout was used for the first week. Wake treatment was conducted prior to the initiation of treatment, to explore antidepressant response and the interaction with light treatment. Urine and saliva samples were collected during a 24-hour period both before and after treatment and assayed for aMT6s and melatonin respectively to observe any change in circadian timing. Subjects wore a wrist monitor to record light exposure and wrist activity. Daily log sheets and weekly mood (GDS) and physical symptom (SAFTEE) scales were administered. Each subject was given a SCID interview and each completed a mood questionnaire (SIGH-SAD-SR) before and after treatment. Also, Hamilton Depression Rating (SIGH-SAD version) interviews were conducted by a researcher who was blind to the treatment condition. A control group of healthy, age-matched, volunteers was studied for one day to obtain baseline data for comparison of actigraphy and hormone levels. Eighty-one volunteers, between 60 and 79 years old, completed the study. Both treatment and placebo groups experienced mood improvement. Average GDS scores improved 5 points, the Hamilton Depression Rating Scale (HDRS) 17 scores (extracted from the self-rated SIGH-SAD-SR) improved 6 points. There were no significant treatment effects or time-by-treatment interactions. No significant adverse reactions were observed in either treatment group. The assays of urine and saliva showed no significant differences between the treatment and placebo groups. The healthy control group was active earlier and slept earlier but received less light than the depressed group at baseline. Antidepressant response to bright light treatment in this age group was not statistically superior to placebo. Both treatment and placebo groups experienced a clinically significant overall improvement of 16%.