Skip to main content
PMC home page
Journal of Psychiatry & Neuroscience : JPN logoLink to Journal of Psychiatry & Neuroscience : JPN
. 1995 May;20(3):226–232.

The effect of adjunctive light therapy on ameliorating breakthrough depressive symptoms in adolescent-onset bipolar disorder.

G Papatheodorou 1, S Kutcher 1
PMCID: PMC1188688  PMID: 7786884

Abstract

Seven adolescents or young adults (aged 16 to 22 years) who met DSM-III-R criteria for bipolar disorder were treated for persistent depressive symptoms (greater than three weeks) with adjunctive light therapy (10,000 lux given twice per day). Patients were evaluated using the Beck Depression Inventory (BDI) and Symptoms Check List (SCL-58). Three patients showed a marked response of greater than 70% decrease of their baseline score. Two patients had a moderate decrease (40% to 74%) and two patients obtained mild to no response. There were no reported side-effects. Paired t-tests done on pre- and post-BDI scores (pre mean = 21.2 sd +/- 10.0; post mean = 11.1, sd +/- 8.8; paired t = 4.31; p > 0.0051) and pre- and post-SCL-58 scores above baseline of 58 (pre mean = 57.4, sd +/- 24.4; post mean = 28.7, sd +/- 18.6; paired t = 5.50; p > 0.0015) showed significant improvement. These preliminary results indicate that some bipolar adolescents with breakthrough depressive symptoms could benefit from light therapy as an adjunct to their continued thymoleptic treatment.

Full text

PDF
227

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bauer M. S. Summertime bright-light treatment of bipolar major depressive episodes. 1993 Apr 15-May 1Biol Psychiatry. 33(8-9):663–665. doi: 10.1016/0006-3223(93)90109-q. [DOI] [PubMed] [Google Scholar]
  2. Blehar M. C., Lewy A. J. Seasonal mood disorders: consensus and controversy. Psychopharmacol Bull. 1990;26(4):465–494. [PubMed] [Google Scholar]
  3. Blehar M. C., Rosenthal N. E. Seasonal affective disorders and phototherapy. Report of a National Institute of Mental Health-sponsored workshop. Arch Gen Psychiatry. 1989 May;46(5):469–474. doi: 10.1001/archpsyc.1989.01810050083013. [DOI] [PubMed] [Google Scholar]
  4. Boulos C., Kutcher S., Marton P., Simeon J., Ferguson B., Roberts N. Response to desipramine treatment in adolescent major depression. Psychopharmacol Bull. 1991;27(1):59–65. [PubMed] [Google Scholar]
  5. Bunney W. E., Jr, Goodwin F. K., Murphy D. L., House K. M., Gordon E. K. The "switch process" in manic-depressive illness. II. Relationship to catecholamines, REM sleep, and drugs. Arch Gen Psychiatry. 1972 Sep;27(3):304–309. doi: 10.1001/archpsyc.1972.01750270014002. [DOI] [PubMed] [Google Scholar]
  6. Bunney W. E., Jr, Goodwin F. K., Murphy D. L. The "switch process" in manic-depressive illness. 3. Theoretical implications. Arch Gen Psychiatry. 1972 Sep;27(3):312–317. doi: 10.1001/archpsyc.1972.01750270022003. [DOI] [PubMed] [Google Scholar]
  7. Bunney W. E., Jr, Murphy D. L., Goodwin F. K., Borge G. F. The "switch process" in manic-depressive illness. I. A systematic study of sequential behavioral changes. Arch Gen Psychiatry. 1972 Sep;27(3):295–302. doi: 10.1001/archpsyc.1972.01750270005001. [DOI] [PubMed] [Google Scholar]
  8. Deltito J. A., Moline M., Pollak C., Martin L. Y., Maremmani I. Effects of phototherapy on non-seasonal unipolar and bipolar depressive spectrum disorders. J Affect Disord. 1991 Dec;23(4):231–237. doi: 10.1016/0165-0327(91)90105-2. [DOI] [PubMed] [Google Scholar]
  9. Dietzel M., Saletu B., Lesch O. M., Sieghart W., Schjerve M. Light treatment in depressive illness. Polysomnographic, psychometric and neuroendocrinological findings. Eur Neurol. 1986;25 (Suppl 2):93–103. doi: 10.1159/000116089. [DOI] [PubMed] [Google Scholar]
  10. Geller B., Cooper T. B., Graham D. L., Marsteller F. A., Bryant D. M. Double-blind placebo-controlled study of nortriptyline in depressed adolescents using a "fixed plasma level" design. Psychopharmacol Bull. 1990;26(1):85–90. [PubMed] [Google Scholar]
  11. Kantor D. A., Browne M., Ravindran A., Horn E. Manic-like response to phototherapy. Can J Psychiatry. 1991 Nov;36(9):697–698. doi: 10.1177/070674379103600920. [DOI] [PubMed] [Google Scholar]
  12. Kramer A. D., Feiguine R. J. Clinical effects of amitriptyline in adolescent depression. A pilot study. J Am Acad Child Psychiatry. 1981 Summer;20(3):636–644. doi: 10.1016/s0002-7138(09)61650-2. [DOI] [PubMed] [Google Scholar]
  13. Kripke D. F., Mullaney D. J., Klauber M. R., Risch S. C., Gillin J. C. Controlled trial of bright light for nonseasonal major depressive disorders. Biol Psychiatry. 1992 Jan 15;31(2):119–134. doi: 10.1016/0006-3223(92)90199-a. [DOI] [PubMed] [Google Scholar]
  14. Kripke D. F., Risch S. C., Janowsky D. Bright white light alleviates depression. Psychiatry Res. 1983 Oct;10(2):105–112. doi: 10.1016/0165-1781(83)90109-9. [DOI] [PubMed] [Google Scholar]
  15. Kripke D. F. Therapeutic effects of bright light in depressed patients. Ann N Y Acad Sci. 1985;453:270–281. doi: 10.1111/j.1749-6632.1985.tb11817.x. [DOI] [PubMed] [Google Scholar]
  16. Kutcher S. P., Marton P. Parameters of adolescent depression. A review. Psychiatr Clin North Am. 1989 Dec;12(4):895–918. [PubMed] [Google Scholar]
  17. Lam R. W., Kripke D. F., Gillin J. C. Phototherapy for depressive disorders: a review. Can J Psychiatry. 1989 Mar;34(2):140–147. doi: 10.1177/070674378903400215. [DOI] [PubMed] [Google Scholar]
  18. Levitt A. J., Joffe R. T., Kennedy S. H. Bright light augmentation in antidepressant nonresponders. J Clin Psychiatry. 1991 Aug;52(8):336–337. [PubMed] [Google Scholar]
  19. Lewy A. J., Kern H. A., Rosenthal N. E., Wehr T. A. Bright artificial light treatment of a manic-depressive patient with a seasonal mood cycle. Am J Psychiatry. 1982 Nov;139(11):1496–1498. doi: 10.1176/ajp.139.11.1496. [DOI] [PubMed] [Google Scholar]
  20. Lewy A. J., Sack R. L., Singer C. M. Treating phase typed chronobiologic sleep and mood disorders using appropriately timed bright artificial light. Psychopharmacol Bull. 1985;21(3):368–372. [PubMed] [Google Scholar]
  21. Magnusson A., Kristbjarnarson H. Treatment of seasonal affective disorder with high-intensity light. A phototherapy study with an Icelandic group of patients. J Affect Disord. 1991 Feb;21(2):141–147. doi: 10.1016/0165-0327(91)90061-v. [DOI] [PubMed] [Google Scholar]
  22. Mghir R., Vincent J. Phototherapy of seasonal affective disorder in an adolescent female. J Am Acad Child Adolesc Psychiatry. 1991 May;30(3):440–442. doi: 10.1097/00004583-199105000-00014. [DOI] [PubMed] [Google Scholar]
  23. Prien R. F., Kupfer D. J., Mansky P. A., Small J. G., Tuason V. B., Voss C. B., Johnson W. E. Drug therapy in the prevention of recurrences in unipolar and bipolar affective disorders. Report of the NIMH Collaborative Study Group comparing lithium carbonate, imipramine, and a lithium carbonate-imipramine combination. Arch Gen Psychiatry. 1984 Nov;41(11):1096–1104. doi: 10.1001/archpsyc.1983.01790220086014. [DOI] [PubMed] [Google Scholar]
  24. Puig-Antich J., Perel J. M., Lupatkin W., Chambers W. J., Tabrizi M. A., King J., Goetz R., Davies M., Stiller R. L. Imipramine in prepubertal major depressive disorders. Arch Gen Psychiatry. 1987 Jan;44(1):81–89. doi: 10.1001/archpsyc.1987.01800130093012. [DOI] [PubMed] [Google Scholar]
  25. Rosenthal N. E., Carpenter C. J., James S. P., Parry B. L., Rogers S. L., Wehr T. A. Seasonal affective disorder in children and adolescents. Am J Psychiatry. 1986 Mar;143(3):356–358. doi: 10.1176/ajp.143.3.356. [DOI] [PubMed] [Google Scholar]
  26. Rosenthal N. E., Sack D. A., Carpenter C. J., Parry B. L., Mendelson W. B., Wehr T. A. Antidepressant effects of light in seasonal affective disorder. Am J Psychiatry. 1985 Feb;142(2):163–170. doi: 10.1176/ajp.142.2.163. [DOI] [PubMed] [Google Scholar]
  27. Rosenthal N. E., Sack D. A., Gillin J. C., Lewy A. J., Goodwin F. K., Davenport Y., Mueller P. S., Newsome D. A., Wehr T. A. Seasonal affective disorder. A description of the syndrome and preliminary findings with light therapy. Arch Gen Psychiatry. 1984 Jan;41(1):72–80. doi: 10.1001/archpsyc.1984.01790120076010. [DOI] [PubMed] [Google Scholar]
  28. Ryan N. D., Puig-Antich J., Rabinovich H., Fried J., Ambrosini P., Meyer V., Torres D., Dachille S., Mazzie D. MAOIs in adolescent major depression unresponsive to tricyclic antidepressants. J Am Acad Child Adolesc Psychiatry. 1988 Nov;27(6):755–758. doi: 10.1097/00004583-198811000-00016. [DOI] [PubMed] [Google Scholar]
  29. Schwitzer J., Neudorfer C., Blecha H. G., Fleischhacker W. W. Mania as a side effect of phototherapy. Biol Psychiatry. 1990 Sep 15;28(6):532–534. doi: 10.1016/0006-3223(90)90489-o. [DOI] [PubMed] [Google Scholar]
  30. Sonis W. A., Yellin A. M., Garfinkel B. D., Hoberman H. H. The antidepressant effect of light in seasonal affective disorder of childhood and adolescence. Psychopharmacol Bull. 1987;23(3):360–363. [PubMed] [Google Scholar]
  31. Stinson D., Thompson C. Clinical experience with phototherapy. J Affect Disord. 1990 Feb;18(2):129–135. doi: 10.1016/0165-0327(90)90069-k. [DOI] [PubMed] [Google Scholar]
  32. Terman J. S., Terman M., Schlager D., Rafferty B., Rosofsky M., Link M. J., Gallin P. F., Quitkin F. M. Efficacy of brief, intense light exposure for treatment of winter depression. Psychopharmacol Bull. 1990;26(1):3–11. [PubMed] [Google Scholar]
  33. Terman M., Remé C. E., Rafferty B., Gallin P. F., Terman J. S. Bright light therapy for winter depression: potential ocular effects and theoretical implications. Photochem Photobiol. 1990 Jun;51(6):781–792. [PubMed] [Google Scholar]
  34. Vogel G. W. A review of REM sleep deprivation. Arch Gen Psychiatry. 1975 Jun;32(6):749–761. doi: 10.1001/archpsyc.1975.01760240077006. [DOI] [PubMed] [Google Scholar]
  35. Vogel G. W., Thurmond A., Gibbons P., Sloan K., Walker M. REM sleep reduction effects on depression syndromes. Arch Gen Psychiatry. 1975 Jun;32(6):765–777. doi: 10.1001/archpsyc.1975.01760240093007. [DOI] [PubMed] [Google Scholar]
  36. Volz H. P., Mackert A., Stieglitz R. D., Müller-Oerlinghausen B. Effect of bright white light therapy on non-seasonal depressive disorder. Preliminary results. J Affect Disord. 1990 May;19(1):15–21. doi: 10.1016/0165-0327(90)90004-r. [DOI] [PubMed] [Google Scholar]
  37. Wehr T. A. Manipulations of sleep and phototherapy: nonpharmacological alternatives in the treatment of depression. Clin Neuropharmacol. 1990;13 (Suppl 1):S54–S65. doi: 10.1097/00002826-199001001-00006. [DOI] [PubMed] [Google Scholar]
  38. Yerevanian B. I., Anderson J. L., Grota L. J., Bray M. Effects of bright incandescent light on seasonal and nonseasonal major depressive disorder. Psychiatry Res. 1986 Aug;18(4):355–364. doi: 10.1016/0165-1781(86)90020-x. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Psychiatry and Neuroscience are provided here courtesy of Canadian Medical Association

RESOURCES