Bright Light Therapy as Add-On to Inpatient Treatment in Youth With Moderate to Severe Depression: A Randomized Clinical Trial.
Study Goal
The researchers aimed to determine whether morning bright light therapy could enhance the effects of standard inpatient treatment for major depressive disorder in adolescents.
Results Summary
The study found no significant difference in symptom reduction between bright light therapy and placebo red light therapy, with both groups showing similar improvements. Serious adverse events were rare and not linked to the treatment.
Population
Adolescents aged 12-18 with moderate or severe major depressive disorder, treated as inpatients at German university hospitals.
Effective Dosage
10,000 lux (bright light therapy) or 100 lux (placebo red light), up to 20 sessions.
Duration
4 weeks.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
morning bright light therapy | no change | Beck Depression Inventory-II (BDI-II) score | adolescent inpatients with moderate or severe major depressive disorder | no significant group × time effect | had no impact on this change | #1 |
multimodal inpatient treatment as usual | decrease | Beck Depression Inventory-II (BDI-II) score | adolescent inpatients with moderate or severe major depressive disorder | mean of -7.5 (95% CI, -9.0 to -6.0; Hedges g = 0.71) | significantly reduced | #2 |
bright light therapy | no change | - | adolescent inpatients with moderate or severe major depressive disorder | - | did not indicate superiority | #3 |
placebo red light therapy | no change | - | adolescent inpatients with moderate or severe major depressive disorder | - | did not indicate superiority | #4 |
treatment as usual | no change | - | adolescent inpatients with moderate or severe major depressive disorder | - | benefited equally | #5 |
treatment as usual | decrease | symptom | adolescent inpatients with moderate or severe major depressive disorder | - | showing relevant symptom reduction | #6 |
IMPORTANCE: Major depressive disorder is one of the most common mental disorders among adolescents, entailing severe, long-term psychosocial impairment and a high risk of chronicity. In view of the large number of patients requiring treatment, along with insufficient treatment responses with small effect sizes, innovative adjunctive treatment strategies are urgently needed. OBJECTIVE: To investigate whether the effect of adolescent psychiatric inpatient treatment as usual for major depressive disorder can be enhanced by simultaneous use of morning bright light therapy. DESIGN, SETTING, AND PARTICIPANTS: This was a double-blind, placebo-controlled randomized parallel-group trial with enrollment between March 2018 and November 2020 and follow-up completed in May 2021. The study took place among inpatients at 4 university hospitals for child and adolescent psychiatry across Germany. Of 248 eligible youth aged 12 to 18 years fulfilling ICD-10 criteria for major depressive disorder, 227 were randomized to bright light therapy (n = 116) or placebo red light (n = 111); 151 participants completed the study. INTERVENTIONS: Up to 20 sessions of either morning bright light therapy with an intensity of 10 000 lux or placebo red light (100 lux) in addition to multimodal inpatient treatment as usual over 4 weeks. MAIN OUTCOMES AND MEASURES: The primary outcome was the change in Beck Depression Inventory-II (BDI-II) score from baseline to posttreatment in the intention-to-treat sample. RESULTS: Among the 224 patients included in the intention-to-treat analyses (192 girls and 32 boys; mean [SD] age, 15.5 [1.4] years), the mean (SD) BDI-II score at baseline was 37.3 (8.7). BDI-II scores were significantly reduced after 4 weeks (postassessment) by a mean of -7.5 (95% CI, -9.0 to -6.0; Hedges g = 0.71). Bright light therapy had no impact on this change (no significant group × time effect). Loss to follow-up was 31% (n = 69) at 16 weeks and 49% (n = 110) at 28 weeks. There were 10 serious adverse events throughout the whole trial, which were not considered related to study treatment. CONCLUSIONS AND RELEVANCE: The findings in this study did not indicate superiority of bright light therapy over placebo red light therapy in a large sample of adolescent inpatients with moderate or severe major depressive disorder. Both groups benefited equally from treatment as usual, showing relevant symptom reduction. TRIAL REGISTRATION: German Clinical Trials Register: DRKS00013188.