Objective: Patients with bipolar disorder have recurrent major depression, residual mood symptoms, and limited treatment options. Building on promising pilot data, the authors conducted a 6-week randomized double-blind placebo-controlled trial to investigate the efficacy of adjunctive bright light therapy at midday for bipolar depression. The aims were to determine remission rate, depression symptom level, and rate of mood polarity switch, as well as to explore sleep quality.
Method: The study enrolled depressed adults with bipolar I or II disorder who were receiving stable dosages of antimanic medication (excluding patients with hypomania or mania, mixed symptoms, or rapid cycling). Patients were randomly assigned to treatment with either 7,000-lux bright white light or 50-lux dim red placebo light (N=23 for each group). Symptoms were assessed weekly with the Structured Interview Guide for the Hamilton Depression Scale With Atypical Depression Supplement (SIGH-ADS), the Mania Rating Scale, and the Pittsburgh Sleep Quality Index. Remission was defined as having a SIGH-ADS score of 8 or less.
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The participant will justify the use of bright light therapy for treatment of depression in bipolar disorder.
This program is designed for all psychiatrists in clinical practice, residents in Graduate Medical Education programs, medical students interested in psychiatry, and other physicians who wish to advance their current knowledge of clinical medicine.
Duration: 1 hour
Begin Date: February 1, 2018
End Date: January 31, 2020
In order to earn CME credit, subscribers should read through the material presented in the article. After reading the article, complete the quiz and submit your evaluation and study hours (up to 1 AMA PRA Category 1 Credit™). A score of 60% or higher is required to receive credit.
The American Psychiatric Association (APA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The APA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Title: Adjunctive Bright Light Therapy for Bipolar Depression: A Randomized Double-Blind Placebo-Controlled Trial
Authors: Dorothy K. Sit, M.D., James McGowan, B.A., Christopher Wiltrout, B.S., Rasim Somer Diler, M.D., John (Jesse) Dills, M.L.S., James Luther, M.A., Amy Yang, M.S., Jody D. Ciolino, Ph.D., Howard Seltman, M.D., Ph.D., Stephen R. Wisniewski, Ph.D., Michael Terman, Ph.D., Katherine L. Wisner, M.D., M.S.
Affiliations: From the Department of Psychiatry and Behavioral Sciences and the Department of Preventive Medicine–Biostatistics Division, Feinberg School of Medicine, Northwestern University, Chicago (D.K.S., K.L.W., A.Y., J.D.C.); the Department of Psychiatry, University of Pittsburgh School of Medicine and University of Pittsburgh Medical Center, Pittsburgh (J.M.G., C.W., R.S.D.); the Epidemiological Data Center, Graduate School of Public Health, University of Pittsburgh, Pittsburgh (J.D., J.L., S.R.W.); the Department of Statistics, Carnegie Mellon University, Pittsburgh (H.S.); and the Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York (M.T.).
Disclosures: The authors report no financial relationships with commercial interests.
Discussion of unapproved or investigational use of products*: No.
*APA policy requires disclosure by CME authors of unapproved or investigational use of products discussed in CME programs. Off-label use of medications by individual physicians is permitted and common. Decisions about off-label use can be guided by scientific literature and clinical experience.
Robert Freedman, M.D. (Editor-in-Chief, AJP); Susan K. Schultz, M.D. (Deputy Editor, AJP); Michael D. Roy (Editorial Director, AJP); Michael A. Pogachar (Online Content Manager, Journals).
Dr. Schultz has received research support from the Alzheimer’s Disease Cooperative Study for projects conducted in partnership with Toyama Chemical Company and in partnership with Eli Lilly and Company. Dr. Freedman, Mr. Roy, and Mr. Pogachar report no financial relationships with commercial interests.
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