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Published Online:https://doi.org/10.1024/1422-4917/a000442

Abstract.Objective: In recent years, bright light therapy (BLT) has been used to treat depression and to stabilize circadian rhythms. In this study we evaluated whether it is also helpful for comorbid symptoms of affective and behavioral dysregulation in depressive inpatients. Method: This article reports a secondary analysis comparing two subgroups of depressive participants with comorbid affective and behavioral dysregulation, captured with the dysregulation-profile of the Strengths and Difficulties Questionnaire (SDQ-DP; n = 16 vs. n = 11). Participants were randomly allocated to active BLT (10,000 lux) or control BLT (approx. 100 lux), and received 45 minutes of BLT for 2 weeks. SDQ-DP scores, sleep parameters, and circadian preference were assessed at baseline, after the intervention, and 3 weeks later. Results: No direct effects on SDQ-DP scores were observed. Sleep improved in both conditions. Only in the active BLT condition was a circadian phase advance found. Correlation and regression analyses indicated an indirect, circadian effect for improved SDQ-DP scores. Conclusions: The data of this pilot trial should be considered preliminary and merely descriptive. Further research is warranted.



Zusammenfassung.Fragestellung: Lichttherapie wird zur Behandlung von Depressionen sowie zur Stabilisierung des zirkadianen Rhythmus’ eingesetzt. Die vorliegende Pilotstudie untersucht die Wirksamkeit von Lichttherapie bei stationären depressiven Jugendlichen mit Symptomen komorbider affektiver und behavioraler Dysregulation. Methodik: In dieser Studie werden Ergebnisse einer Sekundäranalyse berichtet, in der zwei Gruppen von depressiven Patienten mit komorbiden Symptomen affektiver und behavioraler Dysregulation (erfasst durch das Dysregulations-Profil des Fragebogens für Stärken und Schwächen – SDQ-DP; n = 16 vs. n = 11) randomisiert entweder der aktiven Lichttherapie (10 000 lux) oder der Kontrollbedingung zugeordnet (ca. 100 lux) wurden. Alle erhielten täglich 45 Minuten morgendliche Lichttherapie über einen Zeitraum von zwei Wochen. Werte des SDQ-DP, Schlafparameter und die zirkadiane Präferenz wurden vor Beginn der Studie, nach zwei Wochen Intervention und weitere drei Wochen später erhoben. Ergebnisse: Symptome der affektiven und behavioralen Dysregulation zeigten keine direkten Verbesserungen als Folge der Lichttherapie. Schlafparameter zeigten Verbesserungen unabhängig der Lichtbedingung. Eine Vorverlagerung des zirkadianen Rhythmus’ wurde nur bei den Teilnehmern der aktiven Lichtbedingung gefunden. Die Ergebnisse der Korrelationen und Regressionen legen die Vermutung nahe, dass eine Verbesserung der Symptome affektiver und behavioraler Dysregulation durch einen indirekten, zirkadianen Weg möglich ist. Schlussfolgerungen: Weitere Studien sind notwendig, um die vorläufigen Ergebnisse dieser Pilotstudie zu replizieren.


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