Drop-out and mood improvement: a randomised controlled trial with light exposure and physical exercise [ISRCTN36478292].
BACKGROUND
Combining bright light exposure and physical exercise may be an effective way of relieving depressive symptoms. However, relatively little is known about individual factors predicting either a good response or treatment failure. We explored background variables possibly explaining the individual variation in treatment response or failure in a randomised trial.


METHODS
Participants were volunteers of working-age, free from prior mental disorders and recruited via occupational health centres. The intervention was a randomised 8-week trial with three groups: aerobics in bright light, aerobics in normal room lighting, and relaxation/stretching in bright light. Good response was defined as a 50% decrease in the symptom score on either the Hamilton Depression Rating Scale (HDRS) or 8-item scale of atypical symptoms. Background variables for the analysis included sex, age, body-mass index, general health habits, seasonal pattern, and sleep disturbances.


RESULTS
Complete data were received from 98 subjects (11 men, 87 women). Of them, 42 (5 men, 37 women) were classified as responders on the HDRS. Overall, light had a significant effect on the number of responders, as assessed with the HDRS (X2 =.02). The number needed to treat (NNT) for light was 3.8.


CONCLUSIONS
We investigated the effect of bright light and exercise on depressive symptoms. Problems with sleep, especially initial insomnia, may predict a good response to treatment using combined light and exercise. Bright light exposure and physical exercise, even in combination, seem to be well tolerated and effective on depressive symptoms.
Department of Mental Health and Alcohol Research, Unit for Epidemiology and Genetics of Mental Health, National Public Health Institute, Helsinki, Finland. sami.leppamaki@ktl.fi
Sami
S
Leppämäki
Jari
J
Haukka
Jouko
J
Lönnqvist
Timo
T
Partonen
D000328:Adult; D003131:Combined Modality Therapy; D003866:Depressive Disorder / Q000523:psychology / Q000628:therapy*; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D010352:Patient Dropouts; D010789:Phototherapy; D012064:Relaxation Therapy; D016574:Seasonal Affective Disorder / Q000523:psychology / Q000628:therapy; D016896:Treatment Outcome