title: A randomized, double-blind, placebo-controlled study of light therapy for antepartum depression.
abstract: OBJECTIVE
  Affective disorder during pregnancy is a common condition requiring careful judgment to treat the depression while minimizing risk to the fetus. Following up on promising pilot trials, we studied the efficacy of light therapy.
  
  
  METHODS
  Twenty-seven pregnant women with nonseasonal major depressive disorder according to DSM-IV (outpatients, university polyclinic) were randomly assigned to 7,000 lux fluorescent bright white or 70 lux dim red (placebo) light administered at home in the morning upon awakening for 1 h/d in a 5-week double-blind trial carried out between October 2004 and October 2008. Clinical state was monitored weekly with the 29-item Structured Interview Guide for the Hamilton Depression Rating Scale (HDRS) with Atypical Depression Supplement (SIGH-ADS). Changes of rating scale scores over time were analyzed with the general linear model. Differences from baseline of SIGH-ADS and 17-item HDRS scores at every time point were the dependent variables, time was the within-subjects factor, and treatment was the between-subjects factor. The model also included baseline score of depression and gestational age at intervention start.
  
  
  RESULTS
  The superiority of bright light over dim light placebo was shown for both SIGH-ADS (R² = 0.251; F(3,23) = 3.91; P < .05) and HDRS (R² = 0.338; F(3,23) = 5.42; P < .01) when analyzing the week-by-week change from baseline, and HDRS scores showed a significant interaction of treatment with time (F(4,92) = 2.91; P < .05). Categorical analysis revealed that the response rate (HDRS ≥ 50% improvement) at week 5 was significantly greater for bright light (81.3%, n = 16) than for placebo light (45.5%, n = 11) (P < .05). Remission (final score ≤ 8) was attained by 68.6% versus 36.4%, respectively (P < .05). Expectation ratings did not differ significantly between groups.
  
  
  CONCLUSIONS
  Bright white light treatment for 5 weeks improved depression during pregnancy significantly more than placebo dim red light. The study provides evidence that light therapy, a simple, cost-effective antidepressant modality with minimal side effects for the mother and no known risk for the unborn child, may be a useful nonpharmacologic approach in this difficult situation.
  
  
  BACKGROUND
  clinicaltrials.gov Identifier: NCT01043289.
authors.affiliation: Centre for Chronobiology, Psychiatric Hospitals of the University of Basel, Wilhelm Klein Strasse 27, CH-4012 Basel, Switzerland. anna.wirz-justice@unibas.ch
authors.forename: Anna
authors.initials: A
authors.lastname: Wirz-Justice
authors.forename: Anja
authors.initials: A
authors.lastname: Bader
authors.forename: Ulrike
authors.initials: U
authors.lastname: Frisch
authors.forename: Rolf-Dieter
authors.initials: RD
authors.lastname: Stieglitz
authors.forename: Judith
authors.initials: J
authors.lastname: Alder
authors.forename: Johannes
authors.initials: J
authors.lastname: Bitzer
authors.forename: Irene
authors.initials: I
authors.lastname: Hösli
authors.forename: Sandra
authors.initials: S
authors.lastname: Jazbec
authors.forename: Francesco
authors.initials: F
authors.lastname: Benedetti
authors.forename: Michael
authors.initials: M
authors.lastname: Terman
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Wisner
authors.forename: Anita
authors.initials: A
authors.lastname: Riecher-Rössler
mesh_terms: D000293:Adolescent; D000328:Adult; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D010555:Personality Inventory / Q000706:statistics & numerical data; D010789:Phototherapy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D011594:Psychometrics; D013557:Switzerland; D055815:Young Adult