title: Augmentation of light therapy in difficult-to-treat depressed patients: an open-label trial in both unipolar and bipolar patients.
abstract: OBJECTIVE
  We investigated the clinical benefits of bright light therapy (BLT) as an adjunct treatment to ongoing psychopharmacotherapy, both in unipolar and bipolar difficult-to-treat depressed (DTD) outpatients.
  
  
  METHODS
  In an open-label study, 31 depressed outpatients (16 unipolar and 15 bipolar) were included to undergo 3 weeks of BLT. Twenty-five completed the treatment and 5-week follow-up.
  
  
  METHODS
  Clinical outcomes were evaluated by the Hamilton Depression Rating Scale (HDRS). The Snaith-Hamilton Pleasure Scale and the Depression Retardation Rating Scale were used to assess changes in anhedonia and psychomotor retardation, respectively.
  
  
  RESULTS
  The adjunctive BLT seemed to influence the course of the depressive episode, and a statistically significant reduction in HDRS scores was reported since the first week of therapy. The treatment was well-tolerated, and no patients presented clinical signs of (hypo)manic switch during the overall treatment period. At the end of the study (after 5 weeks from BLT discontinuation), nine patients (36%, eight unipolar and one bipolar) still showed a treatment response. BLT augmentation also led to a significant improvement of psychomotor retardation.
  
  
  CONCLUSIONS
  BLT combined with the ongoing pharmacological treatment offers a simple approach, and it might be effective in rapidly ameliorating depressive core symptoms of vulnerable DTD outpatients. These preliminary results need to be confirmed in placebo-controlled, randomized, double-blind clinical trial on larger samples.
authors.affiliation: Institute of Psychiatry and Psychology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Camardese
authors.affiliation: Institute of Psychiatry and Psychology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Beniamino
authors.initials: B
authors.lastname: Leone
authors.affiliation: Institute of Psychiatry and Psychology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Serrani
authors.affiliation: Institute of Psychiatry and Psychology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Coco
authors.initials: C
authors.lastname: Walstra
authors.affiliation: Institute of Psychiatry and Psychology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Di Nicola
authors.affiliation: Institute of Neurology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Della Marca
authors.affiliation: Institute of Psychiatry and Psychology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Bria
authors.affiliation: Institute of Psychiatry and Psychology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Janiri
keywords: anhedonia; bipolar depression; light therapy; psychomotor dysfunction; unipolar depression