A systematic review of light therapy on mood scores in major depressive disorder: light specification, dose, timing and delivery
Keywords:Bright Light, Depression, Natural Light, Non-Seasonal Affective Disorder, Phototherapy.
Background: Depression is associated with prolonged disability, mortality, and morbidity. Ninety percent of patients with Major depressive disorder (MDD) have sleep problems. Light therapy has been shown to be effective in treating sleep disorders and MDD. This review aims to assess the characteristics (colour, intensity), exposure dose (duration and timing) and the mode of delivery (light boxes, visor etc) of light in reducing depression, measured by mood scores, in MDD.
Method: a systematic literature search was performed on 6 major databases. The Physiotherapy Evidence Database (PEDro) Scale was applied to assess study quality.
Result: Twenty-four articles satisfied the inclusion criteria. Effective light intensities varied from 176 -10,000 lux. Effective modes of delivery included light box, table lamp, visor and light emitting diode (LED) glasses. Effective light colours included white, green, and blue with the white colour being the most commonly used. The duration of light treatment ranged from 30 min to 2 h, and evening light generally improved mood.
Conclusion: Light therapy, with exposure durations in the range of 30 min to 2 h per day, intensity range of 176 to 10,000 lux, in any of blue, green, or white light colour and exposure during morning mostly demonstrated a positive change in mood effects. Factors other than the light properties, such as anti-depressant medication use, depression episodes and severity, natural light exposure and sleep deprivation may confound the effects of light therapy.
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