OBJECTIVE Patients with bipolar disorder have recurrent major depression, residual mood symptoms, and limited treatment options. Building on promising pilot data, the authors conducted a 6-week randomized double-blind placebo-controlled trial to investigate the efficacy of adjunctive bright light therapy at midday for bipolar depression. The aims were to determine remission rate, depression symptom level, and rate of mood polarity switch, as well as to explore sleep quality. METHOD The study enrolled depressed adults with bipolar I or II disorder who were receiving stable dosages of antimanic medication (excluding patients with hypomania or mania, mixed symptoms, or rapid cycling). Patients were randomly assigned to treatment with either 7,000-lux bright white light or 50-lux dim red placebo light (N=23 for each group). Symptoms were assessed weekly with the Structured Interview Guide for the Hamilton Depression Scale With Atypical Depression Supplement (SIGH-ADS), the Mania Rating Scale, and the Pittsburgh Sleep Quality Index. Remission was defined as having a SIGH-ADS score of 8 or less. RESULTS At baseline, both groups had moderate depression and no hypomanic or manic symptoms. Compared with the placebo light group, the group treated with bright white light experienced a significantly higher remission rate (68.2% compared with 22.2%; adjusted odds ratio=12.6) at weeks 4-6 and significantly lower depression scores (9.2 [SD=6.6] compared with 14.9 [SD=9.2]; adjusted β=-5.91) at the endpoint visit. No mood polarity switches were observed. Sleep quality improved in both groups and did not differ significantly between them. CONCLUSIONS The data from this study provide robust evidence that supports the efficacy of midday bright light therapy for bipolar depression.

中文翻译：

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双相抑郁的辅助性强光疗法：随机双盲安慰剂对照试验。

目的躁郁症患者反复发作的严重抑郁症，残留的情绪症状和有限的治疗选择。作者基于有希望的试验数据，进行了为期6周的随机双盲安慰剂对照试验，以研究辅助强光疗法在中午治疗双相抑郁症的疗效。目的是确定缓解率，抑郁症状水平和情绪极性转换率，并探讨睡眠质量。方法该研究招募了接受稳定剂量抗躁狂药治疗的抑郁型I型或II型双相情感障碍成年人（不包括躁狂或躁狂，混合症状或快速骑自行车的患者）。患者被随机分配接受7,000-lux的明亮白光或50-lux的暗红色安慰剂光治疗（每组N = 23）。每周用《结构性访谈指南》（含非典型抑郁症补充剂的汉密尔顿抑郁量表（SIGH-ADS），躁狂评分量表和匹兹堡睡眠质量指数）对症状进行评估。缓解定义为SIGH-ADS评分为8或更低。结果基线时，两组均患有中度抑郁症，无轻躁狂或躁狂症状。与安慰剂光组相比，接受亮白光治疗的组在第4-6周的缓解率显着更高（68.2％比22.2％；调整的比值比= 12.6），而抑郁评分明显更低（9.2 [SD = 6.6 ]与14.9 [SD = 9.2]；校正后的β= -5.91）进行比较。没有观察到情绪极性转换。两组的睡眠质量均得到改善，并且两组之间的差异无显着性。