Background Retrospective studies conducted in psychiatric wards have indicated a shorter duration of stay for depressed inpatients in bright compared to dim daylight-exposed rooms, pointing to a possible antidepressant effect of daylight conditions. Dynamic LED lighting, aiming to mimic daylight conditions, are currently been installed in several hospitals, but their feasibility is poorly investigated. Methods To investigate the feasibility of these systems, we developed and installed a LED-lighting system in four rooms in a psychiatric inpatient ward. The system could function statically or dynamically regarding light intensity and colour temperature. The system consisted of (A) a large LED luminaire built into the window jamb mimicking sunlight reflections, (B) two LED light luminaires in the ceiling and (C) a LED reading luminaire. In the static mode, the systems provided constant light from A and B. In the dynamic mode, the system changed light intensity and colour temperature using A, B and C. Patients with unipolar or bipolar depression were randomised to dynamic or static LED lighting for 4 weeks, in addition to standard treatment. Primary outcome was the rate of patients discontinuing the trial due to discomfort from the lighting condition. Secondary outcomes were recruitment and dropout rates, visual comfort, depressive symptoms and suicidal ideation. Results No participants discontinued due to discomfort from the LED lighting. Recruitment rate was 39.8%, dropout from treatment rates were 56.3% in the dynamic group and 33.3% in the static group. 78.1% in the dynamic group were satisfied with the lighting compared with 71.8% in the static group. Discomfort from the light (glare) was reported by 11.5% in the dynamic group compared to 5.1% in the static group. Endpoint suicidal scores were 16.8 (10.4) in the dynamic and 16.3 (14.9) in the static group. The lighting system was 100% functional. The light sensor system proved unstable. Conclusion Dropout from treatment was high primarily due to early discharge and with a lack of endpoint assessments. The feasibility study has influenced an upcoming large-scale dynamic lighting efficacy trial where we will use a shorter study period of 3 weeks and with more emphasis on endpoint assessments. The lighting was well tolerated in both groups, but some found intensity too low in the evening. Thus, we will use higher intensity blue-enriched light in the morning and higher intensity amber (blue-depleted) light in the evening in the upcoming study. The light sensor system needs to be improved. Trial registration ClinicalTrials.gov: NCT03363529.

中文翻译：

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用于抑郁住院患者的动态 LED 灯与静态 LED 灯：随机可行性试验的结果。

背景 在精神科病房进行的回顾性研究表明，与昏暗日光照射的房间相比，抑郁症住院患者的住院时间更短，这表明日光条件可能具有抗抑郁作用。旨在模拟日光条件的动态 LED 照明目前已在多家医院安装，但对其可行性的研究很少。方法 为了研究这些系统的可行性，我们在精神病院的四个房间内开发并安装了一个 LED 照明系统。该系统可以根据光强度和色温静态或动态运行。该系统由 (A) 一个内置在窗框内模仿阳光反射的大型 LED 灯具、(B) 天花板上的两个 LED 灯具和 (C) 一个 LED 阅读灯具组成。在静态模式下，系统从 A 和 B 提供恒定的光。在动态模式下，系统使用 A、B 和 C 改变光强度和色温。单相或双相抑郁症患者被随机分配到动态或静态 LED 照明4周，除标准治疗外。主要结果是患者因照明条件不适而中止试验的比例。次要结果是招募和辍学率、视觉舒适度、抑郁症状和自杀意念。结果 没有参与者因 LED 照明的不适而停药。动态组入组率为39.8%，治疗退出率为56.3%，静态组为33.3%。动态组78.1%的人对照明感到满意，而静态组为71.8%。据报道，动态组的光（眩光）不适感为 11.5%，而静态组为 5.1%。动态组的终点自杀得分为 16.8 (10.4)，静态组为 16.3 (14.9)。照明系统 100% 正常运行。光传感器系统被证明是不稳定的。结论 治疗中的辍学率很高，主要是由于早期出院和缺乏终点评估。可行性研究影响了即将进行的大规模动态照明功效试验，我们将使用更短的 3 周研究期，并更加强调终点评估。两组的照明都能很好地耐受，但有些人发现晚上的强度太低。因此，在即将进行的研究中，我们将在早晨使用更高强度的富含蓝色的光，并在晚上使用更高强度的琥珀色（蓝色耗尽）光。光传感器系统需要改进。试验注册 ClinicalTrials.gov：NCT03363529。