ImportanceSeasonal humor disorders are prone to have a link with daylight exposure. However, the effect of external light on nonseasonal disorders remains unclear. Evidence is lacking for the validity of bright light therapy (BLT) as an adjunctive treatment for these patients.ObjectiveTo assess BLT effectiveness as an adjunctive treatment for nonseasonal depressive disorders.Data SourcesIn March 2024, a comprehensive search was performed of publications in the MEDLINE, Embase, and Cochrane databases for randomized clinical trials (RCTs) evaluating BLT effects in patients with nonseasonal depression.Study SelectionRCTs published since 2000 were eligible. Comparisons between BLT and dim red light or antidepressant monotherapy alone were considered for inclusion.Data Extraction and SynthesisUsing the systematic review approach on RCTs published from January 1, 2000, through March 25, 2024, differences between patients treated with and without BLT were estimated using the Mantel-Haenszel method; heterogeneity was assessed using I2 statistics.Main Outcomes and MeasuresRemission of symptoms, response to treatment rates, and depression scales were assessed.ResultsIn this systematic review and meta-analysis of 11 unique trials with data from 858 patients (649 female [75.6%]), statistically significant better remission and response rates were found in the BLT group (remission: 40.7% vs 23.5%; odds ratio [OR], 2.42; 95% CI, 1.50-3.91; P <.001; I2 = 21%; response: 60.4% vs 38.6%; OR, 2.34; 95% CI, 1.46-3.75; P <.001; I2 = 41%). With BLT, subgroup analysis based on follow-up times also showed better remission (<4 weeks: 27.4% vs 9.2%; OR, 3.59; 95% CI, 1.45-8.88; P = .005; I2 = 0% and >4 weeks: 46.6% vs 29.1%; OR, 2.18; 95% CI, 1.19-4.00; P = .01; I2 = 47%) and response (<4 weeks: 55.6% vs 27.4%; OR, 3.65; 95% CI, 1.81-7.33; P <.001; I2 = 35% and >4 weeks: 63.0% vs 44.9%; OR, 1.79; 95% CI, 1.01-3.17; P = .04; I2 = 32%) rates.Conclusions and RelevanceResults of this systematic review and meta-analysis reveal that BLT was an effective adjunctive treatment for nonseasonal depressive disorders. Additionally, results suggest that BLT may improve the response time to the initial treatment.

中文翻译：

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亮光疗法治疗非季节性抑郁症


重要性季节性体液障碍容易与日光暴露有关。然而，外部光线对非季节性疾病的影响仍不清楚。尚无证据证明亮光疗法 （BLT） 作为这些患者的辅助治疗的有效性。目的评价 BLT 作为非季节性抑郁障碍辅助治疗的有效性。数据来源2024 年 3 月，对 MEDLINE、Embase 和 Cochrane 数据库中的出版物进行了全面检索，以评估 BLT 对非季节性抑郁症患者影响的随机临床试验 （RCT）。研究选择自 2000 年以来发表的 RCT 符合条件。考虑纳入 BLT 与暗红灯或单独抗抑郁药单药治疗之间的比较。资料提取和综合使用 2000 年 1 月 1 日至 2024 年 3 月 25 日发表的 RCT 系统评价方法，使用 Mantel-Haenszel 方法估计接受 BLT 治疗和不接受 BLT 治疗的患者之间的差异;使用 I2 统计量评估异质性。主要结局和指标评估症状缓解、对治疗率的反应和抑郁量表。结果在这项系统评价和荟萃分析中，对 11 项独特试验进行了 858 名患者（649 名女性 [75.6%]）的数据，发现 BLT 组的缓解率和反应率具有统计学意义（缓解率：40.7% 对 23.5%;比值比 [OR]，2.42;95% CI，1.50-3.91;P <。001;I2 = 21%;回答：60.4% 对 38.6%;OR，2.34;95% CI，1.46-3.75;P <。001;I2 = 41%）。使用 BLT 时，基于随访时间的亚组分析也显示更好的缓解 （<4 周：27.4% 对 9.2%;OR，3.59;95% CI，1.45-8.88;P = .005;I2 = 0% 且 >4 周：46.6% 对 29.1%;OR，2.18;95% CI，1.19-4.00;P = .01;I2 = 47%）和响应 （<4 周：55.6% 对 27.4%;OR，3.65;95% CI，1.81-7.33;P <。001;I2 = 35% 且 >4 周：63.0% 对 44.9%;OR，1.79;95% CI，1.01-3.17;P = .04;I2 = 32%）率。结论和相关性本系统评价和荟萃分析的结果显示，BLT 是非季节性抑郁症的有效辅助治疗。此外，结果表明 BLT 可能会缩短对初始治疗的反应时间。