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Patterns of depressive symptom remission during the treatment of seasonal affective disorder with cognitive‐behavioral therapy or light therapy
Author(s) -
Meyerhoff Jonah,
Young Michael A.,
Rohan Kelly J.
Publication year - 2018
Publication title -
depression and anxiety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.634
H-Index - 129
eISSN - 1520-6394
pISSN - 1091-4269
DOI - 10.1002/da.22739
Subject(s) - light therapy , cognitive behavioral therapy , psychology , clinical psychology , major depressive disorder , cognition , cognitive therapy , depression (economics) , psychiatry , medicine , psychotherapist , mood , economics , macroeconomics
Background To elucidate mechanisms related to remission in winter seasonal affective disorder (SAD), we explored the course of individual depressive symptom offset across two distinct treatment modalities that show comparable outcomes at treatment endpoint: cognitive‐behavioral therapy for SAD (CBT‐SAD) and light therapy (LT). Method One hundred seventy‐seven adults with SAD in a depressive episode were randomized to 6‐weeks of CBT‐SAD ( n = 88) or LT ( n = 89). Symptoms were assessed via the 29‐item Structured Interview Guide for the Hamilton Rating Scale for Depression‐SAD Version (SIGH‐SAD) at pretreatment and weekly during treatment. Survival analyses were conducted for the 17 SIGH‐SAD items endorsed by more than 40 participants at pretreatment. Within each of the included symptoms, data from participants who endorsed the symptom at pretreatment and who had 3 or fewer weeks missing were included. Results For most (13/17; 76%) symptoms, CBT‐SAD and LT did not differ in time to remission. However, for four symptoms (early insomnia, psychic anxiety, hypersomnia, and social withdrawal), LT led to symptom remission more quickly than CBT‐SAD. Conclusions Symptom remission progressed comparably across CBT‐SAD and LT for most symptoms. Despite the fact that the two treatments led to similar remission rates and improvements at treatment endpoint, for early insomnia, psychic anxiety, hypersomnia, and social withdrawal, LT led to symptom remission faster than CBT‐SAD. These results suggest different mechanisms and pathways to the same therapeutic end. Speedier remission of early insomnia and hypersomnia is consistent with the theory that SAD is related to a pathological circadian phase‐shift that can be corrected with LT.