Psychological Medicine



Controlled trial of bright light and negative air ions for chronic depression


NAMNI GOEL a1a2c1, MICHAEL TERMAN a2a3, JIUAN SU TERMAN a2, MARIANA M. MACCHI a2a3 and JONATHAN W. STEWART a2a3
a1 Department of Psychology, Wesleyan University, Middletown, CT, USA
a2 New York State Psychiatric Institute, New York, NY, USA
a3 Department of Psychiatry, Columbia University, New York, NY, USA

Article author query
goel n   [PubMed][Google Scholar] 
terman m   [PubMed][Google Scholar] 
su terman j   [PubMed][Google Scholar] 
macchi mm   [PubMed][Google Scholar] 
stewart jw   [PubMed][Google Scholar] 

Abstract

Background. This randomized controlled trial investigates the efficacy of two non-pharmacologic treatments, bright light and high-density negative air ions for non-seasonal chronic depression. Both methods have shown clinical success for seasonal affective disorder (SAD).

Method. Patients were 24 (75%) women and 8 (25%) men, ages 22–65 years (mean age±S.D., 43·7±12·4 years), with Major Depressive Disorder, Single Episode (DSM-IV code, 296.2), Chronic (episode duration [gt-or-equal, slanted]2 years). Patients were entered throughout the year and randomly assigned to exposure to bright light (10000 lux, n=10), or high-density (4·5×1014 ions/s flow rate, n=12) or low-density (1·7×1011 ions/s, n=10, placebo control) negative air ions. Home treatment sessions occurred for 1 h upon awakening for 5 weeks. Blinded raters assessed symptom severity weekly with the Structured Interview Guide for the Hamilton Depression Rating Scale – Seasonal Affective Disorder (SIGH-SAD) version. Evening saliva samples were obtained before and after treatment for ascertainment of circadian melatonin rhythm phase.

Results. SIGH-SAD score improvement was 53·7% for bright light and 51·1% for high-density ions v. 17·0% for low-density ions. Remission rates were 50%, 50% and 0% respectively. The presence or severity of atypical symptoms did not predict response to either treatment modality, nor were phase advances to light associated with positive response.

Conclusions. Both bright light and negative air ions are effective for treatment of chronic depression. Remission rates are similar to those for SAD, but without a seasonal dependency or apparent mediation by circadian rhythm phase shifts. Combination treatment with antidepressant drugs may further enhance clinical response.

(Published Online May 12 2005)


Correspondence:
c1 Department of Psychology, 207 High Street, Judd Hall, Wesleyan University, Middletown, CT 06459, USA. (Email: ngoel@wesleyan.edu)


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