AIM: To compare adherence, response, and remission with light treatment in African-American and Caucasian patients with Seasonal Affective Disorder.METHODS: Seventy-eight study participants, agerange 18-64(51 African-...AIM: To compare adherence, response, and remission with light treatment in African-American and Caucasian patients with Seasonal Affective Disorder.METHODS: Seventy-eight study participants, agerange 18-64(51 African-Americans and 27 Caucasians)recruited from the Greater Baltimore Metropolitan area, with diagnoses of recurrent mood disorder with seasonal pattern, and confirmed by a Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders-Ⅳ, were enrolled in an open label study of daily bright light treatment. The trial lasted6 wk with flexible dosing of light starting with 10000 lux bright light for 60 min daily in the morning. At the end of six weeks there were 65 completers. Three patients had Bipolar Ⅱ disorder and the remainder had Major depressive disorder. Outcome measures were remission(score ≤ 8) and response(50% reduction)in symptoms on the Structured Interview Guide for the Hamilton Rating Scale for Depression(SIGH-SAD)as well as symptomatic improvement on SIGH-SAD and Beck Depression Inventory-Ⅱ. Adherence was measured using participant daily log. Participant groups were compared using t-tests, chi square, linear and logistic regressions. RESULTS: The study did not find any significant group difference between African-Americans and their Caucasian counterparts in adherence with light treatment as well as in symptomatic improvement.While symptomatic improvement and rate of treatment response were not different between the two groups,African-Americans, after adjustment for age, gender and adherence, achieved a significantly lower remission rate(African-Americans 46.3%; Caucasians 75%; P =0.02).CONCLUSION: This is the first study of light treatment in African-Americans, continuing our previous work reporting a similar frequency but a lower awareness of SAD and its treatment in African-Americans. Similar rates of adherence, symptomatic improvement and treatment response suggest that light treatment is a feasible, acceptable, and beneficial treatment for SAD in African-American patients. These results should lead to intensifying education initiatives to increase awareness of SAD and its treatment in African-American communities to increased SAD treatment engagement.In African-American vs Caucasian SAD patients a remission gap was identified, as reported before with antidepressant medications for non-seasonal depression, demanding sustained efforts to investigate and then address its causes.展开更多
基金Supported by The National Institute of Mental Health of the National Institutes of Health under award No.1R34MH073797-01A2(PI Postolache TT)in part by the National Institutes of Health award No.K12RR023250-01(PI Reeves GM)by the National Center for Research Resources of the National Institutes of Health award No.M01 RR 16500(General Clinical Research Program)
文摘AIM: To compare adherence, response, and remission with light treatment in African-American and Caucasian patients with Seasonal Affective Disorder.METHODS: Seventy-eight study participants, agerange 18-64(51 African-Americans and 27 Caucasians)recruited from the Greater Baltimore Metropolitan area, with diagnoses of recurrent mood disorder with seasonal pattern, and confirmed by a Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders-Ⅳ, were enrolled in an open label study of daily bright light treatment. The trial lasted6 wk with flexible dosing of light starting with 10000 lux bright light for 60 min daily in the morning. At the end of six weeks there were 65 completers. Three patients had Bipolar Ⅱ disorder and the remainder had Major depressive disorder. Outcome measures were remission(score ≤ 8) and response(50% reduction)in symptoms on the Structured Interview Guide for the Hamilton Rating Scale for Depression(SIGH-SAD)as well as symptomatic improvement on SIGH-SAD and Beck Depression Inventory-Ⅱ. Adherence was measured using participant daily log. Participant groups were compared using t-tests, chi square, linear and logistic regressions. RESULTS: The study did not find any significant group difference between African-Americans and their Caucasian counterparts in adherence with light treatment as well as in symptomatic improvement.While symptomatic improvement and rate of treatment response were not different between the two groups,African-Americans, after adjustment for age, gender and adherence, achieved a significantly lower remission rate(African-Americans 46.3%; Caucasians 75%; P =0.02).CONCLUSION: This is the first study of light treatment in African-Americans, continuing our previous work reporting a similar frequency but a lower awareness of SAD and its treatment in African-Americans. Similar rates of adherence, symptomatic improvement and treatment response suggest that light treatment is a feasible, acceptable, and beneficial treatment for SAD in African-American patients. These results should lead to intensifying education initiatives to increase awareness of SAD and its treatment in African-American communities to increased SAD treatment engagement.In African-American vs Caucasian SAD patients a remission gap was identified, as reported before with antidepressant medications for non-seasonal depression, demanding sustained efforts to investigate and then address its causes.
