Depressive mood and circadian rhythms disturbances as outcomes of seasonal affective disorder treatment: A systematic review

Sep 2, 2018Journal of affective disorders

Changes in mood and daily body clock after treatment for seasonal affective disorder

AI simplified

Circadian Biology on OpenScience ↗PubMed ↗DOI ↗

Abstract

Bright light therapy (BLT) is associated with improved sleep-wake disorders and mood symptoms in seasonal affective disorder (SAD) based on a review of 40 eligible studies.

The evidence regarding treatment outcomes for circadian disturbances in SAD is not robust.
BLT is shown to phase-advance delayed circadian rhythms.
Both BLT and selective serotonin reuptake inhibitors (SSRIs) demonstrate efficacy in alleviating mood symptoms.
The relationship between mood symptom improvements and changes in circadian outcomes appears to be controversial.
Included studies exhibited considerable methodological heterogeneity and small sample sizes.

AI simplified

BACKGROUND: The present systematic review was aimed at critically summarizing the evidence about interventions focused on circadian rhythms and mood symptoms in seasonal affective disorder (SAD).

METHODS: A systematic search of the electronic databases PUBMED, PsycINFO and Web of Science was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Original papers reporting data about the effects of treatments on both mood and circadian rhythms disturbances in SAD patients were considered for inclusion. The quality of the evidence provided by the eligible studies was assessed using the Revised Cochrane Risk of Bias Tool (RoB 2.0) and the Cochrane Risk of Bias in Non-Randomized Studies of Interventions Tool (ROBINS-I).

RESULTS: Forty papers were deemed eligible for the systematic review. The evidence of treatment outcomes referring to circadian disturbances was not robust. Despite this, bright light therapy (BLT) demonstrates to phase-advance delayed rhythms and to improve sleep-wake disorders. As for mood symptoms, both BLT and selective serotonin reuptake inhibitors (SSRIs) show evidence of efficacy. The possible connection between improvements of mood symptoms and changes in circadian outcomes seems controversial.

LIMITATIONS: The included studies presented considerable methodological heterogeneity, small sample sizes and non-optimal sample selection.

CONCLUSIONS: The effectiveness of BLT in depressive symptoms and circadian disturbances of SAD was outlined by the present systematic review. The evidence about other biological and pharmacological treatments, although promising, should be replicated. A multifactorial etiopathogenesis could explain the heterogeneous clinical presentations of SAD and the complex link between mood and circadian symptoms.

Full Text

Full text is available at the source.

View full text (XML) ↗View full text ↗

Depressive mood and circadian rhythms disturbances as outcomes of seasonal affective disorder treatment: A systematic review

Abstract

Full Text

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the circadian biology brief

Abstract

Full Text

Related papers

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the circadian biology brief