The Effectiveness of Light Therapy - Assignment Example

? Alterative Therapy Annotated Bibliography Lam, R., Levitt, A., Levitan, R., Enns, M., Morehouse, R., Michalak, E., et al. (2006). The Can-SAD Study: A Randomized Controlled Trial of the Effectiveness of Light Therapy and Fluoxetine in Patients With Winter Seasonal Affective Disorder. Am J Psychiatry , 163, 805-812. Different doctors who have specialized in different fields wrote this article. These doctors have vast experience of therapy and antidepressants, as they have tried to compare these two studies in this article. The researchers of this article are M.D., F.R.C.P., M.B.B.S, Ph.D., and M.D.C.M. This shows that these authors have the commitment to explore the field of light therapy as not many studies have been conducted to explore the relationship and outcomes of light therapy with antidepressants. This study has been conducted to compare antidepressant and light therapy in a single trial. The controlled trial was conducted in different centers of Canada where three patients of depressive disorder had to face DSM-IV criteria. After monitoring them for one week, the qualified patients further took eight weeks treatment. A fluorescent light box was used for half hour on morning time in which light therapy was applied. There were 96 patients used for this experiment in which results showed that improvement was seen only for one week. The results reveal that there is no significant difference between the effect of light therapy and antidepressant. The major limitation of this study was that there was no double-placebo condition as this study supports treatments of seasonal effective disorder. Tsai, Y., Wong, T., Juang, Y., & Tsai, H. (2004). The effects of light therapy on depressed elders. International Journal of Geriatric , 19, 545-548. Tsai, Wong, Juang, and Tsai Hsiu-Hsin conducted this research to find out the effect of therapy on depressed elders. The researchers Yun-Fang Tsai and Hsiu-Hsin Tsai belong to school of nursing in Taiwan; Thomas Wong is from the school of nursing in Hong Kong, while Yeong-Yuh Juang works in the department of Psychiatry in Taiwan. The research is conducted because elderly depression has become a major issue and there are no past studies that are conducted for examining light therapy effect on elderly depressions in tropical areas. For this purpose, the old patients that were hospitalized because of depression in a subtropical climate areas are selected. The experiment was conducted in such a way that patients had to sit in front of a light box where they faced 5000 lux early in the morning. This experiment lasted for 5 days in which time duration was 50 minutes each day. Treatment was only given to the experimental group, while there was no treatment for controlling group. The results of this experiment stated that there was a significant reduction of depression on the patients after experiment, but no effect was found on the control group. This research is very helpful for the elders as they can use light therapy for reducing their depression and it has a positive impact on them. The major limitation of this study was that only one hospital was selected for this experiment therefore, different hospitals could be used in future. Terman, M., & Terman, J. (2005). Light Therapy for Seasonal and Nonseasonal Depression:Efficacy, Protocol, Safety, and Side Effects. CNS Spectrums , 10 (8), 647-663. Dr. M Turman and Dr. J. Turman wrote this article in 2005, which was approved by National Institute of Mental Health. Dr. M. Turman teaches Clinical Psychology at College of Physicians and Surgeons at Colombia University whereas Dr. J. Turman is working as a scientist at New York State Psychiatric Institute. This research is based on different previous studies in which Seasonal Affective Disorder (SAD) is examined for the bright therapy. Many doctors belonging to different fields believe that bright therapy is a strong and agile activity for patients in which there is no role of medicines. The role of light therapy has increased beyond SAD to non-seasonal depression as it is playing an effective role for patients who are facing sleep disorders and bulimia nervosa. This therapy has been able to treat inpatients and outpatients in a similar manner despite the fact that different people requires different timings for treatment. The authors have found out from their previous experience that light therapy has no side effect as compared to medicines, which can cause positive or negative effects on patients. Therefore, it has been concluded from the past studies and different experiments that light therapy is useful for antidepressant medication and doctors should consider this therapy when there is a delay in the response of antidepressant. Wileman, S., Andrew, J., Howie, F., Cameron, I., McCormack, K., Naji, S., et al. (2001). Light therapy for seasonal affective disorder in primary care:Randomised controlled trial. The British Journal of Psychiatry , 178, 311-316. The researchers of this study have a vast clinical experience of light therapy and they have made an effort to conduct research on light therapy for primary care, as not many studies have been conducted in this regard. The purpose of this research is to examine light therapy on primary care, and 57 participants were selected for conducting the research that has faced seasonal affective disorder. The participants faced dim red and white light for four weeks and assessment was made on the baseline expectation of treatment. The result of the experiment is based on the guide for structured interview where depression scale is used. The two groups selected for the research showed downfall in their scores, and there was no difference in response proportion of both groups. There was also no difference in the expected treatments of these participants, and the result of this research showed that patients of primary care have shown significant improvement after taking light therapy, but there is no difference of improvement for the light or bright white light. The major limitation found in this research is the sample size as the number of participants was very low and it is difficult to find out low difference in small sample size. Moreover, primary care patients were not aware of light therapy therefore, it was difficult to make the result more valid. Rosenthal, N., Sack, D., Gillin, C., Lewy, A., Goodwin, F., Davenport, Y., et al. (1984). Seasonal Affective Disorder. Arch Gen Psychiatry , 72-80. The researchers have tried to explain seasonal disorder that this disease comes into patient every year at the same time. They have explained strong association between seasons and depression. The reason that this research is conducted is that there are not many comprehensive studies that are carried out for patients who annually faced this problem. The researchers selected 29 patients for carrying this research who regularly experienced seasonal disorder on winter and fall, as depression was again evaluated on following spring and summer. The researchers attempted to modify depression of patients by calculating conditions of environmental lighting. Two lights were used on the patients where one was full spectrum white light whereas other was dim yellow light. These lights were placed vertically or horizontally on the rooms of the patient, and they were randomly selected to live in different lighting rooms. The patients had to sit in the room six hours every day in which they have to sit for three hours before dusk and three hours before dawn. The result of this research shows that environmental light can be used effectively in seasonal affective disorder, as there is a significant difference on patients after using these lights. The presence of SAD in animals is also useful for understanding seasonal disorder and approach of treatment can be improved by this method. Assessment of Findings and Conclusions Reached in Studies All the five studies selected in this assessment relate to the use and significance of light therapy and its effectiveness in treating patients suffering from seasonal disorders. For the purpose of assessing these studies, findings obtained and conclusions reached by the researchers of the studies are being discussed as under. Among the five studies selected, two are clinical trials. The first clinical trial, conducted by Tsai, Wong, Juang and Tsai (2004), found that the treatment given to patients through light therapy helped in bringing down the symptoms which caused depression. The researchers used an experimental design and worked on two different groups, i.e. experimental group and control group. The light therapy used in the trial was applied for 50 minutes on each participant and for 5 days in a row. The researchers have argued in their discussion that young people are able to deal with insufficient exposure to day light, however, with regard to elderly individuals, day light exposure is important, particularly in regions where there is scarcity of sunlight during season change. Identifying this problem and corroborating it with the findings of the study, light therapy appears to be an appealing solution, which has shown to deter depressive symptoms in elderly people. On the other hand, the clinical trial carried out by Lam, Levitt, Levitan, Enns, Morehouse, Michalak and Tam (2006) aimed at determining the comparative effectiveness of ‘light therapy” which is used to reduce disorders caused by seasonal changes and ‘antidepressants’ named Fluoxetine. The researchers found that apart from two major findings, there were no major differences between the use of two options used to cure seasonal disorders. The two differences identified, in the efficacy of light therapy and antidepressant, were that light therapy produced quicker results and lower side effects were recorded for it as compared to antidepressant. The subjects, who were treated in the trial through antidepressant, were seen as more agitated, suffering from sleeplessness and palpitations, in comparison with the subjects who received light therapy. However, the researchers also noted that the two modes of treatment showed equally good tolerance levels with no significant variations in overall adversities noted. Thus keeping in view these findings, the authors recommended that any of these two options can be used to treat seasonal disorders. Apart from this, the use, efficacy and impact of light therapy for curing seasonal and non-seasonal depression disorders have been reviewed by Terman and Terman (2005). In their review of effectiveness of light therapy, Terman and Terman (2005) assessed the findings obtained from the research works conducted in the past. The authors categorized their review into two parts; the first related to seasonal disorders and the second related to non-seasonal disorders. While reviewing the studies and findings from the studies and trials conducted in past, Terman and Terman (2005) noted that there may be side effects by the use of light therapy but such effects are not as severe as they are in the cases of other curing options. Moreover, the researchers also found that the use of light therapy accelerated the cure of disorders caused by seasonal changes. Wileman, Eagles, Andrew, Howie, Cameron, McCormack and Naji (2001) also carried out a study on the efficacy of light therapy in relation to disorders caused by seasonal changes. While identifying the literature gap of no research work conducted in primary care with regard to light therapy use, the aim of the study was set to evaluate the use of light therapy in primary care. The researchers included 57 individuals, who had seasonal disorders, as participants in the study and were subjected to two different kinds of lights, i.e. bright light and dim light. In their findings, the researchers noted that the symptoms of seasonal disorders were reduced by 40 percent in both groups. The conclusions reached in the research showed that the primary care patients having seasonal affective disorders indicated improvement in their disorders caused by seasonal changes after light therapy. However, it was also found that the use of dim light was more effective as compared to the use of bright light while treating the primary care patients. Thus the findings obtained in this study also matched with those mentioned earlier, i.e. light therapy is effective in curing seasonal affected disorders. Rosenthal, Sack, Gillin, Lewy, Goodwin, Davenport, Mueller, Newsome and Wehr (1984) carried out a study titled “Seasonal Affective Disorder”. This is one of the five studies which have been selected in this assessment report for efficacy of light therapy. The study is based on understanding the elements of the disorder and how it impacts the subject in seasonal transformation. 29 patients were tested who were influenced by the seasonal affective disorder. The study projected that the subjects were carrying different problems at the time of SAD. Some of them were carrying bipolar affective disorder and few were found with depression stages at the time of seasonal affective disorder. The study tested the relationship of seasonal affective disorder with other psychological disorders like mania, bipolar or depression. This was to check the association of parallel disorders with SAD. The study analyzed the figure of 29 patients at one time of a year. The study projected the analysis of seasonal affective syndrome, which it suggests to be a chronic disorder which brings out depression for the patient at one specific time of the year. Understanding the disorder the analysts were able to apply the lighting therapy to 29 patients who were victimized by such chronic syndrome. The effort in the study was to engage environmental lighting methods in a way that patients’ depressions, bipolar and mania can be turned down and SAD becomes recoverable with an aspect of time. The study adapted the method of quantitative research in which patients suffering from seasonal changes disorders were observed and tested on different occasions and on different environmental lighting therapies. The therapies included two types of lighting environments, one of a bright fluorescent lighting pattern and second of a dim lighting pattern for the alternate therapy mode. The patterns were taken off to the patients’ homes to apply the method in both lighting modes. This allowed the researchers to test the efficacy of light therapy in two different lightening environments. The findings obtained in the studies and trials discussed in the above discussion show that light therapy can be used in treating patients suffering from seasonal affected disorders, particularly those who are suffering from depression. In nursing, light therapy can therefore be used as an important tool for curing the patients who have gone into a state of mental depression. As concluded in the research work by Lam, Levitt, Levitan, Enns, Morehouse, Michalak and Tam (2006), antidepressants are effective in treating seasonal affected depression disorders but they also have some side effects, such as agitation, lack of sleep, etc. Keeping these findings in view, it would be sensible to choose light therapy in nursing practice. Furthermore, the role of light therapy, as suggested by the clinical trials discussed in this assessment, has been effective. Apart from this, it would be useful to make use of bright light instead of a dim light to treat the patients because of its more effectiveness reported in the study conducted by Wileman, Eagles, Andrew, Howie, Cameron, McCormack and Naji (2001). In short, light therapy is effective in treating depression disorders and shall be given a role in nursing practices. List of References Lam, R., Levitt, A., Levitan, R., Enns, M., Morehouse, R., Michalak, E., et al. (2006). The Can-SAD Study: A Randomized Controlled Trial of the Effectiveness of Light Therapy and Fluoxetine in Patients With Winter Seasonal Affective Disorder. Am J Psychiatry , 163, 805-812. Tsai, Y., Wong, T., Juang, Y., & Tsai, H. (2004). The effects of light therapy on depressed elders. International Journal of Geriatric , 19, 545-548. Terman, M., & Terman, J. (2005). Light Therapy for Seasonal and Nonseasonal Depression:Efficacy, Protocol, Safety, and Side Effects. CNS Spectrums , 10 (8), 647-663. Wileman, S., Andrew, J., Howie, F., Cameron, I., McCormack, K., Naji, S., et al. (2001). Light therapy for seasonal affective disorder in primary care:Randomised controlled trial. The British Journal of Psychiatry , 178, 311-316. Rosenthal, N., Sack, D., Gillin, C., Lewy, A., Goodwin, F., Davenport, Y., et al. (1984). Seasonal Affective Disorder. Arch Gen Psychiatry , 72-80. Read More