Cognitive Behavioral Therapy Yields Less Recurrence of Winter Depression than Light Therapy

Research Topics

Monday, 02 November 2009

Researchers from the Department of Psychology at the University of Vermont in Burlington looked at the recurrence of SAD (seasonal affective disorder or depression) in the fall/winter, one year after receiving cognitive behavioral treatment.

The investigators had previously developed a group cognitive-behavioral therapy approach (CBT) specifically targeted for SAD and tested its efficacy in 2 pilot studies that compared outcomes with light therapy.

This study examines impact during the subsequent winter season (approximately 1 year after acute treatment), following participants randomized to CBT, light therapy, and a combination of both treatments. (N=69).

Seventeen subjects dropped out during treatment, were withdrawn from their protocol, or were just lost to follow-up.

Of the remaining subjects, the CBT (7.0%) and combination treatment (5.5%) groups had significantly smaller proportions of winter depression recurrences than the light therapy group (36.7%).

Additionally, CBT alone, but not combination treatment, was also associated with significantly lower interviewer- and patient-rated depression severity at 1 year as compared to light therapy alone.

Among completers who provided 1-year data, all statistically significant differences between the CBT and light therapy groups persisted after adjustment for ongoing treatment with light therapy, antidepressants, and
psychotherapy.

If these findings are replicated, CBT could represent a more effective, practical, and palatable approach to long-term SAD management than light therapy.

Citation: Rohan KJ, Roecklein KA, Lacy TJ, Vacek PM. Winter depression recurrence one year after cognitive-behavioral therapy, light therapy, or combination treatment. Behavioral Therapy. 2009 Sep; 40 (3): pages 225-38. Epub 2008 Nov 3. This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

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written by Maarten, November 03, 2009

Hmm, surprizing, given the good data I have found elsewhere on lighttherapy - and the great experiences friends of mine and myself have had. (NB I have no commercial links with people who prouduce this material).
I'd like to know more about the kind of light-therapy that was offered.
If this required going to a spa, sit before a lamp and do nothing else, I could understand.
However, it is quite possible and relativly cheap to buy a liitle light column made for the purposes, and have that next to the screen of your computer you're working on , or on the table next to the book you're reading. It seems very likely that this would lead to much lower drop-out rates which seems high. BTW why was there no differntiation between those who dropped out and those who didn't respond for the follow-up?

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written by Robin, November 06, 2009

I pulled the article and read through it. It was very interesting. The LT used a 10,000 Lux Sun-Ray brand light box. The particpants were supervised by a by an "expert light therapy consultant" and gave the Dr.s name. The Dr. tailored their LT times to their schedules etc to get them established over the course of 6 weeks. It was split into a 45 min session in the morning and a 45 minute session in the evening. The particpants were encouraged to continue useage until spring remission and then gave the boxes back to the researchers in May.
They wanted to see what relapse rates would be the following fall if the clients didn't use the boxes vs. a one time series of CBT sessions over 6 weeks the previous year.
They ran the data with and without the 17 "dropouts" and came up with the CBT being significantly more beneficial than the other groups in both calculations. "P" value was .05. The the BDI-II, the SIGH-SAD, and the HAM-D tests were used.
I guess thier point is that you can use CBT one year and get results that last even after the treatment is stopped whereas you have to use the light therapy every year.
Hope that answers your questions. It was very interesting

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written by Marilyn, November 09, 2009

Why would the study have participants use a light box in the evening? I was under the impression that it is only to be used in the morning and that using it in the evening could reduce the quality of your nighttime sleep.

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written by Maarten, November 10, 2009

Hi Robin

Thanks for this additional info. This confirms that they used an application of LT that is unnecessaru cumbersome. LT can very well be used at home in an effortless way. And as Marilyn also asked: why use LT in the evening? Doesn't make sense to me, for the reasons Marilyn mentioned, too.
I makes me think that the researchers had "an agenda"...
Anyway, it does make sense that a therapy that targets psychological issues direcly is more helpful than LT alone (for instance imagery :-).
But the way my friends and I use lighttherapy during ongoing daily activities we found in no way cumbersome... On the contrary, very agreable to do, at no effort other than putting the light on...

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