***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The influence of diurnal variations of mood ( DVM ) and sleep disturbances on treatment response was investigated in 42 patients with major depressive disorder ( not SAD ) under the treatment of either bright white light ( 2,500 lx ) or dim red light ( 50 lx ) . We found only a slight influence in certain subscales of DVM and no influence of sleep disturbances . These results are discussed under a clinical point of view and with respect to phase shift theories of depressive disorders In a group of 17 patients with non-SAD depressive disorders we compared the response of bipolar spectrum versus unipolar patients to treatment with light therapy . The main hypothesis was that bipolar spectrum depressed patients would preferentially respond to bright light therapy as compared to unipolar depressed patients . All patients were treated with either 400 or 2500 lux phototherapy for 2 h on seven consecutive days . All outcome measures , which included the SIGH-SAD , CGI , and the Anxiety and Depressive Factors of the SCL-90 , showed significant improvement in the bipolar vs. the unipolar spectrum patients . Unexpected this occurred regardless of the intensity of the light . These changes were judged to be quite clinical ly significant . All patients showing response were noted to have maintained their response at a 3-month follow-up Patients with recurrent winter depression and its subsyndromal form have been reported to benefit from bright full-spectrum light ( phototherapy ) . In order to determine whether this treatment ( 2 h in the morning ) during winter is effective in a r and om sample of the general population we investigated the responses of 20 subjects with varying degrees of winter difficulties . A control group ( n = 20 ) matched for the degree of seasonality , age , and sex was treated with dim light .  Individuals were selected from a larger survey sample of the Montgomery County population ( MD , U.S.A. ) and were comparable to the latter in their degree of winter difficulties . Enhancement of environmental light does not , on the basis of the present study , appear to be indicated for the public at large , but rather for a subgroup of individuals with histories of winter difficulties Light  therapy ( LT ) is regarded as the treatment of choice for seasonal affective disorder ( SAD ) . In nonseasonal depression the results of light therapy are nonconclusive .  Sleep deprivation ( SD )  , however , is effective in 50 - 60 % of the patients with major depression . The predictive value of  Total Sleep Deprivation ( TSD ) for the treatment outcome of antidepressiva has been already examined . Purpose of the present study was to test whether  light therapy  is more beneficial in TSD responders than in TSD nonresponders . 40 in patients with major depressive disorder completed one night of TSD . Twenty TSD responders and 20 TSD nonresponders were r and omly assigned to 14 days of bright light therapy ( 2500 lux , 7 - 9 a.m. ) or 14 days of dim light therapy ( red light 50 lux , 7 - 9 a.m. ) . Manova with repeated measurements revealed a significant difference in the course of depression over the time between TSD responders and nonresponders , but no significant difference between bright and dim light . Questions of  placebo effect , of SAD and of personality variables as predictors of response to  SD and LT  are being discussed Phototherapy is regularly used in the treatment of  seasonal affective disorder .  There is evidence that it is also useful in the treatment of  non‐seasonal depression  , but relevant controlled experiments are difficult to design . In this study we r and omly assigned depressed in‐ patients to high and low levels of artificial light , the high levels exceeding those most commonly used in earlier reported trials . Both unipolar and bipolar depressions responded when phototherapy was used as an adjunct to pharmacotherapy , and mood improvement was related to the intensity of illumination , that is , patients treated with high levels of illumination improved significantly more than those who received low levels ( P < 0.02 ) . Our findings suggest that light therapy is generally applicable to depressive illnesses , and that the light intensities commonly used are suboptimal The data of the Berlin light therapy study were systematic ally reinvestigated for side-effects of light therapy as described in the literature . Forty-two patients with major depressive disorder ( RDC ) , who also met the criteria of ICD-9 ( 296.1 and 296.3 ) , were included . Patients were either given bright white-light treatment ( 2,500 lux ) or dim red-light treatment ( 50 lux ) from 7.20 a.m. to 9.20 a.m. every morning for a period of seven days . The study did not reveal any differences in side-effects between the two treatments . The results are discussed in relation to the two different treatment conditions The effects of two non-drug treatments ( physical exercise and bright light ) on mood , body weight and oxygen consumption were compared in age-matched groups of female subjects with winter depression , non-seasonal depression or without depression . It was found that oxygen consumption in the pre-treatment condition was similar in non-depressed subjects ( n=18 ) and depressed non-seasonals ( n=18 ) , while comparatively lower values were obtained in winter depression ( n=27 ) . Neither mood nor metabolic parameters changed significantly in the group of nine untreated winter depressives . One week of physical exercise ( 1-h pedaling on a bicycle ergometer between 13.00 and 14.00 h ) increased oxygen consumption in the group of nine winter depressives and lowered oxygen consumption in nine-subject groups of depressed and non-depressed non-seasonals . One week of bright light treatment ( 2-h exposure to 2500 lux between 14.00 and 16.00 h ) increased oxygen consumption in nine winter depressives and nine non-depressed subjects , while no significant change in oxygen consumption was found in nine subjects with non-seasonal depression . Weight loss was observed in the groups treated with physical exercise and in the group of light-treated winter depressives . Winter depression responded equally well to exercising and light , while a significant therapeutic difference in favor of exercising was found in non-seasonal depression . Overall , the results of the study suggest that energy-regulating systems are implicated in the antidepressant action of the non-drug treatments The clinical usefulness of total sleep deprivation ( TSD ) in the treatment of bipolar depression is hampered by a high-rate short-term relapse . Previous literature has suggested that both long-term lithium treatment and light therapy could successfully prevent relapse . We r and omized 115 bipolar depressed in patients to receive three cycles of TSD , alone or in combination with morning light exposure , given at an intensity of 150 or 2500 lux . Forty-nine patients were undergoing long-term treatment with lithium salts ( at least 6 months ) , while 66 patients were taking no psychotropic medication .  Mood was self-rated by the Visual Analogue Scale three times a day during treatment . The results showed that both light therapy and ongoing lithium treatment significantly enhanced the effects of TSD on the perceived mood , with no additional benefit when the two treatments were combined . Subjective sleepiness during TSD , as rated by the self-administered Stanford Sleepiness Scale , was significantly reduced by light exposure , and was correlated with the outcome . This study confirms the possibility of obtaining a sustained antidepressant response to TSD in bipolar patients In previous research , the therapeutic effect of bright white light for so so-called seasonal affective disorder was clearly confirmed . The aim of the present study was to evaluate possible beneficial effects of bright white light in non-seasonal depression . 30 patients fulfilling RDC- criteria for major depressive disorder were r and omly assigned to a 7 day exposure from 7.20 to 9.20 a.m. The degree of illness was ascertained both objective ly with observer rating scales ( Hamilton Depression Scale , AMDP-system ) and through self-rating scales ( Complaint List and Depression Scale by von Zerssen ) . No difference was noted between bright light and dim light though a significant reduction of depressive symptomatology was observed for all patients during the treatment . These results were consistent for both observer rating and self-rating . In conclusion , bright white light has no superior effect as compared to dim light exposure in non-seasonal depression INTRODUCTION The aim of a double-blind study was to assess the efficacy of bright light therapy and /or imipramine in the treatment of in patients suffering with recurrent non-seasonal major depressive disorder . METHOD 34 in- patients with DSM-III-R diagnosis of major depressive disorder , recurrent type , were r and omly allocated into 3 treatment groups . After 4-day washout period with baseline assessment they underwent 3 weeks of different types of treatment : a ) Group A : bright light therapy ( 5000 lux from 6 - 8 a.m. ) and imipramine 150 mg/day . b ) Group B : bright light therapy ( 5000 lux from 6 - 8 a.m. ) and imipramine-like placebo . c ) Group C : dim red light ( 500 lux from 6 - 8 a.m. ) and imipramine 150 mg/day . Outcome measures included weekly Hamilton Psychiatric Rating Scale for Depression , Clinical Global Impression Scale , Montgomery and Asberg Psychiatric Rating Scale for Depression and Beck Depression Inventory . RESULTS Patients of all three groups improved significantly . The improvement of the patients of group B treated with bright light therapy plus placebo was superior to the other two groups , but not significantly . CONCLUSION Bright light therapy can be effective in the treatment of non-seasonal major depressive disorder Light therapy ( bright or dim light ) was given at different times ( morning or evening ) to 27 unmedicated patients with nonseasonal depression ( according to DSM-III-R criteria ) and 16 normal volunteers .  Circadian rhythms in body temperature were measured before and after light therapy . Bright light significantly improved clinical symptoms of depression , as measured by the Hamilton Rating Scale for Depression ( HRSD ) , independent of the time of phototherapy . Dim light therapy had no effect on HRSD scores . Circadian rhythms of body temperatures in patients with affective disorder were more sensitive to the entraining effects of bright light than those of normal subjects , but these effects were not related to clinical improvement . Bright light exposure has an antidepressant effect on patients with nonseasonal depression , but the effect is unlikely to be mediated via the same circadian system that regulates body temperature OBJECTIVE About 5 % of pregnant women meet criteria for major depression . No pharmacotherapy is specifically approved for antepartum depression ; novel treatment approaches may be welcome . The authors explored the use of morning bright light therapy for antepartum depression . METHOD An open trial of bright light therapy in an A-B-A design was conducted for 3 - 5 weeks in 16 pregnant patients with major depression . The Hamilton Depression Rating Scale , Seasonal Affective Disorders Version , was administered to assess changes in mood . A follow-up question naire was used to assess outcome after delivery . RESULTS After 3 weeks of treatment , mean depression ratings improved by 49 % . Benefits were seen through 5 weeks of treatment . There was no evidence of adverse effects of light therapy on pregnancy . CONCLUSIONS These data provide evidence that morning light therapy has an antidepressant effect during pregnancy . A r and omized controlled trial is warranted to test this alternative to medication Inpatient studies have suggested that bright light therapy can be used to sustain the antidepressant effects of wake therapy ( sleep deprivation ) . In an outpatient trial , a half night of home wake treatment was followed by 1 week of light treatment .  All subjects had Major Depressive Disorders according to DSM-IV criteria and were receiving concomitant antidepressant medication . Subjects were r and omly assigned to receive either 10,000 lux bright white light for 30 min between 6 and 9 AM or dim red ( placebo ) light at a comparable time . Seven subjects completed treatment with bright white light and six completed treatment with placebo . On the Hamilton Depression Rating Scale ( HDRS17 , SIGH-SAD-SR version ) , the group receiving bright light improved 27 % in 1 week ( P=0.002 ) . The group receiving placebo did not improve , except for one outlier . The benefit of bright light was significant compared to placebo with removal of the outlier ( P<0.025 ) Antidepressant and energizing effects of bright light exposure ( phototherapy ) have been widely reported to occur in patients with seasonal affective disorder . We have attempted to evaluate whether other segments of the population might benefit from phototherapy , most notably individuals with subsyndromal seasonal affective disorder , as well as healthy individuals with no winter difficulties ( controls ) . We have studied 20 subjects in each of these two categories and have found that bright artificial light did not alter mood and behavior in controls . In contrast , individuals with subsyndromal seasonal affective disorder responded favorably to treatment with bright environmental light . A dose of 5 hours of bright light exposure , divided between morning and evening , was more effective than 2 hours of exposure . This finding may have practical implication s for establishing optimal environmental lighting conditions for those individuals whose winter difficulties do not meet criteria for seasonal affective disorder BACKGROUND Using bright light for treating major depressive disorders which are not seasonal needs re assessment . METHODS Clinical trials of light treatment for nonseasonal major depressive disorders were compared with selected trials of light treatment of winter depression and with antidepressant clinical drug trials . RESULTS Light treatment of nonseasonal depression produces net benefits in the range of 12 - 35 % , often within 1 week . CONCLUSIONS Light 's value for nonseasonal and seasonal depression are comparable . Light appears to produce faster antidepressant benefits than psychopharmacologic treatment . LIMITATIONS Direct r and omizing comparisons between light and medications for nonseasonal 
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In general , the quality of reporting was poor , and many review s did not report adverse effects systematic ally .
The treatment response in the bright light group was better than in the control treatment group , but did not reach statistical significance .
Treatment REVIEW ERS ' CONCLUSIONS For patients suffering from non-seasonal depression , bright light therapy offers modest though promising antidepressive efficacy , especially when administered during the first week of treatment , in the morning , and as an adjunctive treatment to sleep deprivation responders .