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University of Pittsburgh School of Medicine study published in Bipolar Disorders
PITTSBURGH, January 3, 2008 — Bright light therapy can ease bipolar depression in some patients, according to a study published in the journal Bipolar Disorders. Researchers from the University of Pittsburgh School of Medicine’s Western Psychiatric Institute and Clinic studied nine women with bipolar disorder to examine the effects of light therapy in the morning or at midday on mood symptoms.
“There are limited effective treatments for the depressive phase of bipolar disorder,” said Dorothy Sit, M.D., assistant professor of psychiatry and the study’s first author. “While there are treatments that are effective for mania, the major problem is the depression, which can linger so long that it never really goes away.”
In this study, women with bipolar depression were given light boxes and instructed on how to use them at home. The women used the light boxes daily for two-week stretches of 15, 30 and 45 minutes. Some patients responded extremely well to the light therapy, and their symptoms of depression disappeared. The responders to light therapy stayed on the light therapy for an additional three or four months. Four patients received morning light, and five used their light boxes at midday. Participants also continued to take their prescribed medications throughout the study period.
“Three of the women who received morning light initially developed what we call a mixed state, with symptoms of depression and mania that occur all at once – racing thoughts, irritability, sleeplessness, anxiety and low mood,” said Dr. Sit. “But when another group began with midday light therapy, we found a much more stable response.”
Of the nine women treated, six achieved some degree of response, with several reaching full recovery from depressive symptoms. While most attained their best recovery with midday light, a few responded more fully to a final adjustment to morning light.
“People with bipolar disorder are exquisitely sensitive to morning light, so this profound effect of morning treatment leading to mixed states is very informative and forces us to ask more questions,” said Dr. Sit. “Did we introduce light too early and disrupt circadian rhythms and sleep patterns?”
People with bipolar disorder are known to be sensitive to changes in outdoor ambient light and to seasonal changes. Researchers are asking whether the risk of suicide in patients with bipolar disorder could be linked to changes in light exposure.
“In our study, 44 percent of patients were full responders, and 22 percent were partial responders,” Dr. Sit and her colleagues write. “Light therapy, therefore, is an attractive and possibly effective augmentation strategy to improve the likelihood of full-treatment response.”
Optimal response was observed with midday light therapy for 45 or 60 minutes daily, noted Dr. Sit.
Other study authors are Katherine L. Wisner, M.D., Barbara H. Hanusa, Ph.D., and Stacy D. Stull, M.S., all of the Women’s Behavioral HealthCARE program at Western Psychiatric Institute and Clinic; and Michael Terman, Ph.D., Columbia University.
Researchers report funding from the Stanley Foundation, the University of Pittsburgh School of Medicine, National Institute of Mental Health, U.S. Department of Health and Human Services, Pfizer Inc., GlaxoSmithKline and the National Institute of Neurological Disorders and Stroke.
Cover Story on Bipolar Disorder in Children
Read the New York Times Magazine article
Diagnoses of bipolar disorder among children are on the rise, but little is known about the disease in children. As a national leader in pediatric bipolar disorder research and clinical treatment, WPIC has the only clinic in the U.S. solely dedicated to treating children with this illness.
Highly recognized child psychiatry experts, David A. Axelson, M.D. and Boris Birmaher, M.D., have developed the largest and most comprehensive treatment clinic for pediatric bipolar disorder ?in the country.
About WPIC
Western Psychiatric Institute and Clinic (WPIC) is considered to be one of the nation’s foremost university-based psychiatric care facilities and one of the world’s leading centers for research and treatment of mental health disorders. WPIC houses the Department of Psychiatry of the University of Pittsburgh School of Medicine and is the flagship of UPMC Behavioral Health, the psychiatric specialty division of the University of Pittsburgh Medical Center.
Named among the best psychiatric hospitals in the country by U.S. News & World Report, WPIC has more than 60 outpatient programs and 289 licensed inpatient beds, serving individuals across the lifespan, from young children to aging adults. Each year, more than 40,000 individuals receive care through inpatient and outpatient clinical programs at WPIC.
Its research programs are unsurpassed, with researchers from the University of Pittsburgh School of Medicine’s department of psychiatry receiving more federal funding for behavioral health and addiction research than any other institution in the nation. In 2007, the department received more than $72 million in funding from the National Institutes of Health, ranking it first in funding among all psychiatry departments, a distinction the department has earned for more than a decade. Approximately 80 percent of this funding supports clinical research projects, many of which directly benefit individuals who receive services at WPIC or through UPMC Behavioral Health.
WPIC currently houses six federally funded Centers of Excellence: the Mental Health Intervention Center for Mood and Anxiety Disorders, the Conte Center for the Neuroscience of Mental Disorders, the Advanced Center for Intervention and Services Research for Late-Life Mood Disorders, the Pittsburgh Mind/Body Center, the Affect Regulation and Adolescent Brain Center and the Advanced Center for Intervention and Services Research for Early Onset Mood and Anxiety Disorders. Other specialty areas include: Alzheimer’s disease, sleep and sleep disorders, schizophrenia, autism, suicide and eating disorders.
WPIC offers a number of educational and training programs. For professionals, these programs include internship, residency, fellowship and post-doctoral research programs. For the public, outreach programs include crisis, disaster and bioterrorism preparedness training, intimate partner violence training, and school-based training to aid teachers and counselors in recognizing and helping students at risk for mental illness ?and suicide.
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