Light Box Therapy (Phototherapy) for Seasonal Affective Disorder
DESCRIPTION
Seasonal affective disorder (SAD) is defined as a history of major depressive episodes that recur regularly at a particular time of the year, typically winter. SAD is associated with decreases in ambient light exposure during the winter season. Women make up the majority of cases, but men and children also suffer from this condition.
SAD in adults is characterized by sadness or anxiety, fatigue, weight gain, carbohydrate craving, decreased energy, withdrawals from friends and family, difficulty concentrating, and appetite changes (generally increased appetite). Symptoms in children include irritability, difficulty getting out of bed and school problems in fall and winter.
Light therapy consists of daily half-hour to two-hour sessions with the individual sitting in front of the light box, which is equipped with high-intensity florescent lights. The individual can read, study, eat, or perform other daily activities while the sessions are in progress.
POLICY
Light box therapy (phototherapy) for the treatment of seasonal affective disorder is considered investigational.
IMPORTANT REMINDER
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ADDITIONAL INFORMATION
Currently the U. S. Food and Drug Administration (FDA) have not approved any devices to provide light box therapy (phototherapy) for the treatment of seasonal affective disorder. It is also not known if this technology improves net health outcomes when used for the treatment of seasonal affective disorder.
SOURCES
BlueCross BlueShield Association. Medical Policy Reference Manual. (3:2005). Phototherapy light for the treatment of seasonal affective and other depressive disorders (1.01.04). Retrieved September 23, 2011 from BlueWeb. (3 articles and/or guidelines reviewed)
ECRI Institute. Health Technology Information Service. Evidence Reports. (2004, May). Light therapy for seasonal affective disorder. Retrieved September 23, 2011 from ECRI Institute. (96 articles and/or guidelines reviewed)
Lam, R. W., Levitt, A. J., Levitan, R. D., Enns, M. W., Morehouse, R., Michalak, E. 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. American Journal of Psychiatry, 163 (5), 805-812. (Level 2 Evidence - Industry sponsored)
Lavoie, M. P., Lam, R. W., Bouchard, G., Sasseville, A., Charron, M. C., Gagne, A. M., et al. (2009). Evidence of a biological effect of light therapy on the retina of patients with seasonal affective disorder. Biological Psychiatry, 66 (3), 253-258. (Level 3 Evidence - Industry sponsored)
Meesters, Y., Dekker, V., Schangen, L. J., Bos, E. H., & Ruiter, M. J. (2011). Low-intensity blue-enriched white light (750 lux) and standard bright light (10,000 lux) are equally effective in treating SAD. A randomized controlled study. BMC Psychiatry, 11 (17), 1-8. (Level 2 Evidence - Industry sponsored)
National Institute for Health and Clinical Excellence (NICE). (2009, October). Depression: The treatment and management of depression in adults, including adults with a chronic physical health problem. Retrieved September 26, 2011 from http://www.nice.org.uk/nicemedia/live/12329/45890/45890.pdf.
Rohan, K. J., Roecklin, K. A., Tierney Lindsey, K., Johnson, L. G., Lippy, R. D., Lacy, T. J., et al. (2007). A randomized controlled trial of cognitive-behavioral therapy, light therapy, and their combination for seasonal affective disorder. Journal of Consulting and Clinical Psychology, 75 (3), 489-500. (Level 2 Evidence - Independent study)
Soleimani, L., Lapidus, K., & Iosifescu, D. V. (2011). Diagnosis and treatment of major depressive disorder. Neurologic Clinics, 29 (1), 177-193.
Winifred S. Hayes, Inc. Medical Technology Directory. (2010, September; last update search September 2011). Light therapy for seasonal affective disorder. Retrieved September 23, 2011 from www.Hayesinc.com/subscribers. (79 articles and/or guidelines reviewed)
ORIGINAL EFFECTIVE DATE: 7/1/2001
MOST RECENT REVIEW DATE: 10/13/2011
ID_BT
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