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.
ADDITIONAL INFORMATION
Currently the U. S. Food and Drug Administration has not approved any device 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.
Light box therapy (phototherapy) for the treatment of seasonal affective disorder does not meet the following technology evaluation criteria:
The technology must have final approval from the appropriate government regulatory bodies.
The scientific evidence must permit conclusions concerning the effect of the technology on health outcomes.
The technology must improve the net health outcome.
The technology must be as beneficial as any established alternatives.
The improvement must be attainable outside the investigational settings.
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 December 13, 2007 from BlueWeb.
Chesson, A. L., Littner, M., Davila, D., Anderson, W. M., Grigg-Damberger, M., Hartse, K., et al. (1999). Practice parameters for the use of light therapy in the treatment of sleep disorders. Standards of Practice Committee, American Academy of Sleep Medicine. Sleep, 22 (5), 641-660. Abstract retrieved October 15, 2002 from MD Consult database.
Geerts, E., Kouwert, E., Bouhuys, N., Meesters, Y., & Jansen, J. (2000). Nonverbal interpersonal attunement and extravert personality predict outcome of light treatment in seasonal affective disorder. Journal of Affective Disorders, 59 (3), 193-204. Abstract retrieved December 12, 2000 from Pubmed database.
Gloth, F. M., 3rd, Alam, W., & Hollis, B. (1999). Vitamin D vs broad spectrum phototherapy in the treatment of seasonal affective disorder. Journal of Nutrition, Health, and Aging, 3 (1), 5-7. Abstract retrieved October 14, 2002 from PubMed database.
Golden, R. N., Gaynes, B. N., Ekstrom, R. D., Hamer, R. M., Jacobsen, F. M., Suppes, T., et al. (2005). The efficacy of light therapy in the treatment of mood disorders: A review and meta-analysis of the evidence. American Journal of Psychiatry, 162, 656-662.
Health Technology Assessment Information Service. Windows on medical technologyTM. (2004, May). Light therapy for seasonal affective disorder. Retrieved January 17, 2007 from ECRI HTAIS.
Lundberg, G. D. (1998). Dawn's early light to twilight's last gleaming &ldots;. JAMA, 280 (18), 1556-1558.
Roelandts, R. (2002). The history of phototherapy: Something new under the sun? Journal of the American Academy of Dermatology, 46 (6), 926-930. Retrieved October 15, 2002 from MD Consult database.
Terman, J. S., Terman, M., Lo, E. S., & Cooper, T. B. (2001). Circadian time of morning light administration and therapeutic response in winter depression. Archives of General Psychiatry, 58 (1), 69-75. Abstract retrieved February 2, 2001 from PubMed database.
The Technology Evaluation Center. (1999, May). Phototherapy for the treatment of seasonal affective disorder (Vol. 14, No. 4). Chicago: BlueCross BlueShield Association.
ORIGINAL EFFECTIVE DATE: 7/1/2001
MOST RECENT REVIEW DATE: 2/22/2007
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