Psychological therapies for preventing seasonal affective disorder
Background Seasonal affective disorder (SAD) is a seasonal pattern of recurrent major depressive episodes that most commonly occurs during autumn or winter and remits in spring. The prevalence of SAD ranges from 1.5% to 9%, depending on latitude. The predictable seasonal aspect of SAD provides a pro...
Gespeichert in:
| Veröffentlicht in: | Cochrane database of systematic reviews 2019-05, Vol.2019 (5), p.CD011270 |
|---|---|
| Hauptverfasser: | , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | |
|---|---|
| container_issue | 5 |
| container_start_page | CD011270 |
| container_title | Cochrane database of systematic reviews |
| container_volume | 2019 |
| creator | Forneris, Catherine A Nussbaumer‐Streit, Barbara Morgan, Laura C Greenblatt, Amy Van Noord, Megan G Gaynes, Bradley N Wipplinger, Jörg Lux, Linda J Winkler, Dietmar Gartlehner, Gerald Nussbaumer‐Streit, Barbara |
| description | Background
Seasonal affective disorder (SAD) is a seasonal pattern of recurrent major depressive episodes that most commonly occurs during autumn or winter and remits in spring. The prevalence of SAD ranges from 1.5% to 9%, depending on latitude. The predictable seasonal aspect of SAD provides a promising opportunity for prevention. This is one of four reviews on the efficacy and safety of interventions to prevent SAD; we focus on psychological therapies as preventive interventions.
Objectives
To assess the efficacy and safety of psychological therapies (in comparison with no treatment, other types of psychological therapy, second‐generation antidepressants, light therapy, melatonin or agomelatine or lifestyle interventions) in preventing SAD and improving person‐centred outcomes among adults with a history of SAD.
Search methods
We searched Ovid MEDLINE (1950‐ ), Embase (1974‐ ), PsycINFO (1967‐ ) and the Cochrane Central Register of Controlled Trials (CENTRAL) to 19 June 2018. An earlier search of these databases was conducted via the Cochrane Common Mental Disorders Controlled Trial Register (CCMD‐CTR) (all years to 11 August 2015). Furthermore, we searched the Cumulative Index to Nursing and Allied Health Literature, Web of Science, the Cochrane Library, the Allied and Complementary Medicine Database and international trial registers (to 19 June 2018). We also conducted a grey literature search and handsearched the reference lists of included studies and pertinent review articles.
Selection criteria
To examine efficacy, we included randomised controlled trials (RCTs) on adults with a history of winter‐type SAD who were free of symptoms at the beginning of the study. To examine adverse events, we intended to include non‐randomised studies. We planned to include studies that compared psychological therapy versus no treatment, or any other type of psychological therapy, light therapy, second‐generation antidepressants, melatonin, agomelatine or lifestyle changes. We also planned to compare psychological therapy in combination with any of the comparator interventions listed above versus no treatment or the same comparator intervention as monotherapy.
Data collection and analysis
Two review authors screened s and full‐text publications against the inclusion criteria, independently extracted data, assessed risk of bias, and graded the certainty of evidence.
Main results
We identified 3745 citations through electronic searches and reviews of reference lists a |
| doi_str_mv | 10.1002/14651858.CD011270.pub3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6533196</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2232125722</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4733-a999cb1762c97738cdf55039bf3cb652f4414cef673cd0e65ed78b67991fc3ac3</originalsourceid><addsrcrecordid>eNqFUUtLAzEQDqL4qP4F2aOX1jx2k-YiaH2CoAc9h-zspI1sNzVpK_33ptSKevE0gflek4-QU0YHjFJ-zkpZsWE1HIyuKWNc0cFsUYsdcrhe9Neb3R_vA3KU0hulQmqu9smByJSSleyQXD2nFUxCG8YebFvMJxjtzGMqXIjFLOISu7nvxkVCm0KXEdY5hLlfYtH4FGKD8ZjsOdsmPPmaPfJ6e_Myuu8_Pt09jC4f-1AqIfpWaw01U5KDVkoMoXFVRYWunYBaVtyVORGgk0pAQ1FW2KhhLZXWzIGwIHrkYqObL51iAzlZtK2ZRT-1cWWC9eb3pvMTMw5LIyshmJZZ4OxLIIb3Baa5mfoE2La2w7BIhnPBGa9Unj0iN1CIIaWI7tuGUbMuwGwLMNsC1uYiE09_hvymbX88A642gA_f4spAgEnM_v_o_nH5BHrGl80</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2232125722</pqid></control><display><type>article</type><title>Psychological therapies for preventing seasonal affective disorder</title><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><source>Cochrane Library</source><creator>Forneris, Catherine A ; Nussbaumer‐Streit, Barbara ; Morgan, Laura C ; Greenblatt, Amy ; Van Noord, Megan G ; Gaynes, Bradley N ; Wipplinger, Jörg ; Lux, Linda J ; Winkler, Dietmar ; Gartlehner, Gerald ; Nussbaumer‐Streit, Barbara</creator><creatorcontrib>Forneris, Catherine A ; Nussbaumer‐Streit, Barbara ; Morgan, Laura C ; Greenblatt, Amy ; Van Noord, Megan G ; Gaynes, Bradley N ; Wipplinger, Jörg ; Lux, Linda J ; Winkler, Dietmar ; Gartlehner, Gerald ; Nussbaumer‐Streit, Barbara</creatorcontrib><description>Background
Seasonal affective disorder (SAD) is a seasonal pattern of recurrent major depressive episodes that most commonly occurs during autumn or winter and remits in spring. The prevalence of SAD ranges from 1.5% to 9%, depending on latitude. The predictable seasonal aspect of SAD provides a promising opportunity for prevention. This is one of four reviews on the efficacy and safety of interventions to prevent SAD; we focus on psychological therapies as preventive interventions.
Objectives
To assess the efficacy and safety of psychological therapies (in comparison with no treatment, other types of psychological therapy, second‐generation antidepressants, light therapy, melatonin or agomelatine or lifestyle interventions) in preventing SAD and improving person‐centred outcomes among adults with a history of SAD.
Search methods
We searched Ovid MEDLINE (1950‐ ), Embase (1974‐ ), PsycINFO (1967‐ ) and the Cochrane Central Register of Controlled Trials (CENTRAL) to 19 June 2018. An earlier search of these databases was conducted via the Cochrane Common Mental Disorders Controlled Trial Register (CCMD‐CTR) (all years to 11 August 2015). Furthermore, we searched the Cumulative Index to Nursing and Allied Health Literature, Web of Science, the Cochrane Library, the Allied and Complementary Medicine Database and international trial registers (to 19 June 2018). We also conducted a grey literature search and handsearched the reference lists of included studies and pertinent review articles.
Selection criteria
To examine efficacy, we included randomised controlled trials (RCTs) on adults with a history of winter‐type SAD who were free of symptoms at the beginning of the study. To examine adverse events, we intended to include non‐randomised studies. We planned to include studies that compared psychological therapy versus no treatment, or any other type of psychological therapy, light therapy, second‐generation antidepressants, melatonin, agomelatine or lifestyle changes. We also planned to compare psychological therapy in combination with any of the comparator interventions listed above versus no treatment or the same comparator intervention as monotherapy.
Data collection and analysis
Two review authors screened s and full‐text publications against the inclusion criteria, independently extracted data, assessed risk of bias, and graded the certainty of evidence.
Main results
We identified 3745 citations through electronic searches and reviews of reference lists after deduplication of search results. We excluded 3619 records during title and review and assessed 126 articles at full‐text review for eligibility. We included one controlled study enrolling 46 participants. We rated this RCT at high risk for performance and detection bias due to a lack of blinding.
The included RCT compared preventive use of mindfulness‐based cognitive therapy (MBCT) with treatment as usual (TAU) in participants with a history of SAD. MBCT was administered in spring in eight weekly individual 45‐ to 60‐minute sessions. In the TAU group participants did not receive any preventive treatment but were invited to start light therapy as first depressive symptoms occurred. Both groups were assessed weekly for occurrence of a new depressive episode measured with the Inventory of Depressive Syptomatology‐Self‐Report (IDS‐SR, range 0‐90) from September 2011 to mid‐April 2012. The incidence of a new depressive episode in the upcoming winter was similar in both groups. In the MBCT group 65% of 23 participants developed depression (IDS‐SR ≥ 20), compared to 74% of 23 people in the TAU group (risk ratio (RR) 0.88, 95% confidence interval (CI) 0.60 to 1.30; 46 participants; very low quality‐evidence).
For participants with depressive episodes, severity of depression was comparable between groups. Participants in the MBCT group had a mean score of 26.5 (SD 7.0) on the IDS‐SR, and TAU participants a mean score of 25.3 (SD 6.3) (mean difference (MD) 1.20, 95% CI ‐3.44 to 5.84; 32 participants; very low quality‐evidence).
The overall discontinuation rate was similar too, with 17% discontinuing in the MBCT group and 13% in the TAU group (RR 1.33, 95% CI 0.34 to 5.30; 46 participants; very low quality‐evidence).
Reasons for downgrading the quality of evidence included high risk of bias of the included study and imprecision.
Investigators provided no information on adverse events. We could not find any studies that compared psychological therapy with other interventions of interest such as second‐generation antidepressants, light therapy, melatonin or agomelatine.
Authors' conclusions
The evidence on psychological therapies to prevent the onset of a new depressive episode in people with a history of SAD is inconclusive. We identified only one study including 46 participants focusing on one type of psychological therapy. Methodological limitations and the small sample size preclude us from drawing a conclusion on benefits and harms of MBCT as a preventive intervention for SAD. Given that there is no comparative evidence for psychological therapy versus other preventive options, the decision for or against initiating preventive treatment of SAD and the treatment selected should be strongly based on patient preferences and other preventive interventions that are supported by evidence.</description><identifier>ISSN: 1465-1858</identifier><identifier>ISSN: 1469-493X</identifier><identifier>EISSN: 1465-1858</identifier><identifier>EISSN: 1469-493X</identifier><identifier>DOI: 10.1002/14651858.CD011270.pub3</identifier><identifier>PMID: 31124141</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Adult ; Antidepressants ; Antidepressive Agents ; Antidepressive Agents - therapeutic use ; Cognitive Behavioral Therapy ; Condition ; Depression ; Depressive disorder ; Depressive Disorder, Major ; Depressive Disorder, Major - therapy ; Depressive disorders & major depression ; Humans ; Intervention ; Medicine General & Introductory Medical Sciences ; Melatonin ; Melatonin - therapeutic use ; Mental health ; Mood disorders ; Phototherapy ; Population ; Randomized Controlled Trials as Topic ; Seasonal Affective Disorder ; Seasonal Affective Disorder - prevention & control ; Seasonal Affective Disorder - therapy ; SSRIs</subject><ispartof>Cochrane database of systematic reviews, 2019-05, Vol.2019 (5), p.CD011270</ispartof><rights>Copyright © 2019 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4733-a999cb1762c97738cdf55039bf3cb652f4414cef673cd0e65ed78b67991fc3ac3</citedby><cites>FETCH-LOGICAL-c4733-a999cb1762c97738cdf55039bf3cb652f4414cef673cd0e65ed78b67991fc3ac3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31124141$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Forneris, Catherine A</creatorcontrib><creatorcontrib>Nussbaumer‐Streit, Barbara</creatorcontrib><creatorcontrib>Morgan, Laura C</creatorcontrib><creatorcontrib>Greenblatt, Amy</creatorcontrib><creatorcontrib>Van Noord, Megan G</creatorcontrib><creatorcontrib>Gaynes, Bradley N</creatorcontrib><creatorcontrib>Wipplinger, Jörg</creatorcontrib><creatorcontrib>Lux, Linda J</creatorcontrib><creatorcontrib>Winkler, Dietmar</creatorcontrib><creatorcontrib>Gartlehner, Gerald</creatorcontrib><creatorcontrib>Nussbaumer‐Streit, Barbara</creatorcontrib><title>Psychological therapies for preventing seasonal affective disorder</title><title>Cochrane database of systematic reviews</title><addtitle>Cochrane Database Syst Rev</addtitle><description>Background
Seasonal affective disorder (SAD) is a seasonal pattern of recurrent major depressive episodes that most commonly occurs during autumn or winter and remits in spring. The prevalence of SAD ranges from 1.5% to 9%, depending on latitude. The predictable seasonal aspect of SAD provides a promising opportunity for prevention. This is one of four reviews on the efficacy and safety of interventions to prevent SAD; we focus on psychological therapies as preventive interventions.
Objectives
To assess the efficacy and safety of psychological therapies (in comparison with no treatment, other types of psychological therapy, second‐generation antidepressants, light therapy, melatonin or agomelatine or lifestyle interventions) in preventing SAD and improving person‐centred outcomes among adults with a history of SAD.
Search methods
We searched Ovid MEDLINE (1950‐ ), Embase (1974‐ ), PsycINFO (1967‐ ) and the Cochrane Central Register of Controlled Trials (CENTRAL) to 19 June 2018. An earlier search of these databases was conducted via the Cochrane Common Mental Disorders Controlled Trial Register (CCMD‐CTR) (all years to 11 August 2015). Furthermore, we searched the Cumulative Index to Nursing and Allied Health Literature, Web of Science, the Cochrane Library, the Allied and Complementary Medicine Database and international trial registers (to 19 June 2018). We also conducted a grey literature search and handsearched the reference lists of included studies and pertinent review articles.
Selection criteria
To examine efficacy, we included randomised controlled trials (RCTs) on adults with a history of winter‐type SAD who were free of symptoms at the beginning of the study. To examine adverse events, we intended to include non‐randomised studies. We planned to include studies that compared psychological therapy versus no treatment, or any other type of psychological therapy, light therapy, second‐generation antidepressants, melatonin, agomelatine or lifestyle changes. We also planned to compare psychological therapy in combination with any of the comparator interventions listed above versus no treatment or the same comparator intervention as monotherapy.
Data collection and analysis
Two review authors screened s and full‐text publications against the inclusion criteria, independently extracted data, assessed risk of bias, and graded the certainty of evidence.
Main results
We identified 3745 citations through electronic searches and reviews of reference lists after deduplication of search results. We excluded 3619 records during title and review and assessed 126 articles at full‐text review for eligibility. We included one controlled study enrolling 46 participants. We rated this RCT at high risk for performance and detection bias due to a lack of blinding.
The included RCT compared preventive use of mindfulness‐based cognitive therapy (MBCT) with treatment as usual (TAU) in participants with a history of SAD. MBCT was administered in spring in eight weekly individual 45‐ to 60‐minute sessions. In the TAU group participants did not receive any preventive treatment but were invited to start light therapy as first depressive symptoms occurred. Both groups were assessed weekly for occurrence of a new depressive episode measured with the Inventory of Depressive Syptomatology‐Self‐Report (IDS‐SR, range 0‐90) from September 2011 to mid‐April 2012. The incidence of a new depressive episode in the upcoming winter was similar in both groups. In the MBCT group 65% of 23 participants developed depression (IDS‐SR ≥ 20), compared to 74% of 23 people in the TAU group (risk ratio (RR) 0.88, 95% confidence interval (CI) 0.60 to 1.30; 46 participants; very low quality‐evidence).
For participants with depressive episodes, severity of depression was comparable between groups. Participants in the MBCT group had a mean score of 26.5 (SD 7.0) on the IDS‐SR, and TAU participants a mean score of 25.3 (SD 6.3) (mean difference (MD) 1.20, 95% CI ‐3.44 to 5.84; 32 participants; very low quality‐evidence).
The overall discontinuation rate was similar too, with 17% discontinuing in the MBCT group and 13% in the TAU group (RR 1.33, 95% CI 0.34 to 5.30; 46 participants; very low quality‐evidence).
Reasons for downgrading the quality of evidence included high risk of bias of the included study and imprecision.
Investigators provided no information on adverse events. We could not find any studies that compared psychological therapy with other interventions of interest such as second‐generation antidepressants, light therapy, melatonin or agomelatine.
Authors' conclusions
The evidence on psychological therapies to prevent the onset of a new depressive episode in people with a history of SAD is inconclusive. We identified only one study including 46 participants focusing on one type of psychological therapy. Methodological limitations and the small sample size preclude us from drawing a conclusion on benefits and harms of MBCT as a preventive intervention for SAD. Given that there is no comparative evidence for psychological therapy versus other preventive options, the decision for or against initiating preventive treatment of SAD and the treatment selected should be strongly based on patient preferences and other preventive interventions that are supported by evidence.</description><subject>Adult</subject><subject>Antidepressants</subject><subject>Antidepressive Agents</subject><subject>Antidepressive Agents - therapeutic use</subject><subject>Cognitive Behavioral Therapy</subject><subject>Condition</subject><subject>Depression</subject><subject>Depressive disorder</subject><subject>Depressive Disorder, Major</subject><subject>Depressive Disorder, Major - therapy</subject><subject>Depressive disorders & major depression</subject><subject>Humans</subject><subject>Intervention</subject><subject>Medicine General & Introductory Medical Sciences</subject><subject>Melatonin</subject><subject>Melatonin - therapeutic use</subject><subject>Mental health</subject><subject>Mood disorders</subject><subject>Phototherapy</subject><subject>Population</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Seasonal Affective Disorder</subject><subject>Seasonal Affective Disorder - prevention & control</subject><subject>Seasonal Affective Disorder - therapy</subject><subject>SSRIs</subject><issn>1465-1858</issn><issn>1469-493X</issn><issn>1465-1858</issn><issn>1469-493X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>RWY</sourceid><sourceid>EIF</sourceid><recordid>eNqFUUtLAzEQDqL4qP4F2aOX1jx2k-YiaH2CoAc9h-zspI1sNzVpK_33ptSKevE0gflek4-QU0YHjFJ-zkpZsWE1HIyuKWNc0cFsUYsdcrhe9Neb3R_vA3KU0hulQmqu9smByJSSleyQXD2nFUxCG8YebFvMJxjtzGMqXIjFLOISu7nvxkVCm0KXEdY5hLlfYtH4FGKD8ZjsOdsmPPmaPfJ6e_Myuu8_Pt09jC4f-1AqIfpWaw01U5KDVkoMoXFVRYWunYBaVtyVORGgk0pAQ1FW2KhhLZXWzIGwIHrkYqObL51iAzlZtK2ZRT-1cWWC9eb3pvMTMw5LIyshmJZZ4OxLIIb3Baa5mfoE2La2w7BIhnPBGa9Unj0iN1CIIaWI7tuGUbMuwGwLMNsC1uYiE09_hvymbX88A642gA_f4spAgEnM_v_o_nH5BHrGl80</recordid><startdate>20190524</startdate><enddate>20190524</enddate><creator>Forneris, Catherine A</creator><creator>Nussbaumer‐Streit, Barbara</creator><creator>Morgan, Laura C</creator><creator>Greenblatt, Amy</creator><creator>Van Noord, Megan G</creator><creator>Gaynes, Bradley N</creator><creator>Wipplinger, Jörg</creator><creator>Lux, Linda J</creator><creator>Winkler, Dietmar</creator><creator>Gartlehner, Gerald</creator><creator>Nussbaumer‐Streit, Barbara</creator><general>John Wiley & Sons, Ltd</general><scope>7PX</scope><scope>RWY</scope><scope>ZYTZH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20190524</creationdate><title>Psychological therapies for preventing seasonal affective disorder</title><author>Forneris, Catherine A ; Nussbaumer‐Streit, Barbara ; Morgan, Laura C ; Greenblatt, Amy ; Van Noord, Megan G ; Gaynes, Bradley N ; Wipplinger, Jörg ; Lux, Linda J ; Winkler, Dietmar ; Gartlehner, Gerald ; Nussbaumer‐Streit, Barbara</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4733-a999cb1762c97738cdf55039bf3cb652f4414cef673cd0e65ed78b67991fc3ac3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Antidepressants</topic><topic>Antidepressive Agents</topic><topic>Antidepressive Agents - therapeutic use</topic><topic>Cognitive Behavioral Therapy</topic><topic>Condition</topic><topic>Depression</topic><topic>Depressive disorder</topic><topic>Depressive Disorder, Major</topic><topic>Depressive Disorder, Major - therapy</topic><topic>Depressive disorders & major depression</topic><topic>Humans</topic><topic>Intervention</topic><topic>Medicine General & Introductory Medical Sciences</topic><topic>Melatonin</topic><topic>Melatonin - therapeutic use</topic><topic>Mental health</topic><topic>Mood disorders</topic><topic>Phototherapy</topic><topic>Population</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Seasonal Affective Disorder</topic><topic>Seasonal Affective Disorder - prevention & control</topic><topic>Seasonal Affective Disorder - therapy</topic><topic>SSRIs</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Forneris, Catherine A</creatorcontrib><creatorcontrib>Nussbaumer‐Streit, Barbara</creatorcontrib><creatorcontrib>Morgan, Laura C</creatorcontrib><creatorcontrib>Greenblatt, Amy</creatorcontrib><creatorcontrib>Van Noord, Megan G</creatorcontrib><creatorcontrib>Gaynes, Bradley N</creatorcontrib><creatorcontrib>Wipplinger, Jörg</creatorcontrib><creatorcontrib>Lux, Linda J</creatorcontrib><creatorcontrib>Winkler, Dietmar</creatorcontrib><creatorcontrib>Gartlehner, Gerald</creatorcontrib><creatorcontrib>Nussbaumer‐Streit, Barbara</creatorcontrib><collection>Wiley-Blackwell Cochrane Library</collection><collection>Cochrane Library</collection><collection>Cochrane Library (Open Aceess)</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cochrane database of systematic reviews</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Forneris, Catherine A</au><au>Nussbaumer‐Streit, Barbara</au><au>Morgan, Laura C</au><au>Greenblatt, Amy</au><au>Van Noord, Megan G</au><au>Gaynes, Bradley N</au><au>Wipplinger, Jörg</au><au>Lux, Linda J</au><au>Winkler, Dietmar</au><au>Gartlehner, Gerald</au><au>Nussbaumer‐Streit, Barbara</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Psychological therapies for preventing seasonal affective disorder</atitle><jtitle>Cochrane database of systematic reviews</jtitle><addtitle>Cochrane Database Syst Rev</addtitle><date>2019-05-24</date><risdate>2019</risdate><volume>2019</volume><issue>5</issue><spage>CD011270</spage><pages>CD011270-</pages><issn>1465-1858</issn><issn>1469-493X</issn><eissn>1465-1858</eissn><eissn>1469-493X</eissn><abstract>Background
Seasonal affective disorder (SAD) is a seasonal pattern of recurrent major depressive episodes that most commonly occurs during autumn or winter and remits in spring. The prevalence of SAD ranges from 1.5% to 9%, depending on latitude. The predictable seasonal aspect of SAD provides a promising opportunity for prevention. This is one of four reviews on the efficacy and safety of interventions to prevent SAD; we focus on psychological therapies as preventive interventions.
Objectives
To assess the efficacy and safety of psychological therapies (in comparison with no treatment, other types of psychological therapy, second‐generation antidepressants, light therapy, melatonin or agomelatine or lifestyle interventions) in preventing SAD and improving person‐centred outcomes among adults with a history of SAD.
Search methods
We searched Ovid MEDLINE (1950‐ ), Embase (1974‐ ), PsycINFO (1967‐ ) and the Cochrane Central Register of Controlled Trials (CENTRAL) to 19 June 2018. An earlier search of these databases was conducted via the Cochrane Common Mental Disorders Controlled Trial Register (CCMD‐CTR) (all years to 11 August 2015). Furthermore, we searched the Cumulative Index to Nursing and Allied Health Literature, Web of Science, the Cochrane Library, the Allied and Complementary Medicine Database and international trial registers (to 19 June 2018). We also conducted a grey literature search and handsearched the reference lists of included studies and pertinent review articles.
Selection criteria
To examine efficacy, we included randomised controlled trials (RCTs) on adults with a history of winter‐type SAD who were free of symptoms at the beginning of the study. To examine adverse events, we intended to include non‐randomised studies. We planned to include studies that compared psychological therapy versus no treatment, or any other type of psychological therapy, light therapy, second‐generation antidepressants, melatonin, agomelatine or lifestyle changes. We also planned to compare psychological therapy in combination with any of the comparator interventions listed above versus no treatment or the same comparator intervention as monotherapy.
Data collection and analysis
Two review authors screened s and full‐text publications against the inclusion criteria, independently extracted data, assessed risk of bias, and graded the certainty of evidence.
Main results
We identified 3745 citations through electronic searches and reviews of reference lists after deduplication of search results. We excluded 3619 records during title and review and assessed 126 articles at full‐text review for eligibility. We included one controlled study enrolling 46 participants. We rated this RCT at high risk for performance and detection bias due to a lack of blinding.
The included RCT compared preventive use of mindfulness‐based cognitive therapy (MBCT) with treatment as usual (TAU) in participants with a history of SAD. MBCT was administered in spring in eight weekly individual 45‐ to 60‐minute sessions. In the TAU group participants did not receive any preventive treatment but were invited to start light therapy as first depressive symptoms occurred. Both groups were assessed weekly for occurrence of a new depressive episode measured with the Inventory of Depressive Syptomatology‐Self‐Report (IDS‐SR, range 0‐90) from September 2011 to mid‐April 2012. The incidence of a new depressive episode in the upcoming winter was similar in both groups. In the MBCT group 65% of 23 participants developed depression (IDS‐SR ≥ 20), compared to 74% of 23 people in the TAU group (risk ratio (RR) 0.88, 95% confidence interval (CI) 0.60 to 1.30; 46 participants; very low quality‐evidence).
For participants with depressive episodes, severity of depression was comparable between groups. Participants in the MBCT group had a mean score of 26.5 (SD 7.0) on the IDS‐SR, and TAU participants a mean score of 25.3 (SD 6.3) (mean difference (MD) 1.20, 95% CI ‐3.44 to 5.84; 32 participants; very low quality‐evidence).
The overall discontinuation rate was similar too, with 17% discontinuing in the MBCT group and 13% in the TAU group (RR 1.33, 95% CI 0.34 to 5.30; 46 participants; very low quality‐evidence).
Reasons for downgrading the quality of evidence included high risk of bias of the included study and imprecision.
Investigators provided no information on adverse events. We could not find any studies that compared psychological therapy with other interventions of interest such as second‐generation antidepressants, light therapy, melatonin or agomelatine.
Authors' conclusions
The evidence on psychological therapies to prevent the onset of a new depressive episode in people with a history of SAD is inconclusive. We identified only one study including 46 participants focusing on one type of psychological therapy. Methodological limitations and the small sample size preclude us from drawing a conclusion on benefits and harms of MBCT as a preventive intervention for SAD. Given that there is no comparative evidence for psychological therapy versus other preventive options, the decision for or against initiating preventive treatment of SAD and the treatment selected should be strongly based on patient preferences and other preventive interventions that are supported by evidence.</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>31124141</pmid><doi>10.1002/14651858.CD011270.pub3</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1465-1858 |
| ispartof | Cochrane database of systematic reviews, 2019-05, Vol.2019 (5), p.CD011270 |
| issn | 1465-1858 1469-493X 1465-1858 1469-493X |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6533196 |
| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection; Cochrane Library |
| subjects | Adult Antidepressants Antidepressive Agents Antidepressive Agents - therapeutic use Cognitive Behavioral Therapy Condition Depression Depressive disorder Depressive Disorder, Major Depressive Disorder, Major - therapy Depressive disorders & major depression Humans Intervention Medicine General & Introductory Medical Sciences Melatonin Melatonin - therapeutic use Mental health Mood disorders Phototherapy Population Randomized Controlled Trials as Topic Seasonal Affective Disorder Seasonal Affective Disorder - prevention & control Seasonal Affective Disorder - therapy SSRIs |
| title | Psychological therapies for preventing seasonal affective disorder |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-04T00%3A42%3A45IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Psychological%20therapies%20for%20preventing%20seasonal%20affective%20disorder&rft.jtitle=Cochrane%20database%20of%20systematic%20reviews&rft.au=Forneris,%20Catherine%20A&rft.date=2019-05-24&rft.volume=2019&rft.issue=5&rft.spage=CD011270&rft.pages=CD011270-&rft.issn=1465-1858&rft.eissn=1465-1858&rft_id=info:doi/10.1002/14651858.CD011270.pub3&rft_dat=%3Cproquest_pubme%3E2232125722%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2232125722&rft_id=info:pmid/31124141&rfr_iscdi=true |