An Open Trial of Light Therapy for Women With Seasonal Affective Disorder and Comorbid Bulimia Nervosa
J Clin Psychiatry 2001;62(3):164-168
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objective: Many patients with seasonal affective
disorder (SAD) have dysfunctional eating behaviors. Conversely,
many women with bulimia nervosa have marked winter worsening of
mood and bulimic symptoms. Controlled studies of light therapy in
SAD and in bulimia nervosa have shown beneficial effects on mood
and binge/purge symptoms. We explored the clinical use of light
therapy in women with SAD who also had comorbid bulimia nervosa.
Method: Twenty-two female patients diagnosed
using DSM-IV criteria with both bulimia nervosa and major
depressive disorder with a seasonal (winter) pattern were treated
with an open design, 4-week trial of light therapy (10,000 lux
fluorescent light box with an ultraviolet filter, 30 to 60
minutes per day in the early morning). Patients were assessed
before and after treatment with depression scales and with
Results: Light therapy resulted in significant
improvement in mood, with a mean 56% reduction in 29-item
Hamilton Rating Scale for Depression scores following treatment
(p < .001). The frequency of binges and purges per week also
significantly decreased (p < .001) from baseline by a mean of
46% and 36%, respectively. Two (9%) of 22 patients became
abstinent of binge/purge episodes, compared with 10 (45%) of 22
patients who met criteria for remission of depressive symptoms.
The light therapy was well tolerated by patients.
Conclusion: These results suggest that
therapeutic effects of light therapy on mood and bulimic symptoms
in patients with SAD and comorbid bulimia nervosa are sustained
over at least 4 weeks. However, the low abstinence rate in
bulimic symptoms indicates that light therapy may be most
effectively used as an adjunctive treatment to medications and/or
psychotherapy for bulimia nervosa.