An Open Trial of Light Therapy in Adult Attention-Deficit/Hyperactivity Disorder
J Clin Psychiatry 2006;67(10):1527-1535
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Objective: In adults with
attention-deficit/hyperactivity disorder (ADHD), a delayed
sleep/activity rhythm and/or seasonal mood symptoms
may contribute significantly to core pathology and
disability. This study examined whether a chronobiologically based treatment, i.e.,
morning bright light therapy (LT), might have utility as
an adjunctive treatment for adult ADHD in the fall/winter period.
Method: Twenty-nine adults with
DSM-IV ADHD were administered a standard 3-week
open trial of LT during the fall or winter months.
Primary outcome measures included percentage reduction on the Brown Adult ADD Scale and
the Conners' Adult ADHD Scale. Secondary measures were decrease in depression scores according
to the Structured Interview Guide for the Hamilton Depression Rating Scale, Seasonal Affective
Disorder version; improvements on various neuropsychological tests; and shift toward an earlier
circadian preference as measured by the
Horne-Ostberg Morningness-Eveningness questionnaire.
Regression analyses determined which variables at
baseline best predicted improvement on a given outcome measure and which variables changed
in parallel with one another. The study was
conducted from November 2003 through February 2004.
Results: Morning bright light therapy was
associated with a significant decrease in both
subjective and objective measures of core ADHD
pathology, improved mood symptoms, and a
significant phase advance in circadian preference.
Multiple regression showed that the shift toward an
earlier circadian preference with LT was the
strongest predictor of improvement on both subjective
and objective ADHD measures. Neither baseline
global seasonality scores nor baseline depression
scores strongly predicted LT effects on most measures
Conclusion: These findings suggest that
during the fall/winter period, LT may be a useful
adjunct in many adults with ADHD. Strikingly, the
strongest correlate of improvement in core ADHD pathology was a phase advance in circadian
preference rather than alleviation of comorbid
seasonal affective disorder, suggesting important
clinical benefits of LT beyond the treatment of
seasonal affective disorder.