Daytime light exposure in daily life and depressive symptoms in bipolar disorder: A cross-sectional analysis in the APPLE cohort

Yuichi Esaki, Tsuyoshi Kitajima, Kenji Obayashi, Keigo Saeki, Kiyoshi Fujita, Nakao Iwata

Research output: Contribution to journalArticle

Abstract

Objectives: Controlled artificial daylight exposure, such as light therapy, is effective in bipolar depression, but the association between uncontrolled daytime light and depressive symptoms in bipolar disorder (BD) is unclear. This study investigated the association between daytime light exposure under real-life situations and depressive symptom in patients with BD. Methods: This cross-sectional study enrolled 181 outpatients with BD. The average daytime light intensity and the total duration of light intensity of ≥1000 lux were recorded over 7 consecutive days using an actigraph that measured ambient light. Depressive symptoms were assessed using Montgomery–Åsberg Depression Rating Scale, and scores of ≥8 points were treated as depressed state. Results: Ninety-seven (53.6%) subjects were depressed state. At higher average daytime light intensity tertiles, the proportion of depressed state was significantly lower (P for trend, 0.003). In multivariable analysis adjusted for age, employment status, age at onset of BD, Young Mania Rating Scale score, bedtime, and physical activity, the highest tertile group in average daytime light intensity suggested a significantly lower odds ratio (OR) for depressed state than the lowest tertile group (OR, 0.33; 95% confidence interval [CI], 0.14–0.75; P = 0.009). Similarly, the longest tertile group in light intensity ≥1000 lux duration was significantly associated with lower OR for depressed state than lowest tertile group (OR, 0.42; 95% CI, 0.18–0.93; P = 0.033). Conclusions: The findings suggest that greater daytime light exposure in daily life is associated with decreased depressive symptoms in BD.

Original languageEnglish
Pages (from-to)151-156
Number of pages6
JournalJournal of Psychiatric Research
Volume116
DOIs
Publication statusPublished - 01-09-2019

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Bipolar Disorder
Cross-Sectional Studies
Depression
Light
Odds Ratio
Confidence Intervals
Phototherapy
Age of Onset
Outpatients
Exercise

All Science Journal Classification (ASJC) codes

  • Psychiatry and Mental health
  • Biological Psychiatry

Cite this

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title = "Daytime light exposure in daily life and depressive symptoms in bipolar disorder: A cross-sectional analysis in the APPLE cohort",
abstract = "Objectives: Controlled artificial daylight exposure, such as light therapy, is effective in bipolar depression, but the association between uncontrolled daytime light and depressive symptoms in bipolar disorder (BD) is unclear. This study investigated the association between daytime light exposure under real-life situations and depressive symptom in patients with BD. Methods: This cross-sectional study enrolled 181 outpatients with BD. The average daytime light intensity and the total duration of light intensity of ≥1000 lux were recorded over 7 consecutive days using an actigraph that measured ambient light. Depressive symptoms were assessed using Montgomery–{\AA}sberg Depression Rating Scale, and scores of ≥8 points were treated as depressed state. Results: Ninety-seven (53.6{\%}) subjects were depressed state. At higher average daytime light intensity tertiles, the proportion of depressed state was significantly lower (P for trend, 0.003). In multivariable analysis adjusted for age, employment status, age at onset of BD, Young Mania Rating Scale score, bedtime, and physical activity, the highest tertile group in average daytime light intensity suggested a significantly lower odds ratio (OR) for depressed state than the lowest tertile group (OR, 0.33; 95{\%} confidence interval [CI], 0.14–0.75; P = 0.009). Similarly, the longest tertile group in light intensity ≥1000 lux duration was significantly associated with lower OR for depressed state than lowest tertile group (OR, 0.42; 95{\%} CI, 0.18–0.93; P = 0.033). Conclusions: The findings suggest that greater daytime light exposure in daily life is associated with decreased depressive symptoms in BD.",
author = "Yuichi Esaki and Tsuyoshi Kitajima and Kenji Obayashi and Keigo Saeki and Kiyoshi Fujita and Nakao Iwata",
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Daytime light exposure in daily life and depressive symptoms in bipolar disorder : A cross-sectional analysis in the APPLE cohort. / Esaki, Yuichi; Kitajima, Tsuyoshi; Obayashi, Kenji; Saeki, Keigo; Fujita, Kiyoshi; Iwata, Nakao.

In: Journal of Psychiatric Research, Vol. 116, 01.09.2019, p. 151-156.

Research output: Contribution to journalArticle

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T1 - Daytime light exposure in daily life and depressive symptoms in bipolar disorder

T2 - A cross-sectional analysis in the APPLE cohort

AU - Esaki, Yuichi

AU - Kitajima, Tsuyoshi

AU - Obayashi, Kenji

AU - Saeki, Keigo

AU - Fujita, Kiyoshi

AU - Iwata, Nakao

PY - 2019/9/1

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N2 - Objectives: Controlled artificial daylight exposure, such as light therapy, is effective in bipolar depression, but the association between uncontrolled daytime light and depressive symptoms in bipolar disorder (BD) is unclear. This study investigated the association between daytime light exposure under real-life situations and depressive symptom in patients with BD. Methods: This cross-sectional study enrolled 181 outpatients with BD. The average daytime light intensity and the total duration of light intensity of ≥1000 lux were recorded over 7 consecutive days using an actigraph that measured ambient light. Depressive symptoms were assessed using Montgomery–Åsberg Depression Rating Scale, and scores of ≥8 points were treated as depressed state. Results: Ninety-seven (53.6%) subjects were depressed state. At higher average daytime light intensity tertiles, the proportion of depressed state was significantly lower (P for trend, 0.003). In multivariable analysis adjusted for age, employment status, age at onset of BD, Young Mania Rating Scale score, bedtime, and physical activity, the highest tertile group in average daytime light intensity suggested a significantly lower odds ratio (OR) for depressed state than the lowest tertile group (OR, 0.33; 95% confidence interval [CI], 0.14–0.75; P = 0.009). Similarly, the longest tertile group in light intensity ≥1000 lux duration was significantly associated with lower OR for depressed state than lowest tertile group (OR, 0.42; 95% CI, 0.18–0.93; P = 0.033). Conclusions: The findings suggest that greater daytime light exposure in daily life is associated with decreased depressive symptoms in BD.

AB - Objectives: Controlled artificial daylight exposure, such as light therapy, is effective in bipolar depression, but the association between uncontrolled daytime light and depressive symptoms in bipolar disorder (BD) is unclear. This study investigated the association between daytime light exposure under real-life situations and depressive symptom in patients with BD. Methods: This cross-sectional study enrolled 181 outpatients with BD. The average daytime light intensity and the total duration of light intensity of ≥1000 lux were recorded over 7 consecutive days using an actigraph that measured ambient light. Depressive symptoms were assessed using Montgomery–Åsberg Depression Rating Scale, and scores of ≥8 points were treated as depressed state. Results: Ninety-seven (53.6%) subjects were depressed state. At higher average daytime light intensity tertiles, the proportion of depressed state was significantly lower (P for trend, 0.003). In multivariable analysis adjusted for age, employment status, age at onset of BD, Young Mania Rating Scale score, bedtime, and physical activity, the highest tertile group in average daytime light intensity suggested a significantly lower odds ratio (OR) for depressed state than the lowest tertile group (OR, 0.33; 95% confidence interval [CI], 0.14–0.75; P = 0.009). Similarly, the longest tertile group in light intensity ≥1000 lux duration was significantly associated with lower OR for depressed state than lowest tertile group (OR, 0.42; 95% CI, 0.18–0.93; P = 0.033). Conclusions: The findings suggest that greater daytime light exposure in daily life is associated with decreased depressive symptoms in BD.

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