Cognitive-behavioral Therapy vs. Light Therapy for Preventing SAD Recurrence
Seasonal Affective Disorder (SAD), Winter Depression, Major Depressive Disorder, Recurrent, With Seasonal Pattern
About this trial
This is an interventional prevention trial for Seasonal Affective Disorder (SAD) focused on measuring seasonal affective disorder, winter depression, cognitive-behavioral therapy, light therapy
Eligibility Criteria
Inclusion Criteria:
- aged 18 or older
- meet DSM-IV criteria for Major Depression, Recurrent, with Seasonal Pattern
- meet Structured Interview Guide for the Hamilton Rating Scale for Depression-Seasonal Affective Disorder Version (SIGH-SAD) criteria for a current SAD episode
Exclusion Criteria:
- past light therapy or cognitive-behavioral therapy for SAD
- presence of a comorbid Axis I disorder that requires immediate treatment
- acute and serious suicidal intent
- positive laboratory findings for hypothyroidism
- plans for major vacations or absences from the study area through March
Sites / Locations
- University of Vermont, Psychology Department
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Cognitive-Behavioral Therapy (CBT)
Light Therapy (LT)
The CBT is a SAD-tailored version of Beck et al.'s (1979) cognitive therapy for depression called "Coping with the Seasons" (Rohan, 2008). The rationale addresses environmental changes, thoughts, and behaviors in SAD onset and maintenance. It seeks to change behaviors and thoughts to improve coping with winter. Behaviors that promote enjoyment in the winter are increased. Negative thoughts that interfere with self-esteem and negative thoughts about winter are identified and addressed. A relapse-prevention component addresses early identification of negative anticipatory thoughts about winter and SAD-related behavior changes, using the CBT skills learned to cope with subsequent winter seasons, and development of a personalized relapse-prevention plan. The CBT sessions are administered twice a week over 6 weeks (total of 12 sessions) with 4-8 participants per group. The CBT is led by one of three licensed Ph.D.-level psychologists working on the project.
LT will be initiated at 30-minutes in the morning at home, first thing upon awakening, using a light box with an ultraviolet shield that emits 10,000-lux of white fluorescent light. After the first week, an M.D. light therapy consultant will recommend individually-tailored, clinical adjustments to the duration and timing of light use to maximize response and reduce any reported side effects. For each of the 6-weeks of LT, LT participants will complete a Light Therapy Side Effects Questionnaire to assess side effects attributed to LT. Participants will keep daily LT compliance diaries to record the timing and duration of LT. After the 6-weeks of monitoring, participants may choose to continue using the light box through April. We will offer LT participants who wish to use light therapy in the next fall/winter season access to our light boxes if they agree to followup with a physician or other qualified professional for monitoring and side effects management.