A Clinical Trial of Light Therapy on Patients with Premenstrual Dysphoric Disorder

Joe, S H; Kim, J S; Kim, S H; Kim, L

Abstract

OBJECTIVES
Patients with premenstrual dysphoric disorder (or PMDD) have impairments of the social, occupational or academic function due to psychological or somatic symptoms, which have the characteristic pattern of symptom exacerbation in the week before menses begin and remission shortly after the onset of menses. In the chronobiological view, many researchers have assumed that the etiology of PMDD is the advanced circadian rhythm. It has been suggested that light has a therapeutic effect on PMDD, because evening light results in phase delay of circadian rhythm through the biochemical changes including melatonin.
METHODS
The authors investigated the therapeutic effect of light therapy on four patients with prospectively diagnosed PMDD by DSM-IV criteria using clinical psychiatric interview, Premenstrual Assessment Form (PAF)and Daily Rating Form (or DRF). In the evening (6:30pm-8:00pm), the 2,500 lux light administered for seven consecutive days during the symptomatic late luteal phase of menstrual cycle. Beck Depression Inventory (or BDI). Hamilton Rating Scale for Depression (or HAM-D), Spielberg State Anxiety Inventory (or SA), and DRF were evaluated before and after seven days of light therapy.
RESULTS
Premenstrual symptoms of PMDD could be effectively treated with the evening bright light therapy, especially in PMDD patients with atypical symptoms. In addition, the light therapy seemed to more effective on the psychologic symptoms than the somatic symptoms of PMDD. There was no significant side-effect of light therapy, except the transient and mild eye-strain in one case.
CONCLUSIONS
In spite of the results of limited data from our clinical trial, the authors suggest that the potential use of light therapy as an alternative to the pharmacological management of patients with PMDD.