Bright Light Treatment of Child and Adolescent Depression and Depressive Symptoms: A Systematic Review

Background and Purpose: The use of evidence-informed interventions is considered best practice for clinical social workers. Systematic reviews can be used to evaluate an intervention’s efficacy in a comprehensive and unbiased manner. Further, systematic reviews are a needed resource for researchers as they help to identify gaps in the literature, and provide direction for future research to test treatment efficacy. A systematic review of the effectiveness of Bright Light Treatment (BLT) for child and adolescent depression and depressive symptoms was conducted. Depression is the most prevalent mental health disorder in youth and is linked to outcomes such as academic failure, dysfunctional interpersonal relationships, and suicide. These functional impairments often create consequences that follow youth into adulthood. Thus, effective treatment of depression and depressive symptoms is crucial. BLT, first developed to treat a seasonality component of depression, has been demonstrated to be effective in reducing depressive symptoms among adults. This systematic review examined BLT’s efficacy in reducing depressive symptoms among youth meeting formal diagnostic criteria for depression or evidencing subclinical depressive symptoms.  

Methods: Information science and systematic review experts were consulted to develop search protocols and study a priori inclusion/exclusion criteria (i.e., Cochrane and Campbell Collection resources, and PRISMA/AMSTAR systematic review guidelines). A systematic search of English-language reports was completed in six bibliographic databases using predefined search strings developed with a university social science reference librarian. Grey literature was also searched by electronically searching databases of dissertations, theses, and conference proceedings. Two independent authors extracted information from selected articles including study methodology, dose/length of treatment, and outcomes using pilot-tested data extraction forms.  

Results: After removing duplicates, 249 potentially pertinent articles were identified. Upon completion of title, abstract and subsequent full text review, 12 articles remained. Seven articles were case studies. The five experimental studies were dissimilar in research methods, age and diagnosis of participants, and length and dose of treatment. Four of five experimental studies used a standardized measure of depressive symptoms. Minimum side effects were reported. All 12 articles noted a significant reduction in depressive symptoms after BLT use.

Conclusions and Implications: While the promise of BLT use among children and adolescents for the treatment of depression and depressive symptoms is widely heralded, few experimental studies have tested the efficacy of BLT in this population. Results of this systematic review suggest that BLT may be an effective treatment for depression and depressive symptoms in youth; however, due to the lack of rigor in study designs, methods, and measurement, any conclusion as to the efficacy of BLT with depressed youth is premature. In the absence of a systematic review of the type reported herein, it would be difficult to cogently assess the efficacy of BLT for treatment of depressed youth. Further, systematic reviews, such as the one reported herein, can highlight the directions intervention researchers need to take to appropriately improve study designs and methods.