Efficacy of bright light therapy for perinatal depression: A meta-analysis of a randomized controlled trial

doi:10.13105/wjma.v13.i1.99971

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World Journal of Meta-Analysis

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Meta-Analysis

World J Meta-Anal. Mar 18, 2025; 13(1): 99971
Published online Mar 18, 2025. doi: 10.13105/wjma.v13.i1.99971

Efficacy of bright light therapy for perinatal depression: A meta-analysis of a randomized controlled trial

Xue Yang, Yuan-Yuan Gao, Shu-Qi Xu, Jin-Cheng Wang, Yu-Jie Ma, Li-Huan Jiao, Lan Wang, Xue-Yi Wang, Shahid Bashir, Cui-Xia An, Ran Wang

Xue Yang, Yuan-Yuan Gao, Shu-Qi Xu, Jin-Cheng Wang, Yu-Jie Ma, Li-Huan Jiao, Lan Wang, Xue-Yi Wang, Cui-Xia An, Ran Wang, Mental Health Center, The First Hospital of Hebei Medical University, Shijiazhuang 050031, Hebei Province, China

Shahid Bashir, Neuroscience Center, King Fahad Specialist Hospital Dammam, Dammam 0096613, Saudi Arabia

Co-first authors: Xue Yang and Yuan-Yuan Gao.

Co-corresponding authors: Cui-Xia An and Ran Wang.

Author contributions: Yang X contributed to the conceptualization, data curation, formal analysis, investigation and methodology of the study and the writing of the manuscript; Yang X and Gao YY contributed to the writing the manuscript, they contributed equally to this article, they are the co-first authors of this manuscript; Gao YY, Xu SQ, Wang JC, Ma YJ, and Jiao LH contributed to the investigation of the study; Wang L and Bashir S contributed to the investigation and formal analysis of the study; Wang XY contributed to the quality and professional revision; An CX and Wang R contributed to the conceptualization and funding acquisition of the study, they contributed equally to this article, they are the co-corresponding authors of this manuscript; Wang R contributed to the revision of the manuscript; and all authors thoroughly reviewed and endorsed the final manuscript.

Supported by the Hebei Province Natural Science Foundation, No. H2018206034 and No. H2022206544; Hebei Province clinical medicine outstanding personnel training project, No. ZF2024135.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.

Corresponding author: Ran Wang, MD, PhD, Professor, Mental Health Center, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Shijiazhuang 050031, Hebei Province, China. wr104@hebmu.edu.cn

Received: August 4, 2024
Revised: December 13, 2024
Accepted: December 25, 2024
Published online: March 18, 2025
Processing time: 221 Days and 22.4 Hours

Abstract

BACKGROUND

Pharmacological treatments are commonly used in individuals experiencing perinatal depression (PPD); however, a debate regarding the reproductive safety of antidepressants is ongoing. Many pregnant women opt to discontinue antidepressant out of concern about potential negative effects on the developing fetus, while slow and ineffective antidepressant medications hinder improved outcomes in women with PPD. In recent years, bright light therapy (BLT) has gained traction as a treatment option for PPD; however, clinical trials findings examining the efficacy of BLT in this population have been inconclusive.

AIM

To validate the feasibility and safety of BLT for the treatment of PPD.

METHODS

We performed a meta-analysis of randomized controlled trials of patients with PPD treated with BLT vs placebo following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. We searched PubMed, Embase, the Cochrane Library, and Web of Science for randomized controlled studies published up to December 2023. The results were evaluated using the standardized mean difference of improvement for depression scores and odds ratios (ORs) for remission rate, response rate, incidence of adverse events, and dropout rate.

RESULTS

The BLT group had higher PPD response rate [50.68% vs 33.08%; OR = 2.05; 95% confidence interval (CI): 1.25-3.35; P = 0.004; I^² = 35%] and remission rate (54.10% vs 18.52%; OR = 5.00; 95%CI: 2.09-11.99; P = 0.0003; I^² = 0%) than the placebo group. Improvements in depression scores were higher in the BLT group than the placebo group for the overall efficacy (standardized mean difference = -0.47; 95%CI: -0.80 to -0.13; P = 0.007). No significant differences between the two groups in drop-outs (21.84% vs 29.63%; OR = 0.63; 95%CI: 0.31-1.29; P = 0.21; I^² = 0%) or adverse events (17.89% vs 9.68%; OR = 2.01; 95%CI: 0.95-4.25; P = 0.07; I^² = 0%) were observed.

CONCLUSION

BLT can potentially treat PPD, showing better results than the control group in this study. BLT is effective and safe and could increase the available therapeutic options for PPD.

Keywords: Bright light therapy; Randomized controlled trial; Perinatal depression; Pregnancy; Meta-analysis

Core Tip: Bright light therapy represents a promising intervention for the treatment of perinatal depression, demonstrating significant efficacy and a favorable safety profile. This non-pharmacological approach is particularly well-received among pregnant and postpartum individuals, as well as their support networks, due to its lack of systemic side effects. The integration of bright light therapy into the psychiatric armamentarium for perinatal depression may enhance therapeutic flexibility and patient adherence, thereby contributing to improved mental health outcomes in this vulnerable population.