SUICIDAL TENDENCIES AS A COMPLICATION OF LIGHT THERAPY FOR SEASONAL AFFECTIVE-DISORDER - A REPORT OF 3 CASES

Background: Suicidality in seasonal affective disorder (SAD) subjects treated with bright light therapy seems to be a rare phenomenon. We re port on three SAD patients with predominant atypical symptoms who pres ented for treatment in our clinic for SAD. Two suffered from bipolar d isorder, one from recurrent major depressive disorder. Method: All sub jects were drug-free and treated with bright light therapy as a monoth erapy for the first time. Treatment response was assessed weekly by st andardized rating instruments, using the Hamilton Rating Scale for Dep ression (HAM-D) and the HAM-D-SAD addendum for assessment of atypical symptoms. Results: Within the first week after beginning bright light therapy, two subjects attempted suicide. The third patient developed s uicidal thoughts that were so acute and overwhelming that we had to di scontinue bright light therapy and start with psychopharmacologic trea tment in an inpatient setting. Conclusion: It is suggested that bright light-induced amelioration of drive and mood can be dissociated as ca n be the case in the ''critical time'' of antidepressant therapy. The authors believe the collection of prevalence data on suicide and SAD w ould be worthwhile.