DAWN SIMULATION TREATMENT OF ABSTINENT ALCOHOLICS WITH WINTER DEPRESSION

Background: Recent data suggest that winter depression (seasonal affec tive disorder [SAD]) may be a subtype of affective disorder that is cl osely related to alcoholism. Dawn simulation has been shown in control led trials to be effective in SAD. The present study examined the effe ctiveness of dawn simulation in abstinent alcoholics who met DSM-III-R criteria for major depression, or bipolar disorder, depressed with se asonal pattern. Method: All 12 subjects with winter depression had a h istory of either alcohol dependence or alcohol abuse according to DSM- III-R and had been abstinent from alcohol for at least 6 months. They also fulfilled criteria for SAD according to Rosenthal and were hypers omnic and drug free. After a 1-week baseline period, the subjects were randomly assigned to a 1-week treatment period at home with either a white 1.5-hour dawn from 4:30 a.m. to 6:00 a.m. peaking at 250 lux or a red 1.5-hour dawn from 4:30 a.m. to 6:00 a,m. peaking at 2 lux, The subjects were told that they would receive daily either a red or a whi te dawn reaching the same illuminance, an illuminance that would be mu ch dimmer than standard bright light treatment. At the end of each wee k, the subjects were blindly assessed by a psychiatrist using the Stru ctured Interview Guide for the Hamilton Depression Rating Scale-Season al Affective Disorder version (SIGH-SAD). Results: For the 6 subjects completing the white dawn treatment, the mean SIGH-SAD score decreased from 33.0 at baseline to 15.8 after treatment. For the 6 subjects com pleting the dim red dawn treatment, the mean SIGH-SAD score decreased from 34.3 to 32.7. The mean post-dawn SIGH-SAD score was significantly lower after the white dawn treatment than after the dim red dawn trea tment (ANCOVA with baseline SIGH-SAD as the covariate, F = 12.95, p <. 01). Superiority of the white dawn was also found by analogous analyse s for the Hamilton Rating Scale for Depression (HAM-D) (p <.01) and th e SAD Subscale (p <.05), Conclusion: The present study suggests that d awn simulation may be helpful in decreasing depression in abstinent al coholics with SAD. Further study is necessary to confirm these prelimi nary findings and to determine whether dawn simulation might be helpfu l in preventing relapse in abstinent alcoholics who have SAD.