光照治疗在双相情感障碍中的应用进展

Application and research progress of light therapy in bipolar disorder

光照治疗(LT)是双相情感障碍(BD)的新型有效疗法。综述了LT治疗BD的生理学机制与临床应用现况。LT通过视网膜上的固有光敏视网膜神经节细胞,将光信号传递于下丘脑前视交叉上核等区域来发挥生物节律、内分泌、神经递质等调节功能,从而达到改善BD抑郁状态的作用。当前主流观点认为单一LT及LT联合治疗均可显著改善BD的抑郁严重程度。LT治疗BD的安全性良好,强光及弱光治疗均适合BD患者,现阶段的研究主要采用白光治疗,疗程1~8周。未来仍需开展更多关于LT临床参数(如强度、光谱、每日暴露持续时间)的研究,为临床实践提供参考。

Bipolar disorder(BD)is the most dangerous mental illness,with the highest suicide rate among various mental illnesses.Light therapy(LT)is a novel and effective therapy for BD.In this article,the physiological mechanisms and current clinical applications of LT in the treatment of BD are reviewed.LT transmits light signals through the inherent photosensitive retinal ganglion cells on the retina to areas such as the anterior chiasmatic nucleus of the hypothalamus,promoting their regulatory functions concerning circadian rhythm,endocrine,and neurotransmitters,thereby relieving BD depression.The mainstream view is that both single LT and LT combination therapy can significantly reduce the severity of depression in BD.With good safety of LT treatment for BD,both strong and weak light treatments are suitable for BD patients.Currently,research mainly adopts white light treatment,with a course of 1~8 weeks.Further research on LT clinical parameters(such as intensity,spectrum,and daily exposure duration)is still needed to provide reference for clinical practice.