Always an interesting topic – but we thought much more could have been done with this story. (Yes, we know you can’t do all things with all stories, but this story has been told so many times that we look for an emphasis on what’s new or on broader context.)
The story does a credible job of explaining that physicians treat people diagnosed with seasonal affective disorder (SAD) with light to try to shift their biological clocks into a better rhythm. The discussion of actual clinical studies is disappointingly brief. We are not given any idea of how commonly light therapy is prescribed – only the unsubstantiated statement that “for the millions of Americans who suffer from mild to severe winter blues…bright-light therapy is the treatment of choice.”
Our reviewers included a science journalist who lives in the Pacific Northwest, where stories about SAD abound, and who has written about these treatments…and a Duke professor of medicine and psychiatry.
Millions of Americans suffer from depression (not necessarily the seasonal variety) and they take millions of dollars worth of antidepressant medications. Research on what is called chronobiology points to some effectiveness for light therapy on depressive disorders. This story could have delivered a deeper examination of drug vs. non-drug therapies. It stopped short of delivering that larger picture to the readers. The story does say that light therapy may “help” with depression, sleep disorders, dementia, bulimia, bipolar disorder and attention deficit hyperactivity disorder – but it does not provide much actual evidence about these wider implications.
Light sources for therapy cost about $200, the story explains. But it gives an incomplete picture by not factoring in follow up visits to a health provider when getting light therapy vs. receiving medication or psychotherapy. The story raises a very big issue, but does not provide evidence. Do patients need the same level of followup from a physician when getting light therapy as those treated with medication or psychotherapy? Does avoidance of drug side effects lead to additional overall cost savings to the health care system?
The story states “there is little profit to be made from it and no commercial incentive to promote the treatment.” At $200 per box online – and with “millions” using “bright-light therapy as the treatment of choice” – as the story claims – is there not some commercial incentive in those kinds of numbers?
This story did not provide any quantified detail about the results of using light therapy for seasonal affective disorder. It quoted two patients, anecdotally, about how much they believed they had been helped. It quoted the American Psychiatric Association as saying the therapy is “an effective low-risk treatment” for both seasonal and major depressive disorder. But it did not give any metric for how well the treatment works, or how quickly or for how long. How many patients getting light therapy get a little bit better? Much better? No better?
The story stated “Side effects include headaches and hypomania.” And it included the warning: “Using a light box is not as simple as it may appear. Experts recommend consulting with a knowledgeable health care provider.”
Another point the story could have raised is that a person with a disorder that does not respond to light may self-diagnose and fail to seek more effective therapy or advice.
The story tells readers about a 2006 “double-blind” study without naming the journal where it was published or the lead author. This is very selective reporting. There have been many trials and meta-analyses of these trials. The story could easily lead readers to conclude that there are few studies, when in fact there are many. Readers need that broader context in order to evaluate the qualitiy of the evidence.
In fact, another story by the same reporter in the same paper just 10 months ago noted “a new, carefully designed randomized controlled trial — of the kind considered the gold standard in medicine — suggests bright light therapy deserves a closer look.” Granted, it was a study in elderly patients with nonseasonal major depressive disorder, but it was still part of the much larger evidence base for light therapy that could have been referenced.
This story does not exaggerate the consequences of seasonal depression.
The story uses independent sources, but strangely does not quote anyone who participated in the single research study cited from 2006.
The story does mention the existing use of anti-depressant drugs for seasonal depression, but does not compare in detail the price or length of drug therapy vs. light therapy. This comparison would have been very helpful to consumers. Other alternatives – including cognitive behavioral therapy, psychotherapy or exercise – were not mentioned.
The story makes it clear how widely used are the light boxes and that they are sold online and available for rent.
The story doesn’t make any inappropriate claims about the novelty (or lack thereof) in light therapy.
The story quotes four different people – two patient and two researchers. It does not appear to rely on a news release.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
Comments (1)
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Richard J Kres
December 4, 2011 at 12:17 pmThank you very much for the review “A Portable Glow to Help Melt Those Winter Blues”. I agree with the contents. Moreover I like your way of reporting with scentences like: “Does the story use independent sources and identify conflicts of interest?”. I will use your way of reporting to improve my (our) way of reporting about the quality of the authoritys of the town Utrecht NL. Richard Kres, civil socity group http://www.stemmeninutrecht.nl.
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