Light Therapy on Major Depression Disorder

Determine severity of depression (scores: 0-50)

• Depressed Mood (sadness, hopeless, helpless, worthless) (0-4 scores)
• Feelings of Guilt(0-4 scores)
• Suicide(0-4 scores)
• Insomnia - Early(0-2 scores)
• Insomnia - Middle(0-2 scores)
• Insomnia - Late(0-2 scores)
• Work and Activities(0-4 scores)
• Retardation (slowness of thought and speech; impaired ability to concentrate; decreased motor activity)(0-4 scores)
• Agitation(0-2 scores)
• Anxiety - Psychic(0-4 scores)
• Anxiety - Somatic(0-4 scores)
• Somatic Symptoms - Gastrointestinal(0-2 scores)
• Somatic Symptoms - General(0-2 scores)
• Genital Symptoms(0-2 scores)
• Hypochondriasis(0-4 scores)
• Loss of Weight(0-2 scores)
• Insight(0-2 scores)

Scores below 7 generally represent the absence or remission of depression. Scores between 7-17 represent mild depression. Scores between 18-24 represent moderate depression. Scores 25 and above represent severe depression.

Higher MADRS score indicates more severe depression, and each item yields a score of 0 to 6. The overall score ranges from 0 to 60.

The questionnaire includes questions on the following symptoms

• Apparent sadness 2. Reported sadness 3. Inner tension 4. Reduced sleep 5. Reduced appetite 6. Concentration difficulties 7. Lassitude 8. Inability to feel 9. Pessimistic thoughts 10. Suicidal thoughts

0 to 6 - normal /symptom absent 7 to 19 - mild depression 20 to 34 - moderate depression >34 - severe depression

The Clinical Global Impression - Severity scale (CGI-S) is a 7-point scale that requires the clinician to rate the severity of the patient's illness at the time of assessment, relative to the clinician's past experience with patients who have the same diagnosis. Possible ratings are:

• Normal, not at all ill
• Borderline mentally ill
• Mildly ill
• Moderately ill
• Markedly ill
• Severely ill
• Among the most extremely ill patients

Depression screening by a nine-item in adults

Over the last two weeks, how often have you been bothered by any of the following problems? (Scores: 0-27) 0:Not at all, 1:Several days, 2:More than half the days, 3:Nearly every day

• Little interest or pleasure in doing things
• Feeling down, depressed, or hopeless
• Trouble falling or staying asleep, or sleeping too much
• Feeling tired or having little energy
• Poor appetite or overeating
• Feeling bad about yourself, or that you are a failure, or have let yourself or your family down
• Trouble concentrating on things, such as reading the newspaper or watching television
• Moving or speaking so slowly that other people could have noticed? Or the opposite, being so fidgety or restless that you have been moving around a lot more than usual
• Thoughts that you would be better off dead or of hurting yourself in some way

0-4:No depression, 5-9:Mild, 10-14:Moderate, 15-19:Moderately severe, 20-27: Severe

Compare brain resting-state functional MRI change between these two arms.

Including measures brain activity by detecting changes associated with blood flow and difference of Resting State Network which is a functionally connected neural network of apparent brain states.

Increased strength of the activities or resting state network indicates neural activities are elevated within the regions of the brain or the network.

Decreased strength of the activities or resting state network indicates neural activities are diminished within the regions of the brain or the network.

Compare brain Diffusion Tensor Imaging between these two arms.

Evaluation the connection or fiber tracts between regions of the brain. Increased strength means enhanced connection between neuronal regions of the brain.

Decreased strength means decreased connection between neuronal regions of the brain.