Bright light therapy in pregnant women with major depressive disorder: study protocol for a randomized, double-blind, controlled clinical trial.

BACKGROUND: Depression during pregnancy is a common and high impact disease. Generally, 5-10 % of pregnant women suffer from depression. Children who have been exposed to maternal depression during pregnancy have a higher risk of adverse birth outcomes and more often show cognitive, emotional and behavioural problems. Therefore, early detection and treatment of antepartum depression is necessary. Both psychotherapy and antidepressant medication, first choice treatments in a non-pregnant population, have limitations in treating depression during pregnancy. Therefore, it is urgent and relevant to investigate alternative treatments for antepartum depression. Bright light therapy (BLT) is a promising treatment for pregnant women with depressive disorder, for it combines direct availability, sufficient efficacy, low costs and high safety, taking the safety for the unborn child into account as well. METHODS: In this study, 150 pregnant women (12-18 weeks pregnant) with a DSM-V diagnosis of depressive disorder will be randomly allocated in a 1:1 ratio to one of the two treatment arms: treatment with BLT (9.000 lux) or treatment with dim red light therapy (100 lux). Both groups will be treated for 6 weeks at home on a daily basis for 30 min, within 30 min of habitual wake-up time. Follow-up will take place after 6 weeks of therapy, 3 and 10 weeks after end of therapy, at birth and 2, 6 and 18 months postpartum. Primary outcome will be the average change in depressive symptoms between the two groups, as measured by the Structured Interview Guide for the Hamilton Depression Scale - Seasonal Affective Disorder version and the Edinburg Postnatal Depression Scale. Changes in rating scale scores of these questionnaires over time will be analysed using generalized linear mixed models. Secondary outcomes will be the changes in maternal cortisol and melatonin levels, in maternal sleep quality and gestational age, birth weight, infant behaviour, infant cortisol exposure and infant cortisol stress response. DISCUSSION: If BLT reduces depressive symptoms in pregnant women, it will provide a safe, cheap, non-pharmacological and efficacious alternative treatment for psychotherapy and antidepressant medication in treating antepartum depression, without any expected adverse reactions for the unborn child. TRIAL REGISTRATION: Netherlands Trial Register NTR5476 . Registered 5 November 2015.

Using music to change mood while driving.

This study investigated whether gradual or abrupt music change towards more calming music is most effective in calming drivers during high-demand driving situations. Twenty-eight participants were subjected to two types of music change (gradual, abrupt) in a within-subject design. First, a relatively happy mood was induced with personally selected music during an eight-minute simulated high-demand drive. The drive then continued and the mood was changed either gradually or abruptly. Subjective results showed successful music mood induction irrespective of gradual or abrupt changes. The results further showed lower skin conductance (less arousal) and more facial corrugator muscle tension (more sadness) during the abrupt music change. Fewer accidents occurred during the abrupt music mood change. To conclude, the results support the abrupt way of changing music type to down-regulate one's mood: during high-demand driving, abrupt changes in music led to more physiological calmness and improved driving performance, and were thus safer and more effective. PRACTITIONER SUMMARY: The current study shows that during high-demand drives, drivers are calmed more effectively using abrupt music changes compared to gradual music changes. This is illustrated by reductions in physiological arousal and improved driving behaviour. Hence, in-car music presentation can be used as a tool to improve driver's mood and behaviour.

The influence of music on mood and performance while driving.

Mood can influence our everyday behaviour and people often seek to reinforce, or to alter their mood, for example by turning on music. Music listening while driving is a popular activity. However, little is known about the impact of music listening while driving on physiological state and driving performance. In the present experiment, it was investigated whether individually selected music can induce mood and maintain moods during a simulated drive. In addition, effects of positive, negative, and no music on driving behaviour and physiological measures were assessed for normal and high cognitive demanding rides. Subjective mood ratings indicated that music successfully maintained mood while driving. Narrow lane width drives increased task demand as shown in effort ratings and increased swerving. Furthermore, respiration rate was lower during music listening compared to rides without music, while no effects of music were found on heart rate. Overall, the current study demonstrates that music listening in car influences the experienced mood while driving, which in turn can impact driving behaviour. PRACTITIONERS SUMMARY: Even though it is a popular activity, little is known about the impact of music while driving on physiological state and performance. We examined whether music can induce moods during high and low simulated drives. The current study demonstrates that in car music listening influences mood which in turn can impact driving behaviour. The current study shows that listening to music can positively impact mood while driving, which can be used to affect state and safe behaviour. Additionally, driving performance in high demand situations is not negatively affected by music.