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SAD sufferers may find a "cure" in multi treatments

If you suffer from SAD, seasonal affective disorder, you couldn't find a glommier place to live than Vermont. Vermont's long, cold, damp, cloudy winters are the worst things for SAD sufferers; many SAD victims dream of moving to either Arizona or Florida during the dark nadir of a Vermont winter.

Now, a new approach to treating SAD may enable more sufferers to live out rich, full lives during the winter months in the Green Mountain State.

In the September issue of the journal Behavior Therapy, Kelly Rohan, associate professor of psychology at the University of Vermont, presents the first published research study of the long-term effects of different treatments for seasonal affective disorder (SAD), a form of severe depression that occurs annually in the fall and winter seasons.

The first year Rohan randomized 69 people with SAD into one of four groups: light therapy treatment, cognitive behavior therapy (CBT), a combination of the two or a wait-list control. She then surveyed participants on how they were doing the next winter-one year later.

Of those treated with CBT, only 7 percent had a recurrence compared to 36.7 percent of people treated with light therapy. The recurrence rate for the combination group was 5.5 percent. When Rohan looked at the severity of the depression that did occur, however, CBT was associated with less severe depression than those treated with either light therapy or a combination of both.

In a previous study that measured the acute affects of each treatment (immediately following six weeks of intervention), combination therapy was highly effective, with a nearly 80 percent remission rate compared to 50 percent for both CBT and light therapy alone and 20 percent on the wait-list.

Rohan hypothesizes that such dramatic results for the combination therapy are the result of being in a heavily monitored study with full participation. When people are left on their own to manage symptoms the subsequent winter, follow-through is much more difficult. This "watered-down" effect of a two-modality treatment, Rohan notes, has been reported for 20 years across psychology disorders of all sorts.

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