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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Depressive Disorder, Major, Double-Blind Method, Female, Humans, Hydrocortisone, Male, Middle Aged, Phototherapy, Predictive Value of Tests, Psychometrics, Saliva, Serotonin Uptake Inhibitors, Sertraline, Treatment Failure, Wakefulness.
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Is high cortisol awakening response associated with an impairment of the effect of bright light therapy? Context: We investigated the predictive validity of the cortisol awakening response (CAR) in patients with non-seasonal major depression. Patients were treated with sertraline in combination with bright or dim light therapy for a 5-week period. Saliva cortisol levels were measured in 63 patients, as an awakening profile, before medication and light therapy started. The CAR was calculated by using three time-points: awakening and 20 and 60 min after awakening. Patients with low CAR had a very substantial effect of bright light therapy compared with dim light therapy, whereas patients with a high CAR had no effect of bright light therapy compared with dim light therapy.
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High CAR was associated with an impairment of the effect of bright light therapy. This result raises the question of whether bright light acts through a mechanism different from that of antidepressants. Final Decision: yes