Backround. Borderline personality disorder (BPD) is typically characterized by instability and impairmed behaviour,-affectivity, interpersonal relations and lifestyle. The most common condition comorbid with BPD is a depressive-episode. Depression is associated with severe disturbance of the circadian rhythms. This is apparent in depressive-patients with BPD. Both sleep and diurnal rhythms are disturbed and the symptoms fluctuate. Bright light may be an-effective in treatment of seasonal affective disorder, circadian sleep disorder and jet lag. It also improves sleep-wake-patterns and behavioural disorders in hospitalized patients with Alzheimer’s disease. Several studies have suggested-antidepressant effects of phototherapy in non-seasonal depressive episodes. The treatment of comorbid depressive-disorder and borderline personality disorder (BPD) is usually reported to be less successful than the treatment of-patients without personality disorder. Studies describing the use of bright light in depressed patients with comorbid-BPD have not been published so far. Method. The aim of this open study was to assess the effectiveness of a 6-week combined therapy with the application-of bright light (10,000 lux, 6:30 to 7:30 a.m. for 6 weeks) added to SSRIs in drug-resistant depressed patients-with comorbid BPD who did not respond with improvement to 6-week administration of antidepressants. The study-comprised 13 female patients who met the ICD-10 diagnostic criteria for research and the DSM-IV-TR diagnostic-criteria for major depression. The participants were regularly evaluated using the CGI, HAMD and MADRS scales-and the BDI and BDI self-report inventories. Results. According to all the assessment instruments, the application of bright white light leads to a significant-improvement. However, the results must be interpreted with caution due to the open nature of the study.

Department of Psychiatry University Hospital Olomouc

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