Overview
Depression, HRSD
BLIND, PARRY
We described the essential features of our protocol including screening, eligibility, inclusion, and exclusion criteria previously (Parry et al. Study flow: Luteinizing hormone surge (LHS) marks ovulation. Women begin actigraphy recordings on LHS for 10 days on menstrual cycle days (CD) 14–24. In months 2, 3, and 5, beginning on CD 14, women collect urine samples for 6-sulphatoxymelatonin (6-SMT) for 36 h over 2 nights between 8 and 9 days after the LHS (c. CD 22–23). They undergo phase-advance sleep (PAS) or phase-delay sleep (PDS) at home on the night of the LHS, and receive bright morning (AM) or bright evening (PM) light on days 1–7 after LHS (CD 15–21) in a counterbalanced, cross-over design in months 3 and 5. Mood ratings (Structured Interview Guide for the Hamilton Rating Scale for Depression (HRSD) with Atypical Depression supplement-SIGH-ADS) are obtained as follows: months 1 and 2—once per week; months 3 and 5—LHS (Pre-PAI/PDI), daily LHS + 1 day → LHS + 2 days, and once during the evening after last treatment day (LHS + 7/8 days). Blind raters assessed mood by the SIGH-ADS once during month 4 and once a month after intervention 2 for 3 months to clinically monitor relapse

PAI vs. PDI will normalize melatonin circadian rhythms in PMDD by phase-advancing urinary melatonin timing measures (i.e., 6-SMT offset time).PAI will improve mood more than PDI.Mood improvement will correlate positively with the magnitude of phase-advance in 6-SMT offset time after PAI.