Seasonal affective disorder and non-seasonal affective disorders: results from the NESDA study (original) (raw)
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Biological Psychiatry, 1999
The aim of the present study was to assess the prevalence of seasonal affective disorder (SAD) in The Netherlands. The subjects (n = 5356), randomly selected from community registers, were given the Seasonal Pattern Assessment Questionnaire and the Centre for Epidemiological Studies Depression Scale over a period of 13 months. The response rate was 52.6%. Three percent of the respondents met the criteria for winter SAD, 0.1% for summer SAD. The criteria for subsyndromal SAD, a milder form of SAD, were met by 8.5%, 0.3% of whom showed a summer pattern. Younger women received a diagnosis of SAD more often than men or older women. SAD subjects were significantly more often unemployed or on sick leave than other subjects. Respondents who met winter SAD criteria were significantly more depressed than healthy subjects, in both winter and summer. Finally, month of completion had no influence on the number of subjects meeting the SAD criteria.
Seasonal sensitivity and psychiatric morbidity: study about seasonal affective disorder
2021
Background Seasonal Affective Disorder is a recurrent depressive disorder which usually begins in the fall/winter and enters into remission in the spring/summer, although in some cases may occur in the summer with remission in the autumn-winter. In this study the authors evaluated the association between seasonal changes in mood and behavior with psychiatric disturbance. Method Descriptive, cross-sectional study. Participants, students attending higher education and vocational courses ( N = 324), were evaluated with the Seasonal Pattern Assessment Questionnaire (SPAQ) and the Screening Scale for Mental Health (ER80). Results Among the respondents, 12.7% showed seasonal affective disorder (SAD), 29.0% showed subsyndromal seasonal affective disorder (s-SAD) and 58.3% did not show significant seasonal affective symptomatology. As for psychiatric morbidity, 36.6% of subjects with SAD and 13.8% of those with s-SAD were considered “psychiatric cases” whereas for subjects without SAD this...
What is this thing called "SAD"? A critique of the concept of Seasonal Affective Disorder
Epidemiologia e psichiatria sociale
Seasonal Affective Disorder (SAD) is supposed to be caused by lack of daylight in winter. Yet the population of Northern Norway, living without sun for two winter months, does not spontaneously complain about depression during the dark period. To summarize research bearing upon the validity of the concept of SAD. Review of relevant literature concerning the epidemiology of SAD and the questionnaire developed to measure it in general populations, the Seasonal Pattern Assessment Questionnaire (SPAQ). Large population studies from northern Norway do not point to a higher prevalence of depression in winter than expected in any other general population. The psychometric properties of SPAQ are rather poor, and the diagnosis of SAD based on SPAQ bears little relationship to a meaningful concept of depression. Seasonal Affective Disorder is not a valid medical construct. Instead, "Recurrent depression with seasonal pattern" as defined in the DSM-IV and the ICD-10 should be used as...
Assessing Usual Seasonal Depression Symptoms: The Seasonality Assessment Form
Journal of Psychopathology and Behavioral Assessment, 2014
This paper presents findings on the psychometric properties of a new measure of the usual severity of winter symptomatology commonly found in Seasonal Affective Disorder (SAD), the Seasonality Assessment Form (SAF). Many existing SAD-related measures focus on diagnostic screening, include a limited range of symptoms or are revisions of standard self-report depression measures that have not undergone psychometric evaluation. The SAF was developed to address these limitations, in particular to include the full range of cognitive, affective, and vegetative symptoms that are in DSM criteria for a depressive episode. Data came from a diverse sample of 741 students, community members recruited for having winter vegetative changes, and diagnosed SAD patients. The SAF total score, as well as vegetative and cognitive/affective subscales, exhibited good internal consistency and convergent and construct validity. The SAF demonstrated a bifactor structure, suggesting a large global severity factor and additional subfactors related to appetite/weight and negative thought content. Symptomatic participants reported relatively high levels of impairment in daily activities, in particular avoiding or delaying doing daily tasks. In sum, the SAF appears to be a concise, comprehensive, reliable, and valid measure of SAD symptom severity. In addition, its instructions can be revised easily to provide parallel forms for assessing the current episode or recent weeks.
Seasonality is associated with anxiety and depression: The Hordaland health study
Journal of Affective Disorders, 2008
Background: The purpose of this study was to assess how seasonal changes in mood and behaviour were associated with depression and anxiety symptoms in a sample from a general population, and to investigate how prevalence figures were affected by month of questionnaire completion. Methods: The target population included all individuals in the Hordaland county (Norway) born 1953-57 (N = 29,400). In total, 8598 men (57% response rate) and 9983 women (70% response rate) attended the screening station. Half of the men (randomly chosen) and all of the women were offered a questionnaire to fill in with items on seasonality. This was measured using the Global Seasonality Score (GSS), a central component of the Seasonal Pattern Assessment Questionnaire (SPAQ). The Hospital Anxiety and Depression Scale (HADS) was used to measure anxiety and depression. Both questionnaires were completed by 2980 men (68.9%) and 8074 women (80.9%). Results: Seasonality was positively associated with levels of both anxiety and depression regardless of the season the interview took place. In subjects with a low/moderate degree of seasonality there were modestly higher levels of depressive symptoms during November through March than the other months. Limitations: We had a substantial number of non-responders. Conclusions: Our results raise the possibility of seasonality being a separate dimensional trait associated with both anxiety and depression.
Seasonal affective disorder: a clinical update
Annals of clinical psychiatry, 2007
A Medline search was conducted to identify studies relating to clinical management of SAD using the Medical Subject Heading, seasonal affective disorder, and key words, depress* and season*, focusing on studies published in the past 10 years. The Cochrane library of systematic reviews was also searched for relevant studies. Results. A careful history is important to make the diagnosis and differentiate SAD from other similar conditions such as subsyndromal SAD and atypical depression. Seasonal patterns with winter worsening are also recognized in "nonseasonal" depression as well as many other psychiatric conditions, and comorbidity with SAD is common. The pathophysiology of SAD seems to be heterogeneous as research on circadian, neurotransmitter function and genetic hypotheses have shown discrepant results. A dual vulnerability model with differential loading on separate seasonal and depression factors has been proposed to explain these findings. Recent systematic reviews have shown that light therapy is an efficacious and well-tolerated treatment for SAD. There is also evidence for efficacy of pharmacotherapy to treat and prevent SAD. Clinical studies show equal effectiveness with light and antidepressants, so patient preference should be considered in the selection of initial treatment. Dawn stimulation, negative air ions, exercise and cognitve behaviour therapy are under investigation and may also be helpful treatments for SAD. Conclusions. SAD is a common condition with significant psychosocial impairment. Clinicians should be vigilant in recognizing seasonal patterns of depressive episodes because there are effective, evidence-based treatments for SAD.
Seasonal Affective Disorder: An Overview of Assessment and Treatment Approaches
Depression Research and Treatment, 2015
Seasonal affective disorder or SAD is a recurrent major depressive disorder with a seasonal pattern usually beginning in fall and continuing into winter months. A subsyndromal type of SAD, or S-SAD, is commonly known as "winter blues." Less often, SAD causes depression in the spring or early summer. Symptoms center on sad mood and low energy. Those most at risk are female, are younger, live far from the equator, and have family histories of depression, bipolar disorder, or SAD. Screening instruments include the Seasonal Pattern Assessment Questionnaire (SPAQ). Typical treatment includes antidepressant medications, light therapy, Vitamin D, and counselling. This paper provides an overview of SAD.
Depressive symptomatology differentiates subgroups of patients with seasonal affective disorder
Depression and anxiety, 2002
Patients with seasonal affective disorder (SAD) may vary in symptoms of their depressed winter mood state, as we showed previously for nondepressed (manic, hypomanic, hyperthymic, euthymic) springtime states [Goel et al., 1999]. Identification of such differences during depression may be useful in predicting differences in treatment efficacy or analyzing the pathogenesis of the disorder. In a cross-sectional analysis, we determined whether 165 patients with Bipolar Disorder (I, II) or Major Depressive Disorder (MDD), both with seasonal pattern, showed different symptom profiles while depressed. Assessment was by the Structured Interview Guide for the Hamilton Depression Rating Scale-Seasonal Affective Disorder Version (SIGH-SAD), which includes a set of items for atypical symptoms. We identified subgroup differences in SAD based on categories specified for nonseasonal depression, using multivariate analysis of variance and discriminant analysis. Patients with Bipolar Disorder (I and II) were more depressed (had higher SIGH-SAD scores) and showed more psychomotor agitation and social withdrawal than those with MDD. Bipolar I patients had more psychomotor retardation, late insomnia, and social withdrawal than bipolar II patients. Men showed more obsessions/compulsions and suicidality than women, while women showed more weight gain and early insomnia. Whites showed more guilt and fatigability than blacks, while blacks showed more hypochondriasis and social withdrawal. Darker-eyed patients were significantly more depressed and fatigued than blue-eyed patients. Single and divorced or separated patients showed more hypochondriasis and diurnal variation than married patients. Employed patients showed more atypical symptoms than unemployed patients, although most of the subgroup distinctions lay on the Hamilton Scale. These results comprise a set of biological and sociocultural factors-including race, gender, and marital and employment status-which contribute to depressive symptomatology in SAD. Significant mood and sociocultural factors, in contrast to biological factors of gender and eye color, were similar to those reported for nonseasonal depression. Lightly pigmented eyes, in particular, may serve to enhance photic input during winter and allay depressive symptoms in vulnerable populations. Depression and Anxiety 15:34-41, 2002.
BMC Psychiatry, 2011
Little is known about seasonality of specific depressive symptoms and anxiety symptoms in different patient populations. This study aims to assess seasonal variation of depressive and anxiety symptoms in a primary care population and across participants who were classified in diagnostic groups 1) healthy controls 2) patients with a major depressive disorder, 3) patients with any anxiety disorder and 4) patients with a major depression and any anxiety disorder. Methods: Data were used from the Netherlands Study of Depression and Anxiety (NESDA). First, in 5549 patients from the NESDA primary care recruitment population the Kessler-10 screening questionnaire was used and data were analyzed across season in a multilevel linear model. Second, in 1090 subjects classified into four groups according to psychiatric status according to the Composite International Diagnostic Interview, overall depressive symptoms and atypical versus melancholic features were assessed with the Inventory of Depressive Symptoms. Anxiety and fear were assessed with the Beck Anxiety Inventory and the Fear questionnaire. Symptom levels across season were analyzed in a linear regression model.