1
|
Winthorst WH, Roest AM, Bos EH, Meesters Y, Penninx BWJH, Nolen WA, de Jonge P. Seasonal affective disorder and non-seasonal affective disorders: results from the NESDA study. BJPsych Open 2017; 3:196-203. [PMID: 28904813 PMCID: PMC5572284 DOI: 10.1192/bjpo.bp.116.004960] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 07/07/2017] [Accepted: 07/19/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Seasonal affective disorder (SAD) is considered to be a subtype of depression. AIMS To compare the clinical picture of SAD to non-seasonal affective disorders (non-SADs). METHOD Diagnoses according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) were established in 2185 participants of the Netherlands Study of Depression and Anxiety. The Seasonal Pattern Assessment Questionnaire was administered to diagnose SAD. Symptoms of depression and anxiety were measured with the Inventory of Depressive Symptoms, the Beck Anxiety Inventory and the Fear Questionnaire. RESULTS Participants with SAD, participants with a lifetime bipolar disorder and participants with a lifetime comorbid anxiety and depressive disorder scored highest in terms of psychopathology in the past year. The seasonal distribution of major depressive episodes was not different for participants with or without SAD. CONCLUSIONS SAD may be a measure of severity of depression with a subjectively perceived worsening of symptoms in the winter months. DECLARATION OF INTEREST Y.M. has received research funding and served as a consultant for Royal Philips Electronics NV and The Litebook Company Ltd. W.A.N. has received grants from the Netherlands Organization for Health Research and Development, the European Union, the Stanley Medical Research Institute, Astra Zeneca, Eli Lilly, GlaxoSmithKline and Wyeth; has received honoraria/speaker's fees from Astra Zeneca, Pfizer, Servier and Wyeth; and has served in advisory boards for Astra Zeneca, Pfizer and Servier. COPYRIGHT AND USAGE © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.
Collapse
Affiliation(s)
- Wim H Winthorst
- , MD, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Annelieke M Roest
- , PhD, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Elisabeth H Bos
- , PhD, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ybe Meesters
- , PhD, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Brenda W J H Penninx
- , PhD, Department of Psychiatry/EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Willem A Nolen
- , MD, PhD, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Peter de Jonge
- , PhD, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| |
Collapse
|
2
|
Kao LT, Xirasagar S, Chung KH, Lin HC, Liu SP, Chung SD. Weekly and holiday-related patterns of panic attacks in panic disorder: a population-based study. PLoS One 2014; 9:e100913. [PMID: 25006664 PMCID: PMC4090070 DOI: 10.1371/journal.pone.0100913] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2014] [Accepted: 06/01/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND While chronobiological studies have reported seasonal variation in panic attacks (PA) episodes, information on the timing of PA by week-days may enable better understanding of the triggers of PA episodes and thereby provide pointers for suitable interventional approaches to minimize PA attacks. This study investigated weekly variation in potential PA admissions including associations with holidays using a population-based longitudinal, administrative claims-based dataset in an Asian population. METHODS This study used ambulatory care data from the "Longitudinal Health Insurance Database 2000. We identified 993 patients with panic disorder (PD), and they had 4228 emergency room (ER) admissions for potential PA in a 3-year period between 1 January 2009 and 31 December 2011. One-way analysis of variance (ANOVA) was used to examine associations between the potential PA admissions and holidays/weekend days/work-days of the week. RESULTS The daily mean number of potential PA admissions was 3.96 (standard deviation 2.05). One-way ANOVA showed significant differences in potential PA admissions by holiday and day of the week (p<0.001). Daily frequencies showed a trough on Wednesday-Thursday, followed by a sharp increase on Saturday and a peak on Sunday. Potential PA admissions were higher than the daily mean for the sample patients by 29.4% and 22.1%, respectively on Sundays and holidays. Furthermore, the weekly variations were similar for females and males, although females always had higher potential PA admissions on both weekdays and holidays than the males. CONCLUSIONS We found that potential PA admissions among persons with PD varied systematically by day of the week, with a significant peak on weekends and holidays.
Collapse
Affiliation(s)
- Li-Ting Kao
- Graduate Institute of Life Science, National Defense Medical Center, Taipei, Taiwan
- Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Sudha Xirasagar
- Arnold School of Public Health, Department of Health Services Policy and Management, University of South Carolina, Columbia, South Carolina, United States of America
| | - Kuo-Hsuan Chung
- Taipei Medical University Hospital, Department of Psychiatry, Taipei, Taiwan
- Taipei Medical University, School of Medicine, Department of Psychiatry, Taipei, Taiwan
| | - Herng-Ching Lin
- Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Taipei Medical University, School of Health Care Administration, Taipei, Taiwan
| | - Shih-Ping Liu
- Department of Urology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Shiu-Dong Chung
- Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, Ban Ciao, Taipei, Taiwan
- School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
- * E-mail:
| |
Collapse
|
3
|
Winthorst WH, Roest AM, Bos EH, Meesters Y, Penninx BWJH, Nolen WA, de Jonge P. Self-attributed seasonality of mood and behavior: a report from the Netherlands study of depression and anxiety. Depress Anxiety 2014; 31:517-23. [PMID: 23695951 DOI: 10.1002/da.22130] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Revised: 03/07/2013] [Accepted: 04/19/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Seasonal changes in mood and behavior are considered to be common in the general population and in patients with psychiatric disorders. However, in several studies this seasonality could not be demonstrated. The present study examined self-attributed seasonality of depressive symptoms among patients with a lifetime diagnosis of a depressive disorder (D), an anxiety disorder (A), a comorbid depressive and anxiety disorder (DA), and healthy controls (HC). METHODS The CIDI was used to establish diagnoses according to DSM-IV criteria in 2,168 participants of the Netherlands Study of Depression and Anxiety (NESDA). The Seasonal Pattern Assessment Questionnaire (SPAQ) was administered to assess variation in mood and behavior. RESULTS Of the 2,168 participants 53.5% reported seasonality of mood. Highest percentages of low mood were seen in the winter months. Although all groups showed this pattern of lowered mood during the winter months, D, A, and DA were significantly (P < .001) more likely to experience seasonality is this respect. This was also shown for seasonal changes in energy, social activities, sleeping, eating, weight and for the Global Seasonality Score. A limitation of this study was the cross-sectional design. CONCLUSIONS Seasonal variation in mood and behavior was demonstrated for both participants with a lifetime diagnosis of depression and/or anxiety disorder and for healthy controls, but patients with anxiety and/or depression were more likely to experience this seasonal variation. Clinicians should take into account that the time of the year could influence the feelings of well- and ill-being of their patients.
Collapse
Affiliation(s)
- Wim H Winthorst
- Department of Psychiatry and Interdisciplinary Center Psychopathology and Emotion regulation, University of Groningen, University Medical Center Groningen, The Netherlands
| | | | | | | | | | | | | |
Collapse
|
4
|
Berg K, Siever D. A Controlled Comparison of Audio-Visual Entrainment for Treating Seasonal Affective Disorder. ACTA ACUST UNITED AC 2009. [DOI: 10.1080/10874200903107314] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
5
|
Affiliation(s)
- D Servant
- Service de Psychiatrie (Pr M. Goudemand), rue André Verhaeghe, 59037 Lille cedex
| |
Collapse
|
6
|
Seasonal Reactivity: Attentional Bias and Psychophysiological Arousal in Seasonal and Nonseasonal Depression. COGNITIVE THERAPY AND RESEARCH 2006. [DOI: 10.1007/s10608-006-9029-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
7
|
Ohtani T, Kaiya H, Utsumi T, Inoue K, Kato N, Sasaki T. Sensitivity to seasonal changes in panic disorder patients. Psychiatry Clin Neurosci 2006; 60:379-83. [PMID: 16732757 DOI: 10.1111/j.1440-1819.2006.01517.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
It has been suggested that symptoms of panic disorder may be significantly affected by seasonal factors including weather changes, although few studies have explored the issue. The purpose of the present paper was to investigate clinical data to examine sensitivity of panic disorder patients to seasonal changes and seasonal fluctuation of panic disorder symptoms. A self-rating questionnaire consisting of the Seasonal Pattern Assessment Questionnaire (SPAQ) and additional self-rating questions were analyzed in 146 Japanese patients (50 male, 96 female) with panic disorder (DSM-IV) at an outpatient clinic for anxiety disorder. The average of the Global Seasonality Scores (GSS) was 12.5+/-4.7 and 25.3% of the patients were suggested to suffer from seasonal affective disorder, according to the GSS. Frequency of the panic attack was found to fluctuate seasonally, with peaks in August and December (P=0.005 and 0.01, chi2 test). The present results indicate that panic disorder patients may be more sensitive to seasonal and meteorological factors than the general population and become more fragile in a specific season or months. This might assist in the development of preventive measures for the frequent recurrence of symptoms in panic disorder.
Collapse
Affiliation(s)
- Toshiyuki Ohtani
- Research Center for Panic Disorder, Nagoya Nental Clinic, Nagoya, and Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Japan
| | | | | | | | | | | |
Collapse
|
8
|
Abstract
The operational criteria for seasonal affective disorder (SAD) have undergone several changes since first proposed in 1984. SAD is currently included as a specifier of either bipolar or recurrent major depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The International Classification of Diseases, Tenth Edition has provisional diagnostic criteria for SAD. The most characteristic quality of SAD is that the symptoms usually present during winter and remit in the spring. Furthermore, the symptoms tend to remit when the patients are exposed to daylight or bright light therapy. The cognitive and emotional symptoms are as in other types of depression but the vegetative symptoms are the reverse of classic depressive vegetative symptoms, namely increased sleep and increased appetite. SAD is a common condition, but the exact prevalence rates vary between different studies and countries and is consistently found to be more common in women and in youth. SAD probably possibly occurs in children although not as commonly as in young adults. Some studies have found that certain ethnic groups who live at high northern latitudes may have adapted to the long arctic winter.
Collapse
Affiliation(s)
- Andres Magnusson
- Department of Psychiatry, Aker University Hospital, Oslo, Norway.
| | | |
Collapse
|
9
|
Bossini L, Martinucci M, Paolini K, Castrogiovanni P. Panic-agoraphobic spectrum and light sensitivity in a general population sample in Italy. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2005; 50:39-45. [PMID: 15754664 DOI: 10.1177/070674370505000108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study aimed to verify a possible correlation between panic symptoms and photosensitivity, not only in panic disorder (PD) but also in the panic-agoraphobic spectrum. METHOD One hundred and sixty-nine healthy and drug-free subjects completed the Structured Clinical Interview for Panic-Agoraphobic Spectrum-Lifetime version (SCI-PAS-Lifetime) and the Photosensitivity Assessment Questionnaire (PAQ). RESULTS The SCI-PAS-Lifetime total score was positively correlated with the total score of the PAQ photophobia subdimension (r = 0.44; P < 0.001); the SCI-PAS-Lifetime total score was not significantly correlated with the photophilia subdimension. As photophobia increased, we observed significant score increases in all SCI-PAS-Lifetime domains. Bivariate correlation showed higher coefficient correlation between the panic-like symptoms domain and photophobia (r = 0.44; P < 0.001). CONCLUSIONS A high total score in the SCI-PAS-Lifetime, which denotes more typical features of the spectrum, is associated with a higher level of light sensitivity and intolerance toward bright stimuli. This finding reflects clinical evidence that widely documents photophobic behaviours in subjects with PD and the importance of light stimuli exposure during the onset and course of such a disorder. Bright stimulation seems to be relevant both in PD diagnosed according to current DSM criteria and in the entire panic-agoraphobic spectrum, from nuclear elements of the disorder through subclinical states to the normal condition.
Collapse
Affiliation(s)
- Letizia Bossini
- Department of Neuroscience, Division of Psychiatry, University of Siena, Italy.
| | | | | | | |
Collapse
|
10
|
Abstract
OBJECTIVE To estimate the prevalence of seasonal affective disorder (SAD) and its subsyndromal form (S-SAD) in Switzerland (47 degrees N). METHOD A representative sample from all three language areas of Switzerland (n = 980) were given a structured telephone interview using the extended Seasonal Pattern Assessment Questionnaire (SPAQ+). A smaller, but also representative sample in the city of Basel filled in the SPAQ+ form as well as undergoing a structured diagnostic interview. RESULTS In this Swiss sample, 2.2% of the population presented with symptom severity of SAD, 8.9% with S-SAD. In Basel, a much higher prevalence of SAD was found. Seasonal problems occurred more often in patients with the Diagnostic and Statistical Manual (DSM)-III diagnosis of major affective disorders than in those with pure anxiety disorders or no psychiatric diagnosis. CONCLUSION These estimates for SAD in Switzerland are similar to those found in the Zürich Study, using other methods, and for populations in the UK, with the limitations inherent in retrospective questionnaire studies.
Collapse
Affiliation(s)
- A Wirz-Justice
- Centre for Chronobiology, Psychiatric University Clinic and Outpatient Clinic, Basel, Switzerland
| | | | | | | |
Collapse
|
11
|
Abstract
OBJECTIVE In DSM-IV, winter seasonal affective disorder (SAD) is classified as a seasonal pattern of recurrent major depressive episodes in winter with full remission of symptoms in summer. However, other groups with "winter depression" have been identified, including patients with incomplete summer remission (ISR) and subsyndromal SAD (sub-SAD, winter depressive symptoms that do not meet criteria for major depression). In this study, we compare the clinical characteristics of these three seasonal groups and their response to light therapy. METHOD 558 patients assessed at a specialized SAD Clinic were diagnosed using DSM-III-R or DSM-IV criteria. Clinical information was recorded using a checklist at index assessment. A subset of patients (N=192) were treated with an open, 2 week trial of light therapy using a 10000 lux fluorescent light box for 30 min per day in the early morning. Patients were assessed before and after treatment with the 29 item modified Hamilton Depression Rating Scale and clinical response was defined as greater than 50% improvement in scores. RESULTS The rates of some melancholic symptoms, anxiety, panic, suicidal ideation, and family history of mood disorder were lowest in the sub-SAD group. The clinical response rates to light therapy were highest in the sub-SAD group (N=32, 78%), intermediate in the SAD group (N=113, 66%), and lowest in the ISR group (N=47, 51%). LIMITATIONS This was a retrospective study of patients seen in a specialty clinic, although information was obtained in a standardized format. The light therapy trial had an open design so that placebo response could not be determined. CONCLUSIONS There are differences in both the patterns of clinical symptoms and the response to light therapy in these three groups with winter depression. These results are consistent with a dual vulnerability hypothesis that considers these groups to result from interaction of separate factors for seasonality and depression.
Collapse
Affiliation(s)
- R W Lam
- Division of Mood Disorders, Department of Psychiatry, University of British Columbia Hospital, Vancouver Hospital and Health Sciences Centre, 2255 Wesbrook Mall, BC, Canada V6T 2A1.
| | | | | | | | | |
Collapse
|
12
|
Castrogiovanni P, Pieraccini F, Iapichino S, Pacchierotti C, Bossini L, Truglia E, Malpassi C, Natale B. Electroretinogram B-wave amplitude in panic disorder. CNS Spectr 2001; 6:210-3. [PMID: 16951655 DOI: 10.1017/s1092852900008580] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abnormal light-related behaviors have been described for patients with panic disorder (PD). The present study was undertaken to investigate the retinal light response in PD using electroretinography (ERG). The authors conducted b-wave ERG measurements with a bright light (after dark adaptation) in 28 patients with PD and 28 control subjects. There were no significant differences in the mean b-wave amplitude between the two groups, but the retinal response to light in PD patients was generally lower than in healthy subjects. A large interindividual variability was found; also noted was a significant difference in the mean b-wave amplitude between the right and left eyes in the control group. The data indicate subtle variation of retinal photosensitivity in a subgroup of patients with PD. Because dopaminergic retinal activity affects b-ERG amplitude, the authors hypothesize that the dopaminergic system is involved in the response to light in PD patients.
Collapse
|
13
|
Abstract
BACKGROUND There is currently no literature on the relationship between weather parameters and admissions of organic brain syndromes such as dementias. In this present study we aimed to examine the effect of weather parameters such as relative humidity, sunshine hours, diurnal variations in temperature and rainfall on dementia admissions in North Cheshire. METHOD Daily number of hospital admissions of dementias and other diagnoses in North Cheshire was analysed in relation to meteorological data, which were measured at the nearest meterological office to the study population. RESULTS The study found no evidence of any statistically significant association between weather parameters and dementia admissions. There was a weak, lagged inverse relationship between dementia admissions and relative humidity and a positive association with diurnal variations in temperature within a week of admission. However, neither finding achieved statistical significance. CONCLUSION The study is the first in currently available literature on the subject and may therefore provide a base reference for future studies. The interesting observation relating to relative humidity and diurnal variations in temperature is unexpected and may suggest further research.
Collapse
Affiliation(s)
- E Salib
- Hollins Park Hospital, Warrington, UK
| | | |
Collapse
|
14
|
Abstract
The validity of the Seasonal Pattern Assessment Questionnaire (SPAQ) was examined by interviewing 81 individuals who had participated in an earlier community survey of seasonal affective disorder (SAD) in Iceland. When SAD and subsyndromal SAD (S-SAD) were combined into a 'winter problem' group, the questionnaire's sensitivity, specificity and positive predictive value for that group were 94%, 73% and 45%, respectively. The SPAQ discriminated poorly between SAD and S-SAD, and hence it had a poor case-finding ability for SAD. Clinical evaluation verified a diagnosis of SAD in individuals who had no previous information about this syndrome. The questionnaire furthermore identified a group of individuals who had generalized anxiety and marked seasonal variations. Clinical evaluation arrived at a similar prevalence rate of SAD as the questionnaire.
Collapse
Affiliation(s)
- A Magnusson
- Department of Psychiatry, Ullevål Hospital, Oslo, Norway
| |
Collapse
|