1
|
Ragab MM, Eid EM, Badr NH. Effect of Demographic Factors on Quality of Life in Children with ADHD under Atomoxetine Treatment: 1-Year Follow-up. JOURNAL OF CHILD SCIENCE 2020. [DOI: 10.1055/s-0040-1717104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AbstractAttention-deficit hyperactivity disorder (ADHD) is the most common psychiatric disorder in children and adolescents. Symptoms of ADHD and its treatment can impact an individual's quality of life (QoL). The present study aimed to evaluate the effect of atomoxetine treatment, demographic characteristics, and seasonal variation on QoL in children with a recent diagnosis of ADHD and their parents. The present study included a cohort of 200 children diagnosed with ADHD. In addition to the recruited children, one of their parents was included in the study. ADHD symptoms were assessed using Conners' Parent Rating Scale. QoL of the participants was assessed with the PedsQL, while parents' QoL was evaluated using the World Health Organization Quality of Life questionnaire (WHOQOL-Bref). There was significant improvement in pediatric and parental QoL after treatment with atomoxetine. Significant factors related to better QoL in the participants included spring season, above average Conner's score, male sex, and rural residence. However, after using multivariate regression analysis, only patients' sex and Conner's score were significant predictors of pediatric QoL at the end of treatment with atomoxetine. Medical treatment significantly improved QoL in children with ADHD and their parents. Level of improvement was affected by patients' sex and ADHD severity.
Collapse
Affiliation(s)
- Moustafa M. Ragab
- Public Health Department, Institute of Environmental Studies and Researches, Ain Shams University, Cairo, Egypt
| | - Ehab M. Eid
- Public Health Department, Faculty of Postgraduate Childhood Studies, Ain Shams University, Cairo, Egypt
| | - Nahla H. Badr
- Public Health Department, Faculty of Postgraduate Childhood Studies, Ain Shams University, Cairo, Egypt
| |
Collapse
|
2
|
Lukmanji A, Williams JVA, Bulloch AGM, Patten SB. Seasonal variation in specific depressive symptoms: A population based study. J Affect Disord 2020; 261:153-159. [PMID: 31630036 DOI: 10.1016/j.jad.2019.10.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 09/13/2019] [Accepted: 10/04/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Depression varies with season in Canadian youth. However, the symptom profile of seasonal depression may differ from that of non-seasonal depression. Here we evaluate which specific symptoms vary by season. METHODS Using data from the 2015/2016 Canadian Community Health Survey, cross-sectional analysis was conducted. The Patient Health Questionnaire-9 (PHQ-9) was administered to respondents in 8 provinces/territories (n ≈ 53,000), with interviews conducted throughout the year. Seasonal effects were assessed using quadratic terms in a logistic regression model. Guided by previous literature and analysis, analyses were stratified by age into youth (age 12-24) and adult (age 25+) groups. RESULTS In the youth, 8 items of the PHQ-9 exhibited a significant season variation: lack of interest/pleasure, feeling depressed/down, hypersomnia/insomnia, lacking energy, poor appetite/overeating, feeling bad about yourself/ like a failure, being slow/fidgety, and trouble concentrating. In the adult group, only sleep and poor appetite/overeating exhibited a seasonal effect. Notably, symptoms of self-harm/suicide did not demonstrate seasonality in either group. LIMITATIONS Due to use of cross-sectional data and a brief symptom rating scale, conventional criteria for Seasonal Affective Disorder or Major Depressive Disorder with seasonal variation could not be applied. Also, treatment status of respondents was not assessed in the survey, therefore possible confounding by this variable could not be assessed. CONCLUSIONS A seasonal pattern was observed in most symptoms of depression in Canadian youth, whereas in adults, only symptoms related to sleep and appetite disturbance displayed seasonal variation.
Collapse
Affiliation(s)
- Aysha Lukmanji
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW Calgary, Alberta T2N 4Z6, Canada
| | - Jeanne V A Williams
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW Calgary, Alberta T2N 4Z6, Canada
| | - Andrew G M Bulloch
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW Calgary, Alberta T2N 4Z6, Canada; Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW Calgary, Alberta T2N 4Z6, Canada
| | - Scott B Patten
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW Calgary, Alberta T2N 4Z6, Canada; Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW Calgary, Alberta T2N 4Z6, Canada; Cuthbertson & Fischer Chair in Pediatric Mental Health, University of Calgary.
| |
Collapse
|
3
|
Henderson SEM, Brady EM, Robertson N. Associations between social jetlag and mental health in young people: A systematic review. Chronobiol Int 2019; 36:1316-1333. [DOI: 10.1080/07420528.2019.1636813] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Sarah E. M. Henderson
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Emer M. Brady
- Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK
| | - Noelle Robertson
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| |
Collapse
|
4
|
Wiens V, Kyngäs H, Pölkki T. Insight from focus group interviews: adolescent girls' well-being in relation to experiences of winter, nature and seasonal changes in Northern Finland. Scand J Caring Sci 2019; 33:969-977. [PMID: 31058329 DOI: 10.1111/scs.12695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 03/17/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND According to previous studies, gender-related differences have been found in relation to the experience of well-being. There are also research results indicating that environment and seasonal variation have an influence on the well-being. AIM The aim of the study was to describe how adolescent girls living in northern Finland experience nature, winter and seasonal changes and meaning of these to their well-being. METHODS In this descriptive, qualitative research, 17 girls aged 13-16 who live in northern Finland participated in five focus group interviews where they presented photographs of nature they took themselves. Participation for the girls was voluntary, and the data were analysed by using content analysis. FINDINGS Three main categories were found: winter which expresses participative and confrontational meanings, natural environment that provides meaningful stimulus and seasonal variations binding experiences. Winter had a dual effect on girls' well-being. Nature's healing elements were described by the girls as invigorating, varying and stimulating of a wide range of senses. Nature offered soothing and revitalising experiences for the girls. On the one hand, seasonal changes were seen as a refreshing change, but on the other hand, the changes were described oppressive and burdensome. CONCLUSION The girls described how they experienced the multiple elements of nature and environment through different senses. These sensations and feelings seem to transport the girls to a larger experience in which nature and seasonal changes were partially elements that fulfilled the girls' needs but also required adaptation. RELEVANCE TO CLINICAL PRACTICE This experiential description encourages us to develop new means of promotive actions and brings a novel perspective and understanding about how to incorporate and implement these findings to enhance girls' well-being. Findings from this study need to be understood in this particular context in northern Finland among adolescent girls.
Collapse
Affiliation(s)
- Varpu Wiens
- Research Unit of Nursing Science and Health Management, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Helvi Kyngäs
- Research Unit of Nursing Science and Health Management, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Tarja Pölkki
- Clinical Nursing Science, University of Oulu, Oulu, Finland.,Unit of Children and Women, Oulu University Hospital, Oulu, Finland
| |
Collapse
|
5
|
Abstract
Much the most common type of seasonal affective disorder at temperate latitudes is recurrent winter depression, which probably affects around 3% of adults in the UK to a clinically significant degree. In this article, diagnosis and presentation are discussed and symptoms are contrasted with those of non-seasonal depression. Aetiology and epidemiology, with regard to age, gender and latitude of residence, are described. Sufferers are often treated with light therapy, and this is described in some detail, with mention of effectiveness, prediction of outcome, timescales of response, side-effects, use of lightboxes and alternatives to lightboxes. Other general aspects of the management of seasonal affective disorder, including the use of antidepressant medication, are also outlined.
Collapse
|
6
|
Benard V, Geoffroy PA, Bellivier F. [Seasons, circadian rhythms, sleep and suicidal behaviors vulnerability]. Encephale 2016; 41:S29-37. [PMID: 26746320 DOI: 10.1016/s0013-7006(15)30004-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Suicidal behaviors are common in the general population and are so a major public health problem. In order to improve suicide prevention and to reduce the mortality by suicide, it appears essential to better identify suicide risk factors. Seasonality, circadian rhythms and sleep abnormalities have been already associated with numerous psychiatric disorders. This review aimed to characterize the associations between seasonality, circadian rhythms, sleep and suicidal behaviors including suicide attempts and completed suicides. METHODS We conducted a literature search between 1973 and 2015 in PubMed databases using the following terms: ("suicide" OR "suicidality" OR "suicide attempts" OR "suicidal behavior") AND ("circadian rhythms" OR "seasons" OR "sleep"). RESULTS Many studies confirm a specific seasonality for suicide with a higher peak of suicides in spring for both sex and a lower peak in autumn especially for women. This distribution seems to correlate with depressive symptoms (especially for the autumn peak), gender and different types of suicide. Regarding gender and type of suicide differences, males more commonly commit violent suicide with a higher rate of suicides in spring. Suicide behaviors appear to be influenced by climatic and biological factors like sunshine, daylight cycles, temperature, air pollutants, viruses, parasites and aeroallergens. Circadian variations exist in suicide rates depending on age with a morning peak for elder and an evening peak for youth. In addition, completed suicide peak in early morning whereas suicide attempts peak rather in later afternoon. Several biomarkers dysregulation like melatonin, serotonin and cortisol may be implicated in suicide circadian variations. Furthermore, specific sleep disorders like insomnia, nightmares and sleep deprivation are common risk factors of suicide and possibly independently of the presence of depressive symptoms. Finally, the efficacy of chronotherapeutics (such as luminotherapy, dark therapy, sleep deprivation and melatonin drugs) has been suggested in the reduction of suicidal behaviors. CONCLUSION The suicide seasonality is very well documented showing a main peak in spring and another one in autumn. A suicide circadian distribution also exists depending of the suicidal behavior intensity and of the age. Numerous sleep disorders are also suicide risk factors and can be treated with chronotherapeutics. A better identification of seasonality, circadian rhythms and sleep abnormalities in suicidal behaviors could allow a better prevention in suicidal attempts and a reduction in death by suicide.
Collapse
Affiliation(s)
- V Benard
- Centre Hospitalier Universitaire de Lille (CHRU), Lille, F-59000, France; Université de Lille, Lille, F-59000, France
| | - P A Geoffroy
- Inserm, U1144, Paris, F-75006, France; Université Paris Descartes, UMR-S 1144, Paris, F-75006, France; Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, Paris, F-75013, France; AP-HP, GH Saint-Louis - Lariboisière - F. Widal, Pôle de Psychiatrie et de Médecine Addictologique, 75475 Paris cedex 10, France; Fondation FondaMental, Créteil, 94000, France
| | - F Bellivier
- Inserm, U1144, Paris, F-75006, France; Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, Paris, F-75013, France; AP-HP, GH Saint-Louis - Lariboisière - F. Widal, Pôle de Psychiatrie et de Médecine Addictologique, 75475 Paris cedex 10, France; Fondation FondaMental, Créteil, 94000, France.
| |
Collapse
|
7
|
Short photoperiod condition increases susceptibility to stress in adolescent male rats. Behav Brain Res 2015; 300:38-44. [PMID: 26655789 DOI: 10.1016/j.bbr.2015.12.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 11/30/2015] [Accepted: 12/03/2015] [Indexed: 11/22/2022]
Abstract
The seasonality of depressive symptoms is prevalent in children and adolescents. However, the mechanisms that underlie such susceptibility to seasonal influences on mood disorders are unclear. We examined the effects of a short photoperiod condition on the susceptibility to subchronic unpredictable mild stress (SCUS) and rhythmic alterations of plasma corticosterone (CORT), melatonin, and neuropeptide Y (NPY) in adolescent male rats. Compared with the 12h/12h light/dark photoperiod control (CON) rats, the 8h/16h photoperiod SCUS rats exhibited significant anhedonia, a core symptom of human depression, together with a blunted diurnal rhythm and elevation of 24h CORT, melatonin, and NPY levels. The 8h/16h photoperiod condition also blunted the rhythmicity of CORT, caused a phase inversion of melatonin, and caused a phase delay of NPY compared with 12h/12h CON rats. Such abnormalities of plasma CORT, NPY, and melatonin might cause adolescent individuals to present higher stress reactivity and greater vulnerability to stress over their lifetimes. The present study provides evidence of the susceptibility to the seasonality of stress-related disorders in adolescence.
Collapse
|
8
|
Borisenkov MF, Petrova NB, Timonin VD, Fradkova LI, Kolomeichuk SN, Kosova AL, Kasyanova ON. Sleep characteristics, chronotype and winter depression in 10-20-year-olds in northern European Russia. J Sleep Res 2014; 24:288-95. [PMID: 25431234 DOI: 10.1111/jsr.12266] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 10/25/2014] [Indexed: 11/29/2022]
Abstract
The purpose of this work was to examine the relationships between geographical coordinates and the prevalence of winter depression (SADW ), and to compare the sleep characteristics and chronotype of youths with and without SADW . We conducted a cross-sectional study of self-reported sleep characteristics, chronotype and winter depression in northern European Russia. Two questionnaires, the Munich Chronotype Questionnaire (MCTQ) and the Seasonal Pattern Assessment Questionnaire (SPAQ), were administered to a total of 3435 adolescents aged 10-20 years (1517 males and 1918 females). The prevalence of SADW in the study population was 8.4% and sub-SADW 11.8%. Four variables predicted the likelihood of SADW in youths: sex [higher in females: odds ratio (OR): 1.87, P < 0.0001], age (increases with age: OR: 1.09, P < 0.001), latitude (higher in the North: OR: 1.49, P < 0.029) and position in the time zone (higher in the West: OR: 1.61, P < 0.001). Later sleeping and waking, longer sleep latencies, more severe sleep inertia, shorter total sleep times and lower sleep efficiencies were observed in both males and females with SADW . The influence of SADW on sleep characteristics was more pronounced on school days. Significant phase delays of the sleep-wake rhythm and severe social jetlag (the difference between the mid-point of sleep phase at weekends and on workdays) were observed in females with SADW , but not in males. There are significant differences in sleep characteristics and chronotype between people with SADW and no-SAD. We demonstrate that both latitude of residence and location within the time zone are significant predictors of SADW in young inhabitants of the North.
Collapse
Affiliation(s)
- Mikhail F Borisenkov
- Institute of Physiology, Komi Science Centre, Ural Branch, Russian Academy of Science, Syktyvkar, Russia
| | | | | | | | - Sergey N Kolomeichuk
- Institute of Biology, Karelian Science Centre, Russian Academy of Sciences, Petrozavodsk, Russia.,Petrozavodsk State University, Petrozavodsk, Russia
| | - Anna L Kosova
- Institute of the North Industrial Ecology Problem, Kola Science Centre, Russian Academy of Science, Apatity, Russia
| | | |
Collapse
|
9
|
Tonetti L, Fabbri M, Erbacci A, Martoni M, Natale V. Association between seasonal affective disorder and subjective quality of the sleep/wake cycle in adolescents. Psychiatry Res 2014; 215:624-7. [PMID: 24405784 DOI: 10.1016/j.psychres.2013.12.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 12/11/2013] [Accepted: 12/15/2013] [Indexed: 10/25/2022]
Abstract
The relationship between seasonal affective disorder (SAD) and subjective quality of sleep/wake cycle in adolescents was explored. The Seasonal Pattern Assessment Questionnaire for Children and Adolescents (SPAQ-CA) and Mini Sleep Questionnaire (MSQ) were administered to 345 adolescents living in the city of Cesena (Emilia-Romagna region, Italy) (299 females; age range: 14-18 years), to determine SAD and perceived quality of the sleep/wake cycle. The response rate was 92% for females and 90.2% for males. The MSQ includes two factors, sleep and wake, with lower scores corresponding to a lower quality of sleep and wake. The MSQ includes cut-off criteria to detect a good or bad sleep and wake quality. Adolescents with SAD (16 ± 5.7) scored significantly lower than those not affected on wake factor (19.5 ± 4.3), while no effect has been observed on sleep factor. SAD was the only one significant predictor of good/bad wake quality, while it did not reach significant level with reference to good/bad sleep quality. Present results are indications of a possible influence of SAD on wake quality and further studies are necessary to confirm them.
Collapse
Affiliation(s)
- Lorenzo Tonetti
- Department of Psychology, University of Bologna, Viale Berti Pichat 5, 40127 Bologna, Italy.
| | - Marco Fabbri
- Department of Psychology, Second University of Naples, Caserta, Italy
| | - Alex Erbacci
- Department of Psychology, University of Bologna, Viale Berti Pichat 5, 40127 Bologna, Italy
| | - Monica Martoni
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Vincenzo Natale
- Department of Psychology, University of Bologna, Viale Berti Pichat 5, 40127 Bologna, Italy
| |
Collapse
|
10
|
Kristjánsdóttir J, Olsson GI, Sundelin C, Naessen T. Self-reported health in adolescent girls varies according to the season and its relation to medication and hormonal contraception--a descriptive study. EUR J CONTRACEP REPR 2013; 18:343-54. [PMID: 23944249 DOI: 10.3109/13625187.2013.821107] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To study seasonal variations in self-rated health and depressive symptoms in adolescent girls and possible differences in reported health with regard to use of medications. METHOD The SF-36 questionnaire was completed by 1250 girls with a mean age of 17 years, who visited a health centre in the course of one year. From January to July inclusive, depressive symptoms in 453 of the participants were also assessed using MADRS-S. Age and regular medication data were recorded. RESULTS Significantly better mental health and less depressive symptoms were reported during the summer, than in winter months. Seasonality was more related to the SF-36 mental, than physical health subscales. Respondents treated with hormonal contraceptives (HCs) only and those not taking any medication scored better on several SF-36 subscales, than girls on antidepressives and other medications. Respondents taking HCs tended to report better physical health and less depressive symptoms on MADRS-S than those taking no medication. CONCLUSIONS Adolescent girls showed seasonal variations in self-reported health and depressive symptoms, with more symptoms during winter months. HC users tended to report better physical health and less depressive symptoms than those on no medication. The high prevalence of suspected depression during the winter months deserves attention.
Collapse
Affiliation(s)
- Jóna Kristjánsdóttir
- * Department of Women's and Children's Health, Division of Obstetrics & Gynaecology
| | | | | | | |
Collapse
|
11
|
Abstract
The aim of the present study was to investigate, for the first time, the relationship between circadian preference and mood seasonality in adolescents. To this end, 1539 participants (881 female; 658 male) completed the Morningness-Eveningness Questionnaire for Children and Adolescents and the Seasonal Pattern Assessment Questionnaire for Children and Adolescents to determine circadian preference and mood seasonality, respectively. Evening types achieved significantly higher mood seasonality scores than intermediate and morning types, as intermediates did than morning types. Agreeing with previous studies on young adults and adults, the present data indicate a significant relationship between eveningness and higher mood seasonality in adolescents.
Collapse
Affiliation(s)
- Lorenzo Tonetti
- Department of Psychology, University of Bologna, Bologna, Italy.
| | | | | | | |
Collapse
|
12
|
Season of birth and mood seasonality in late childhood and adolescence. Psychiatry Res 2012; 195:66-8. [PMID: 21840608 DOI: 10.1016/j.psychres.2011.07.033] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Revised: 06/23/2011] [Accepted: 07/23/2011] [Indexed: 11/22/2022]
Abstract
A significant season of birth effect on mood seasonality has been detected in young adults, with higher sensitivity to seasonal changes for people born during spring or summer months (long photoperiod) than those born during autumn or winter months (short photoperiod). The aim of this study was to verify whether the birth season effect on mood seasonality is already present in late childhood and adolescence. To this end, the Seasonal Pattern Assessment Questionnaire for Children and Adolescents (SPAQ-CA) was administered to 1523 Italian participants (870 females, 653 males), ranging from 10 to 17 years of age. The Global Seasonality Score (GSS) was computed as a measure of mood seasonality. Analysis of covariance showed a significant season of birth effect on GSS; although no comparisons were significant when Tukey's posthoc test for unequal samples was performed, it was observed that adolescents born in summer achieved the highest scores while those born in winter obtained the lowest. The present data point out that a significant season of birth effect on mood seasonality is already present in late childhood and adolescence.
Collapse
|
13
|
Evolutionary origin of bipolar disorder-revised: EOBD-R. Med Hypotheses 2011; 78:113-22. [PMID: 22036090 DOI: 10.1016/j.mehy.2011.10.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Revised: 09/07/2011] [Accepted: 10/04/2011] [Indexed: 11/19/2022]
Abstract
The hypothesis of the evolutionary origin of bipolar disorder (EOBD) synthesized ideas about the biological clock and seasonal shifts in mood (Rosenthal, Wehr) with theorizing that bipolar disorder descends from a pyknic (compact, cold-adapted) group (Kretchmer). The hypothesis suggested that bipolar behaviors evolved in the northern temperate zone as highly derived adaptations to the selective pressures of severe climatic conditions during the Pleistocene. Given evidence of Neandertal contributions to the human genome, the hypothesis is extended (EOBD-R) to suggest Neandertal as the ancestral source for bipolar vulnerability genes (susceptibility alleles). The EOBD-R hypothesis explains and integrates existing observations: bipolar disorder has the epidemiology of an adaptation; it is correlated with a cold-adapted build, and its moods vary according to light and season. Since the hypothesis was first published, data consistent with it have continued to appear. Individuals with seasonal affective disorder, which is related to bipolar disorder, have been shown to manifest a biological signal of season change similar to that found in hibernating animals. The involvement of the circadian gene network in the pathophysiology of bipolar disorder has been confirmed. Because selective pressures during the Pleistocene would have been greatest for women of reproductive age, they are expected to manifest winter depression more than males or younger females, which is the case. (This sex difference is also found in hibernating mammals.) Because it is hypothesized that the evolution of bipolar disorder took place in the northern temperate zone during the Pleistocene, it is not expected that individuals of African descent, lacking Neandertal genes, will manifest circular bipolar I disorder, and in fact, the incidence of bipolar disorder among black individuals is less than among whites. A definitive test of the hypothesis is proposed: It is predicted that the bipolar and Neandertal genomes will be more similar than the modern human and Neandertal genomes, and the modern human and San and Yoruba genomes will be more similar than the bipolar and San and Yoruba genomes. Failure to confirm these predictions will falsify the EOBD-R hypothesis. The EOBD-R hypothesis has important implications in the search for bipolar vulnerability genes and our understanding of ourselves and our Neandertal ancestor. At a practical level, confirmation of the EOBD-R hypothesis will boost interest and research in the prevention and management of bipolar symptoms by manipulation of ambient light.
Collapse
|
14
|
Rawana JS, Ahola Kohut S. Eating Attitudes, Coping Styles, and Peer Victimization Among Adolescents with Seasonal and Nonseasonal Depression Symptoms. COGNITIVE THERAPY AND RESEARCH 2010. [DOI: 10.1007/s10608-010-9333-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
15
|
Nillni YI, Rohan KJ, Rettew D, Achenbach TM. Seasonal trends in depressive problems among United States children and adolescents: a representative population survey. Psychiatry Res 2009; 170:224-8. [PMID: 19896720 DOI: 10.1016/j.psychres.2008.07.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2008] [Revised: 07/10/2008] [Accepted: 07/22/2008] [Indexed: 10/20/2022]
Abstract
This study examined season-of-assessment differences in parent and child reports of depressive problems on well-validated instruments in 2009 U.S. children and adolescents, aged 6 to 18 years, from a nationally representative population survey. A parent completed the Child Behavior Checklist (CBCL) for each participant and 1226 of the 11-18-year-olds completed the Youth Self-Report (YSR). Outcome measures were CBCL and YSR withdrawn/depressed syndrome scale scores and rates of clinically elevated scores. Overall fall/winter versus spring/summer differences were not found on the CBCL or YSR for depressive problem severity or rates of depressive problems. Age, sex, and latitude were examined as potential moderators of the association between season-of-assessment and the outcomes. Of these, the effect of season-of-assessment on CBCL depressive problem severity depended upon age. Parents of 16-18-year-old adolescents rated depressive problems as significantly more severe in fall and winter than in spring and summer. Parents also rated depressive problems as significantly more severe in 16-18-year-olds than in 6-15-year-olds, but only when assessed in the fall and winter. There were no season-of-assessment differences among 6-15-year-old children and adolescents. The overall lack of season-of-assessment differences and the finding of age as a moderator on only one of four outcomes suggest minimal seasonality effects.
Collapse
Affiliation(s)
- Yael I Nillni
- Department of Psychology, University of Vermont, Burlington, VT, USA
| | | | | | | |
Collapse
|
16
|
Abstract
Seasonal affective disorder (SAD) is defined as a history of major depressive episodes that recur regularly at a particular time of year. Depending on the diagnostic instruments and criteria available, the reported prevalence (1%-10%) varies. Neurotransmitter abnormalities have been implicated in the pathophysiology, but they do not necessarily explain the seasonal pattern or the known chronobiological abnormalities in SAD compared with nonseasonal depression. Circadian rhythm abnormalies have been hypothesized to account for these aspects of SAD, and they provide a rationale for the therapeutic use of light therapy. Family history, twin, and molecular genetics studies suggest that hereditary factors are also involved. Light therapy and antidepressant medication are effective treatment options, with limited evidence for the efficacy of psychotherapy. Some studies demonstrate that narrow-band short wavelength "blue" light, naturalistic dawn simulation, and high-density negative air ionization are effective. Patients should be informed of the benefits of diet and exercise. Light therapy should be clinically monitored in the same manner, as it is done for other antidepressant treatments.
Collapse
Affiliation(s)
- Robert H Howland
- University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh, PA 15213, USA.
| |
Collapse
|
17
|
van de Looij-Jansen PM, de Wilde EJ, Mieloo CL, Donker MCH, Verhulst FC. Seasonal variation in self-reported health and health-related behaviour in Dutch adolescents. Public Health 2009; 123:686-8. [PMID: 19783266 DOI: 10.1016/j.puhe.2009.07.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2008] [Revised: 05/30/2009] [Accepted: 07/30/2009] [Indexed: 11/25/2022]
|
18
|
Turner EH, Leibenluft E, Albert PS, Wehr TA, Rosenthal NE. Effect of Season and Light Treatment Upon Hot Flashes in a Perimenopausal SAD Patient. Chronobiol Int 2009. [DOI: 10.3109/07420529509057277] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
19
|
Winter Depression: Integrating mood, circadian rhythms, and the sleep/wake and light/dark cycles into a bio-psycho-social-environmental model. Sleep Med Clin 2009; 4:285-299. [PMID: 20160896 DOI: 10.1016/j.jsmc.2009.02.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The phase shift hypothesis (PSH) states that most patients with SAD become depressed in the winter because of a delay in circadian rhythms with respect to the sleep/wake cycle: According to the PSH, these patients should preferentially respond to the antidepressant effects of bright light exposure when it is scheduled in the morning so as to provide a corrective phase advance and restore optimum alignment between the circadian rhythms tightly coupled to the endogenous circadian pacemaker and those rhythms that are related to the sleep/wake cycle. Recent support for the PSH has come from studies in which symptom severity was shown to correlate with the degree of circadian misalignment: it appears that a subgroup of patients are phase advanced, not phase delayed; however, the phase-delayed type is predominant in SAD and perhaps in other disorders as well, such as non-seasonal unipolar depression. It is expected that during the next few years the PSH will be tested in these and other conditions, particularly since healthy subjects appear to have more severe symptoms of sub-clinical dysphoria correlating with phase-delayed circadian misalignment; critically important will be the undertaking of treatment trials to investigate the therapeutic efficacy of morning bright light or afternoon/evening low-dose melatonin in these disorders in which symptoms are more severe as the dim light melatonin onset (DLMO) is delayed with respect to the sleep/wake cycle (non-restorative sleep should also be evaluated, as well as bipolar disorder). The possibility that some individuals (and disorders) will be of the phase-advanced type should be considered, taking into account that the correct timing of phase-resetting agents for them will be bright light scheduled in the evening and/or low-dose melatonin taken in the morning. While sleep researchers and clinicians are accustomed to phase-typing patients with circadian-rhythm sleep disorders according to the timing of sleep, phase typing based on the DLMO with respect to the sleep/wake cycle may lead to quite different recommendations for the optimal scheduling of phase-resetting agents, particularly for the above disorders and conditions.
Collapse
|
20
|
Prevalence of self-reported seasonal affective disorders and the validity of the seasonal pattern assessment questionnaire in young adults Findings from a Swiss community study. J Affect Disord 2009; 115:347-54. [PMID: 18947880 DOI: 10.1016/j.jad.2008.09.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2008] [Revised: 09/18/2008] [Accepted: 09/18/2008] [Indexed: 11/21/2022]
Abstract
BACKGROUND The objective of this study was to expand the knowledge on the prevalence of self-reported Seasonal Affective Disorder (SAD) and to further study the validity of the Seasonal Pattern Assessment Questionnaire (SPAQ). METHODS A total of N=844 young adults were assessed in a Swiss community study by use of the SPAQ, a Seasonal Affective Disorders Questionnaire (SADQ), the Young Adult Self Report (YASR), the Centre for Epidemiologic Depression Scale (CES-D), and scales for measuring self-esteem, self-awareness and life events. At a second stage, a total of N=534 screen positives and controls were subjected to the Composite International Diagnostic Interview (M-CIDI) for the assessment of mental disorders. According to the SPAQ classification a group of SAD subjects and a group of subsyndromal SAD subjects (S-SAD) were defined. In addition, a third group of high-scoring depressives (HSD) subjects scoring above the 75th percentile of the CES-D was defined. Comparisons included these three groups and the rest of the sample serving as controls. RESULTS The weighted prevalence for SAD in this sample was 7.84% based on the SPAQ alone. With the addition of the SADQ, weighted prevalence rates dropped to 2.22%. Weighted subsyndromal SAD was 33.04%. Across the vast majority of scales, the SAD group was indistinguishable from the HSD group. These two groups scored highest, whereas the S-SAD group had an intermediate position and the controls had the lowest scores. SAD was best predicted by the CES-D total score. CONCLUSIONS The SPAQ as a single measure leads to an overestimation of SAD which, nevertheless, is a rather common phenomenon also in this central European population. The findings on the validity of the SPAQ are extended by showing that predominantly general aspects of depression are measured.
Collapse
|
21
|
|
22
|
Practice parameter for the assessment and treatment of children and adolescents with depressive disorders. J Am Acad Child Adolesc Psychiatry 2007; 46:1503-26. [PMID: 18049300 DOI: 10.1097/chi.0b013e318145ae1c] [Citation(s) in RCA: 557] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
This practice parameter describes the epidemiology, clinical picture, differential diagnosis, course, risk factors, and pharmacological and psychotherapy treatments of children and adolescents with major depressive or dysthymic disorders. Side effects of the antidepressants, particularly the risk of suicidal ideation and behaviors are discussed. Recommendations regarding the assessment and the acute, continuation, and maintenance treatment of these disorders are based on the existent scientific evidence as well as the current clinical practice.
Collapse
|
23
|
Benabid N, Mesfioui A, Ouichou A. Effects of photoperiod regimen on emotional behaviour in two tests for anxiolytic activity in Wistar rat. Brain Res Bull 2007; 75:53-9. [PMID: 18158095 DOI: 10.1016/j.brainresbull.2007.07.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2007] [Revised: 07/09/2007] [Accepted: 07/16/2007] [Indexed: 10/23/2022]
Abstract
Seasonal changes are often gone with mood and behaviour changes which are probably linked to change in day length or photoperiod. The experiments developed in this work are based on the hypothesis that changes in photoperiod affect emotionality in rats. To check this hypothesis, female rats were exposed to four different photoperiods (LP: 16L/8D; MP: 12L/12D; SP: 8L/16D; SP-F: 8L/16D with a light pulse in midpoint of the dark phase). Eight or 14 weeks later, rats were subjected to two behavioural tests to quantify anxiety level. Independently of duration, rats exposed to SP exhibited higher levels of anxious-like behaviour than rats raised in LP and SP-F, in an open field test (OFT) and in elevated plus maze (EPM). Significant differences in EPM are obtained only after 14 weeks of treatment. Moreover rats treated more long time showed greater suprarenal gland mass. Compared to all other groups, females exposed to SP had greater suprarenal gland. Our results indicate that changes in day length are associated with different levels of anxious-like behaviours consistent with the conjecture that short days may have an anxiogenic effect in female rats.
Collapse
Affiliation(s)
- N Benabid
- Unité de Physiologie Nerveuse et Endocrinienne, Laboratoire de Génétique et Physiologie Neuroendocrinienne, Faculté des Sciences, Université Ibn Tofaïl, Kénitra, Maroc.
| | | | | |
Collapse
|
24
|
Lahti A, Räsänen P, Karvonen K, Särkioja T, Meyer-Rochow VB, Hakko H. Autumn peak in shooting suicides of children and adolescents from northern Finland. Neuropsychobiology 2007; 54:140-6. [PMID: 17199100 DOI: 10.1159/000098265] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2005] [Accepted: 10/03/2006] [Indexed: 11/19/2022]
Abstract
Suicide is one of the leading causes of death among adolescents worldwide. Studies on the seasonal pattern of youth suicides are rare and the results are very contradictory and heterogeneous. Generally, suicide methods affect the pattern of suicide seasonality. Shooting is the most common suicide method among Finnish adolescents. We investigated whether shooting suicides of victims aged less than 18 years are correlated with a specific period of the year. Also, the seasonal pattern of shooting suicides in adolescents was compared with that of adult victims. Our data comprised 42 adolescent suicide victims and, for comparison, 1,926 adult suicide victims over the years 1988 to 2004 from Northern Finland. Of these, 59.5% (n = 25) of the adolescents and 28.8% (n = 554) of the adults had committed suicide by shooting. We observed that shooting suicides among the under-aged showed a significant peak in autumn (ratio 2.70, 95% CI: 1.97-3.42), while those of adult victims peaked in spring (ratio 1.19, 95% CI: 1.05-1.35). The monthly pattern of suicides correlated significantly with the mean duration of daily sunshine hours (trailing by 3 months) in the under-aged (r = 0.67, p = 0.016), but not in the adults (r = 0.06, p = 0.854). The role of firearm availability, psychosocial factors such as start of the school year, and some biological factors are discussed.
Collapse
Affiliation(s)
- Anniina Lahti
- Department of Psychiatry, University Hospital, University of Oulu, FI-90029 Oulu, Finland
| | | | | | | | | | | |
Collapse
|
25
|
Tonetti L, Barbato G, Fabbri M, Adan A, Natale V. Mood seasonality: a cross-sectional study of subjects aged between 10 and 25 years. J Affect Disord 2007; 97:155-60. [PMID: 16860875 DOI: 10.1016/j.jad.2006.06.008] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2006] [Revised: 06/09/2006] [Accepted: 06/12/2006] [Indexed: 10/24/2022]
Abstract
BACKGROUND Most of the earlier studies on mood seasonality were conducted in adults and there are few available data on children and adolescents. In two cross sectional surveys, we examined the role of age and gender on seasonal sensitivity in subjects aged 10 to 25 years. METHODS In survey one, the Seasonal Pattern Assessment Questionnaire for Children and Adolescents (SPAQ-CA) was administered to 1709 subjects (845 females and 864 males) from 10 to 17 years. In survey two, the Seasonal Pattern Assessment Questionnaire (SPAQ) was administered to 1867 subjects (1061 females and 806 males) from 18 to 25 years. RESULTS Only in survey one was a significant positive correlation found between age and Global Seasonality Score (GSS) (r=.29; p<.00001). Significant gender differences were found at age 14 years and above in survey one, and at all ages in survey two. CONCLUSIONS The results support the hypothesis that seasonal sensitivity is higher in female subjects.
Collapse
|
26
|
Portella ATN, Haaga DAF, Rohan KJ. The association between seasonal and premenstrual symptoms is continuous and is not fully accounted for by depressive symptoms. J Nerv Ment Dis 2006; 194:833-7. [PMID: 17102707 DOI: 10.1097/01.nmd.0000244488.17025.0e] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Seasonal affective disorder (SAD) frequently co-occurs with premenstrual dysphoric disorder. Explanations of this comorbidity highlighting the cyclical nature of female sex hormones imply that seasonal and premenstrual symptoms should correlate positively even in nonclinical samples. In a sample of 91 female college students, we found a sizable positive correlation (r = .45; p < 0.001) between seasonal and premenstrual symptoms. This relation held up even in a subsample selected on the basis of not qualifying for SAD or subsyndromal SAD on a screening measure. Although the correlation was reduced when depressive symptom severity was statistically controlled, it remained positive and significant. Future research testing possible explanations of the co-occurrence of seasonal and premenstrual symptoms should incorporate the full range of severity on symptom variables, treating them as continua rather than solely as binary categories.
Collapse
|
27
|
Rastad C, Ulfberg J, Sjödén PO. High prevalence of self-reported depressive mood during the winter season among Swedish senior high school students. J Am Acad Child Adolesc Psychiatry 2006; 45:231-238. [PMID: 16429094 DOI: 10.1097/01.chi.0000190466.93447.0e] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE There are few studies regarding the prevalence of seasonal variation in mood among children and adolescents. The main objective of this study was to estimate the prevalence of self-reported depressive mood during the winter season among Swedish adolescents and to investigate gender differences. Another aim was to analyze the factor structure and internal consistency of the Kiddie SPAQ (K-SPAQ), a pediatric version of the Seasonal Pattern Questionnaire (SPAQ). METHOD All students 17 to 18 years old, registered in the second year of senior high school in Falun, a district in central Sweden, were screened with the K-SPAQ in January 2003 (response rate 87.3%, n = 756). RESULTS The prevalence of self-reported depressive mood during the winter season was estimated at 20.1% (n = 151/751) and was higher among girls (25.5%) than boys (13.8%). Approximately 8% reported more severe depressive symptoms. Depressive mood during the summer was rare (0.1%, n = 1/751). Factor analysis of the General Seasonal Score items in the K-SPAQ revealed a two-factor structure. A Cronbach's alpha of 0.87 demonstrated a good internal consistency. CONCLUSIONS Depressive symptoms during autumn and winter were common among Swedish senior high school students, especially among girls. This is probably an underdiagnosed condition among adolescents that ought to receive more attention from the health and school authorities.
Collapse
Affiliation(s)
- Cecilia Rastad
- From the Center for Clinical Research Dalarna (CKF) and the Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden (C.R.); the Sleep Disorders Center, Department of Internal Medicine, Avesta Hospital, Avesta, Sweden, and CKF (J.U.); and the Department of Public Health and Caring Sciences, Uppsala University, and CKF (P.O.S.).
| | - Jan Ulfberg
- From the Center for Clinical Research Dalarna (CKF) and the Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden (C.R.); the Sleep Disorders Center, Department of Internal Medicine, Avesta Hospital, Avesta, Sweden, and CKF (J.U.); and the Department of Public Health and Caring Sciences, Uppsala University, and CKF (P.O.S.)
| | - Per-Olow Sjödén
- From the Center for Clinical Research Dalarna (CKF) and the Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden (C.R.); the Sleep Disorders Center, Department of Internal Medicine, Avesta Hospital, Avesta, Sweden, and CKF (J.U.); and the Department of Public Health and Caring Sciences, Uppsala University, and CKF (P.O.S.)
| |
Collapse
|
28
|
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
|
29
|
Ibrahim ZG, Strempel J, Tschernitschek H. The effects of seasonal changes on temporomandibular disorders. Cranio 2005; 23:67-73. [PMID: 15727323 DOI: 10.1179/crn.2005.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The aim of our study was the evaluation of seasonal influences on development and evolution of temporomandibular disorders (TMD). In a retrospective study based on data from 1997 and 1998, we analyzed the monthly number of patients at the Department of Prosthodontics. The total number of first time examinations during these two years was 11,747. Nine hundred and sixty-one (961) patients showed symptoms frequently found in TMD. These patients were submitted to a special TMD diagnosis based on the criteria of a validated craniomandibular index questionnaire. In 568 patients (group A1), a TMD was confirmed, in the other 393 patients (group A2), the disorder could not be confirmed. Dividing up the numbers of patients into summer and winter half years, we found statistically significant relationships between patient numbers and season in TMD patients (A1) as well as in all patients (group B). The distribution of the monthly numbers of TMD patients with its maximum in winter, however, was characteristically different from that of all patients with the maximum in summer. The number of TMD patients per month was significantly correlated to the mean daily sunshine duration per month. Parallels could be drawn to seasonal variations of symptoms in Seasonal Affective Disorders (SAD). As the mechanisms which influence the emergence of psychologically impacted disease in TMD patients might be comparable to SAD, we propose that a similar therapy may be applied.
Collapse
Affiliation(s)
- Ziad G Ibrahim
- Department of Prosthetic Dentistry, Faculty of Dental Medicine, University of Witten/Herdecke, Germany
| | | | | |
Collapse
|
30
|
Eagles JM. Seasonal affective disorder: a vestigial evolutionary advantage? Med Hypotheses 2005; 63:767-72. [PMID: 15488644 DOI: 10.1016/j.mehy.2004.07.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2004] [Accepted: 07/09/2004] [Indexed: 10/26/2022]
Abstract
The typical symptoms of recurrent winter depression include lowered mood, lethargy, hypersomnia, social withdrawal, decreased libido, increased appetite and weight gain. Mild hypomania often occurs in spring and summer. It is argued that this pattern of attenuated hibernation constituted an adaptive evolutionary mechanism which enhanced the likelihood of reproductive success, most notably for females, among populations living at temperate latitudes. Women were more likely to become pregnant in the summer and thus to give birth at a time of year when their babies had a higher chance of survival. Winter depression symptoms also promoted healthier pregnancies and gave rise to enhanced female-male pair-bonding which improved the survival chances of both mothers and babies. Hypomania in spring and summer also served to increase the likelihood of procreation at the optimal time of year. In the modern era, it is probable that recurrent winter depression is becoming a reproductive disadvantage.
Collapse
Affiliation(s)
- J M Eagles
- Royal Cornhill Hospital, Block A, Clerkseat Building, Cornhill Road, Aberdeen AB25 2ZH, UK.
| |
Collapse
|
31
|
Morken G, Sund AM, Linaker OM. A help-line for children. Seasonal variations in issues. Psychiatry Res 2004; 128:191-7. [PMID: 15488962 DOI: 10.1016/j.psychres.2004.05.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2003] [Revised: 04/09/2004] [Accepted: 05/24/2004] [Indexed: 11/22/2022]
Abstract
The objectives of the study were to describe monthly variations in issues in calls to a help-line for children and adolescents. All 80,983 calls to a Red Cross Help-Line for children in 1991-1997 were included. In 22,698 calls, information about age, sex or issue could be identified. A monthly variation in frequency of calls with peaks in April and November and a correlation with the absolute values of monthly changes in length of day were found. Conversations concerning psychiatric suffering were more frequent in January or February and less frequent than expected in May/June and December. Conversations about sexuality correlated with the frequencies of births in the adult population 9 months later. A spring and fall peak in total calling and a winter peak in calls for depression, anxiety, pain and neglect were described.
Collapse
Affiliation(s)
- Gunnar Morken
- Østmarka Psychiatric Department, St. Olavs Hospital, Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Box 3008 Lade, N-7441 Trondheim, Norway.
| | | | | |
Collapse
|
32
|
Abstract
Although the exact nature of sleep disturbances present in children with psychiatric disorders has not been studied extensively, it is apparent that children with significant emotional and behavioral problems are more likely to experience sleep difficulties. Children with sleep-related issues that are limited to bedtime can be managed effectively with specific cognitive-behavioral interventions. Children with more pervasive anxiety (eg, PTSD or OCD, mood disorders such as major depression or bipolar disorder, or neurodevelopmental disabilities such as autism) require a more exhaustive evaluation, and most of them also need sleep problems to be managed by sleep professionals using combinations of psychotherapeutic and pharmacologic approaches.
Collapse
Affiliation(s)
- Anna Ivanenko
- Division of Pediatric Sleep Medicine, University of Louisville, 571 South Floyd Street, Room 438, Louisville, KY 40202, USA.
| | | | | |
Collapse
|
33
|
Imai M, Kayukawa Y, Ohta T, Li L, Nakagawa T. Cross-regional survey of seasonal affective disorders in adults and high-school students in Japan. J Affect Disord 2003; 77:127-33. [PMID: 14607389 DOI: 10.1016/s0165-0327(02)00110-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND In Asian countries, there is no epidemiological report on seasonal affective disorder (SAD) in different age groups and different geographic regions surveyed at the same time. The aim of this study was to estimate the prevalence rates of SAD and risk factors for SAD in adults and high-school students, with special reference to the difference of winter SAD between northern and southern regions in Japan. METHODS A total of 3237 high-school students and 4858 workers living in Japan (31.3-43.5 degrees N) responded to this epidemiological survey using Japanese version of the Seasonal Pattern Assessment Questionnaire (SPAQ). RESULTS The overall prevalence rates of winter SAD (subsyndromal winter SAD) and summer SAD (subsyndromal summer SAD) in high-school students were 0.91(2.21) and 0.81(2.57)%, respectively. In workers, these rates were 0.45(1.16) and 0.43(0.71)%, respectively. Although no regional difference was noted in high-school students with winter seasonal type, the estimated odds ratio of this type for northern workers was nearly 3-fold higher than the southern counterparts. The prevalence rates of each seasonal type were not significantly different between two sexes in both age groups. No clear dependence on latitude was seen with regard to summer SAD in both age groups. LIMITATIONS The effect of climate on SAD could not be entirely excluded from geophysical factor as indexed by latitude. CONCLUSIONS SAD was less common in adults than in high-school students. While latitude was a major determinant of winter type in adults, socio-cultural factors or other contributing factors might affect the development of this type in high-school students.
Collapse
Affiliation(s)
- Makoto Imai
- Department of Clinical Laboratory, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | | | | | | | | |
Collapse
|
34
|
Abstract
Seasonal Affective Disorder (SAD) is a condition of regularly occurring depressions in winter with a remission the following spring or summer. In addition to depressed mood, the patients tend to experience increased appetite and an increased duration of sleep during the winter. SAD is a relatively common condition, affecting 1-3% of adults in temperate climates, and it is more prevalent in women. The pathological mechanisms underlying SAD are incompletely understood. Certain neurotransmitters have been implicated; a dysfunction in the serotonin system in particular has been demonstrated by a variety of approaches. The role of circadian rhythms in SAD needs to be clarified. The phase-delay hypothesis holds that SAD patients' circadian rhythms are delayed relative to the sleep/wake or rest/activity cycle. This hypothesis predicts that the symptoms of SAD will improve if the circadian rhythms can be phase-advanced. There is some experimental support for this. SAD can be treated successfully with light therapy. In classical light therapy, the SAD sufferer sits in front of a light box, exposed to 2000-10,000 lux for 30-120 min daily during the winter. Other forms of light treatments, pharmacotherapy, and other therapies are currently being tested for SAD.
Collapse
Affiliation(s)
- Andres Magnusson
- Department of Psychiatry, Ullevaal University Hospital, Oslo, Norway.
| | | |
Collapse
|
35
|
Affiliation(s)
- John M Eagles
- Royal Cornhill Hospital, Cornhill Road, Aberdeen AB25 2ZH, UK
| |
Collapse
|
36
|
Sund AM, Morken G, Linaker OM. Seasonal variations in children's calls to a help-line: implications for preventive services. J Affect Disord 2002; 70:175-80. [PMID: 12117629 DOI: 10.1016/s0165-0327(01)00339-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND To investigate seasonal variations in telephone calls to a help-line for children, and their correlation to changes in length of day, latitude and age. METHOD 691,787 calls to the Red Cross Help-Line in Norway for children in the three-year period 1996-1998 were included. RESULTS Monthly frequencies of calls deviated significantly from an expected even distribution (chi2=9446.34, df=11, P<0.0001). The frequency curve for calls peaked in April and October and had its lowest level in July and December. Variation was pronounced: the mean number of daily calls varied between 436 in July and 886 in April. There was a strong and positive correlation between the number of calls and the change in length of day across the year (r(s)=0.76, N=12, P<0.01). Increasing latitude correlated positively with the range of the monthly observed/expected ratios of calls (r(s)=0.79, N=7, P<0.05). The frequency of calls was largest among children 12 to 14 years of age. Age correlated negatively with the range of monthly observed/expected ratios of calls (r=-0.94, N=12, P<0.001). LIMITATIONS Social and cultural factors could not be explored in the design used in the present study. CONCLUSIONS The frequency of calls from children correlates positively with change in length of day (i.e., maximal in spring and fall), and the magnitude of the seasonal variation correlates positively with latitude and negatively with age. Knowledge of seasonal variation in requests for help may have value in planning services for children.
Collapse
Affiliation(s)
- Anne Mari Sund
- Department of Child and Adolescent Psychiatry, The Medical Faculty, The Norwegian University of Science and Technology, Trondheim, Norway.
| | | | | |
Collapse
|
37
|
Aronen ET, Fjällberg M, Paavonen EJ, Soininen M. Day length associates with activity level in children living at 60 degrees north. Child Psychiatry Hum Dev 2002; 32:217-26. [PMID: 11893171 DOI: 10.1023/a:1017956706208] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The associations between day length and activity, rest-activity rhythm, and psychiatric symptoms were studied. Sixty-six healthy children participated in the study during one year. They were monitored for 72 consecutive hours with belt-worn activity monitors (actigraphs) to obtain objective data on their activity levels during the day and night. In addition, the parents filled out the Child Behavior Checklists. It was found, that the mean total and day and night time activity levels were increased and the relative circadian amplitude blunted with the longer day length. It was concluded that day length was associated with activity level and rest-activity rhythm and this association may reflect the seasonal changes in these parameters.
Collapse
Affiliation(s)
- Eeva T Aronen
- Department of Child Psychiatry, Hospital for Children and Adolescents, University of Helsinki, Finland.
| | | | | | | |
Collapse
|
38
|
Abstract
Seasonal affective disorder (SAD) is a form of depression that starts in the fall and ends in the spring. This article reviews existing theories about the relationship between circadian rhythms and the disorder. Recent research indicates that as with pharmacologic antidepressants, at least 2-4 weeks are needed to demonstrate the effectiveness of bright-light therapy compared to placebo. The response to such treatment is strongest with precisely timed light exposure: treatment is optimal during the morning hours when the circadian system is susceptible to phase advance. Such clinical improvement is correlated with the magnitude of the phase shift induced. These observations suggest a model of circadian function in SAD and provide important guidelines for its treatment.
Collapse
Affiliation(s)
- P H Desan
- Psychiatric Consultation Service, Yale-New Haven Hospital, New Haven, CT, USA
| | | |
Collapse
|
39
|
Kovalenko PA, Hoven CW, Wicks J, Moore RE, Mandell DJ, Liu H. Seasonal variations in internalizing, externalizing, and substance use disorders in youth. Psychiatry Res 2000; 94:103-19. [PMID: 10808036 DOI: 10.1016/s0165-1781(00)00140-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Seasonal variations were assessed in symptoms of internalizing (anxiety and mood), externalizing (attention-deficit/hyperactivity and oppositional defiant disorders), and substance use disorders in youth. This study is based on secondary data analysis of two NIMH-funded epidemiologic-services studies: (a) Alternative Service Use Patterns by Youth with Serious Emotional Disturbance (N=936, ages 9-17); and (b) Methods for the Epidemiology of Child and Adolescent Mental Disorders (N=1285, ages 9-17). Child psychiatric diagnoses were measured by the Diagnostic Interview Schedule for Children. Variables that indicate site of the interview and service system, as well as age, gender, and ethnicity, were used as covariates. Significant annual variations were found in symptom counts of overanxious disorder, obsessive-compulsive disorder, separation anxiety disorder, social phobia, and major depressive disorder, with the estimated nadir in August-October. There may be weak seasonal variations in attention-deficit/hyperactivity disorder with estimated nadir in August, oppositional defiant disorder with estimated nadir in August-September, and marijuana use with estimated zenith in August-September. Significant seasonality in alcohol, other substance use, agoraphobia, and panic disorder was not found. There may be an instrument-specific bias in estimated nadir. Real nadirs may be up to 3 months prior to the estimated nadirs specified above. Findings suggest that seasonality in symptoms should be considered when assessment instruments of childhood psychiatric disorders are developed, as well as when epidemiological and clinical data are collected and analyzed.
Collapse
Affiliation(s)
- P A Kovalenko
- Department of Child Psychiatry, Columbia University and New York State Psychiatric Institute, New York, NY 10032, USA.
| | | | | | | | | | | |
Collapse
|
40
|
Abstract
OBJECTIVE To examine the effect of sex, latitude, and behavior problems on symptoms related to pediatric seasonal affective disorder among seventh and ninth graders. METHOD A school survey including a modified version of the Seasonal Pattern Assessment Questionnaire was carried out in 2 Finnish cities located in the 60th and 67th northern latitudes. Altogether 1,458 questionnaires were analyzed, representing 89% of the target population. RESULTS Seasonal changes in mood and behavior were commonly reported among seventh and ninth graders. A high Global Seasonality score (> 95th percentile) was associated with female gender and emotional and hyperactivity symptoms. During February and March, girls living in the 67th latitude reported more seasonal distress than girls living at the 60th latitude. CONCLUSIONS It is important to recognize pediatric seasonal affective disorder and related problems among adolescents. Seasonal alterations in child and adolescent behavior are not well understood and need to be investigated more thoroughly.
Collapse
Affiliation(s)
- A Sourander
- Department of Child Psychiatry, Turku University, Finland
| | | | | |
Collapse
|
41
|
Mersch PP, Middendorp HM, Bouhuys AL, Beersma DG, van den Hoofdakker RH. Seasonal affective disorder and latitude: a review of the literature. J Affect Disord 1999; 53:35-48. [PMID: 10363665 DOI: 10.1016/s0165-0327(98)00097-4] [Citation(s) in RCA: 112] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND The aim of the study is to investigate the relationship between the prevalence of SAD and latitude. METHODS An overview of the epidemiological literature on the prevalence of SAD is given and studies relevant for the latitudinal dependency of prevalence will be analyzed and discussed. RESULTS The mean prevalence of SAD is two times higher in North America compared to Europe. Over all prevalence studies, the correlation between prevalence and latitude was not significant. A significant positive correlation was found between prevalence and latitude in North America. For Europe there was a trend in the same direction. CONCLUSIONS The influence of latitude on prevalence seems to be small and other factors like climate, genetic vulnerability and social-cultural context can be expected to play a more important role. Additional controlled studies taking these factors into account are necessary to identify their influence.
Collapse
Affiliation(s)
- P P Mersch
- Department of Biological Psychiatry, University Hospital Groningen, The Netherlands
| | | | | | | | | |
Collapse
|
42
|
Abstract
We investigated the prevalence of seasonal affective disorder (SAD) and subsyndromal SAD (S-SAD) in rural populations in south-western and northern Finland by using the Seasonal Pattern Assessment Questionnaire (SPAQ). A total of 1710 SPAQs were analysed. The prevalences of overall SAD and S-SAD were 12.0% and 27.1%, respectively. Winter SAD (W-SAD) was the most common type, with prevalences of 9.5% for W-SAD and 18.4% for W-S-SAD. The prevalences of overall and winter SAD did not differ between Finns living in northern and south-western Finland. Among the Lapps, W-SAD cases were less frequent than among the Finns in Lapland. Overall seasonality correlated significantly with female gender, high body mass index, high level of education and young age.
Collapse
Affiliation(s)
- S Saarijärvi
- Department of Psychiatry, Turku University Central Hospital, Finland
| | | | | | | |
Collapse
|
43
|
Abstract
Seasonal affective disorder (SAD) is a form of recurrent depressive or bipolar disorder, with episodes that vary in severity. Seasonal patterns of depressive episodes are common, but SAD seems to be less common than such patterns suggest. SAD was at first believed to be related to abnormal melatonin metabolism, but later findings did not support this hypothesis. Studies of brain serotonin function support the hypothesis of disturbed activity. The short-allele polymorphism for serotonin transporter is more common in patients with SAD than in healthy people. Atypical depressive symptoms commonly precede impaired functioning, and somatic symptoms are frequently the presenting complaint at visits to family physicians. The best treatment regimens include 2500 Ix of artificial light exposure in the morning. When patients seem to have no response or to prefer another treatment, antidepressants should be considered.
Collapse
Affiliation(s)
- T Partonen
- Department of Psychiatry, University of Helsinki, National Public Health Institute, Finland.
| | | |
Collapse
|
44
|
Practice parameters for the assessment and treatment of children and adolescents with depressive disorders. AACAP. J Am Acad Child Adolesc Psychiatry 1998; 37:63S-83S. [PMID: 9785729 DOI: 10.1097/00004583-199810001-00005] [Citation(s) in RCA: 140] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Child and adolescent major depressive disorder and dysthymic disorder are common, chronic, familial, and recurrent conditions that usually persist into adulthood. These disorders appear to be manifesting at an earlier age in successive cohorts and are usually accompanied by comorbid psychiatric disorders, increased risk for suicide, substance abuse, and behavior problems. In addition, depressed youth frequently have poor psychosocial, academic, and family functioning, which highlights the importance of early identification and prompt treatment. Both psychotherapy and pharmacotherapy have been found to be beneficial for the acute treatment of youth with depressive disorders. Opinions vary regarding which of these treatments should be offered first and whether they should be offered in combination. In general, the choice of initial therapy depends on clinical and psychosocial factors and therapist's expertise. Based on the current literature and clinical experience, psychotherapy may be the first treatment for most depressed youth. However, antidepressants must be considered for those patients with psychosis, bipolar depression, severe depressions, and those who do not respond to an adequate trial of psychotherapy. All patients need continuation therapy and some patients may require maintenance treatment. Further research is needed on the etiology of depression; the efficacy of different types of psychotherapy; the differential effects of psychotherapy, pharmacotherapy, and integrated therapies; the continuation and maintenance treatment phases; treatment for dysthymia, treatment-resistant depression, and other subtypes of major depressive disorder; and preventive strategies for high-risk children and adolescents.
Collapse
|
45
|
Meesters Y. Case study: dawn simulation as maintenance treatment in a nine-year-old patient with seasonal affective disorder. J Am Acad Child Adolesc Psychiatry 1998; 37:986-8. [PMID: 9735618 DOI: 10.1097/00004583-199809000-00019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
After four winter seasons of successful treatment with light boxes, a 9-year-old patient with seasonal affective disorder refused to make further use of the light box. Instead he was treated with dawn simulation (a dim light administered just before waking up and gradually increased in intensity). The patient used dawn simulation therapy from October until mid-May, with an occasional variation of the maximum light intensity (100, 200, or 300 iux). The patient, his parents, and his teacher were all happy with this type of treatment.
Collapse
Affiliation(s)
- Y Meesters
- Department of Biological Psychiatry, Academic Hospital Groningen, The Netherlands.
| |
Collapse
|
46
|
Giedd JN, Swedo SE, Lowe CH, Rosenthal NE. Case series: pediatric seasonal affective disorder. A follow-up report. J Am Acad Child Adolesc Psychiatry 1998; 37:218-20. [PMID: 9473919 DOI: 10.1097/00004583-199802000-00015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Six subjects who as children had received a diagnosis of seasonal affective disorder consented to participate in a 7-year follow-up study. Structured and semistructured interviews were conducted to assess the course of illness, response to treatment, and current clinical state. Seasonal patterns of symptoms and response to light therapy remained relatively stable over a 7-year period. Two subjects were using adjunctive fluoxetine. Seasonal affective disorder can occur in children and adolescents, responds to light therapy, and should be considered in the differential diagnosis of pediatric affective symptoms or cyclic school performance.
Collapse
Affiliation(s)
- J N Giedd
- National Institute of Mental Health, Child Psychiatry Branch, Bethesda, MD 20892, USA.
| | | | | | | |
Collapse
|
47
|
Abstract
BACKGROUND Little is known about seasonal fluctuations in psychological well-being among elderly people. METHOD Over a period of 21 months, 1466 elderly people completed the General Health Questionnaire and the Leeds Scales for Depression and Anxiety. Scores during the winter months (December to February) were compared with those during other months of the year. RESULTS Scores on all scales were significantly higher during the winter months, but there was no difference in rates of caseness. Unlike younger populations, elderly women did not exhibit greater seasonality in well-being than did elderly men. CONCLUSIONS Elderly people exhibit a small seasonal fluctuation in psychological well-being, which is probably of little clinical importance, and there is no gender difference. The findings support the contention that seasonal mood changes are most pronounced among females of reproductive age.
Collapse
|
48
|
Swedo SE, Allen AJ, Glod CA, Clark CH, Teicher MH, Richter D, Hoffman C, Hamburger SD, Dow S, Brown C, Rosenthal NE. A controlled trial of light therapy for the treatment of pediatric seasonal affective disorder. J Am Acad Child Adolesc Psychiatry 1997; 36:816-21. [PMID: 9183137 DOI: 10.1097/00004583-199706000-00019] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To evaluate the efficacy of light therapy for the treatment of pediatric seasonal affective disorder (SAD). METHOD 28 children (aged 7 to 17 years) at two geographically distinct sites were enrolled in a double-blind, placebo-controlled, crossover trial of bright-light treatment. Subjects initially entered a week-long baseline period during which they wore dark glasses for an hour a day. They were then randomly assigned to receive either active treatment (1 hour of bright-light therapy plus 2 hours of dawn simulation) or placebo (1 hour of clear goggles plus 5 minutes of low-intensity dawn simulation) for 1 week. The treatment phase was followed by a second dark-glasses phase lasting 1 to 2 weeks. After this phase, the children received the alternate treatment. Response was measured using the parent and child versions of the Structured Interview Guide for the Hamilton Depression Rating Scale, Seasonal Affective Disorders version (SIGH-SAD). RESULTS Data were analyzed as change from baseline. SIGH-SAD-P total depression scores were significantly decreased from baseline during light therapy compared with placebo (one-way analysis of variance, rho = .009), and no differences were found between the placebo and control phases. Subscores of atypical and typical depression were also significantly decreased during the active treatment (rho = .004 and .028, respectively). A similar trend was noted with the SIGH-SAD-C, but this did not reach significance. At the end of the study, 78% of the parents questioned and 80% of the children questioned rated light therapy as the phase during which the child "felt best." CONCLUSION Light therapy appears to be an effective treatment for pediatric SAD.
Collapse
Affiliation(s)
- S E Swedo
- Department of Psychiatry, McLean Hospital, Belmont, MA, USA
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Glod CA, Teicher MH, Polcari A, McGreenery CE, Ito Y. Circadian rest-activity disturbances in children with seasonal affective disorder. J Am Acad Child Adolesc Psychiatry 1997; 36:188-95. [PMID: 9031571 DOI: 10.1097/00004583-199702000-00009] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Seasonal affective disorder (SAD) affects from 1.7% to 5.5% of children. Previous studies found that nonseasonally depressed children had a blunted circadian rhythm, while adults with SAD had a delayed and poorly entrained rhythm. The purpose of this study was to determine whether pediatric SAD more closely resembles nonseasonal pediatric depression or adult SAD. METHOD Twelve normal, healthy volunteers (11.6 +/- 3.7 years; 6 female, 6 male) and 14 unmedicated children with SAD (11.0 +/- 3.3 years; 9 female, 5 male) meeting Rosenthal/NIMH criteria for SAD and Schedule for Affective Disorders and Schizophrenia for School-Age Children-Epidemiologic version criteria for major depression had their levels of activity recorded for 72 hours (weekdays) using belt-worn actigraphs. RESULTS The SAD group had blunted circadian amplitudes that were 10% lower than normal (p = .004). They were more poorly modeled by the standard cosinor equation (p = .001), and a circadian rhythm accounted for 39% less of the variability in their activity profile (p = .007). The amplitude of the 12-hour harmonic rhythm was markedly increased. There were no differences between SAD and control children in the timing of the circadian rhythm and degree of entrainment. CONCLUSIONS Children with SAD displayed dysregulated circadian activity rhythms comparable with those reported in nonseasonally depressed children, yet different from those observed in adults.
Collapse
Affiliation(s)
- C A Glod
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | | | | | | | | |
Collapse
|
50
|
Birmaher B, Ryan ND, Williamson DE, Brent DA, Kaufman J, Dahl RE, Perel J, Nelson B. Childhood and adolescent depression: a review of the past 10 years. Part I. J Am Acad Child Adolesc Psychiatry 1996; 35:1427-39. [PMID: 8936909 DOI: 10.1097/00004583-199611000-00011] [Citation(s) in RCA: 990] [Impact Index Per Article: 35.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To qualitatively review the literature of the past decade covering the epidemiology, clinical characteristics, natural course, biology, and other correlates of early-onset major depressive disorder (MDD) and dysthymic disorder (DD). METHOD A computerized search for articles published during the past 10 years was made and selected studies are presented. RESULTS Early-onset MDD and DD are frequent, recurrent, and familial disorders that tend to continue into adulthood, and they are frequently accompanied by other psychiatric disorders. These disorders are usually associated with poor psychosocial and academic outcome and increased risk for substance abuse, bipolar disorder, and suicide. In addition, DD increases the risk for MDD. There is a secular increase in the prevalence of MDD, and it appears that MDD is occurring at an earlier age in successive cohorts. Several genetic, familial, demographic, psychosocial, cognitive, and biological correlates of onset and course of early-onset depression have been identified. Few studies, however, have examined the combined effects of these correlates. CONCLUSIONS Considerable advances have been made in our knowledge of early-onset depression. Nevertheless, further research is needed in understanding the pathogenesis of childhood mood disorders. Toward this end, studies aimed at elucidating mechanisms and interrelationships among the different domains of risk factors are needed.
Collapse
Affiliation(s)
- B Birmaher
- Department of Psychiatry, Western Psychiatric Institute and Clinic, School of Medicine, University of Pittsburgh, PA 15213, USA
| | | | | | | | | | | | | | | |
Collapse
|