What is this thing called “SAD”? A critique of the concept of seasonal affective disorder

2008 ◽  
Vol 17 (2) ◽  
pp. 120-127 ◽  
Author(s):  
Vidje Hansen ◽  
Ingunn Skre ◽  
Eiliv Lund
Keyword(s):  
Affective Disorder ◽  
Seasonal Affective Disorder ◽  
Seasonal Pattern ◽  
Relevant Literature ◽  
Large Population ◽  
Recurrent Depression ◽  
Northern Norway ◽  
Prevalence Of Depression ◽  
Icd 10 ◽  
General Populations

SummaryBackground– Seasonal Affective Disorder (SAD) is supposed to be caused by lack of daylight in winter. Yet the population of Northern Norway, living without sun for two winter months, does not spontaneously complain about depression during the dark period.Aims– To summarize research bearing upon the validity of the concept of SAD.Method– Review of relevant literature concerning the epidemiology of SAD and the questionnaire developed to measure it in general populations, the Seasonal Pattern Assessment Questionnaire (SPAQ).Results– Large population studies from northern Norway do not point to a higher prevalence of depression in winter than expected in any other general population. The psychometric properties of SPAQ are rather poor, and the diagnosis of SAD based on SPAQ bears little relationship to a meaningful concept of depression.Conclusions– Seasonal Affective Disorder is not a valid medical construct. Instead, “Recurrent depression with seasonal pattern” as defined in the DSM-IV and the ICD-10 should be used as terms. However, more research is needed to establish whether it is at all fruitful to single out such a subtype of recurrent depression.Declaration of Interest: None.

Classification of recurrent depression with seasonal pattern: a comparison between two diagnostic instruments

2011 ◽  
Vol 26 (S2) ◽  
pp. 610-610 ◽  
Author(s):  
G. Brancaleoni ◽  
V. Hansen
Keyword(s):  
Seasonal Affective Disorder ◽  
Seasonal Pattern ◽  
Recurrent Depression ◽  
Two Samples ◽  
Prevalence Of Depression ◽  
Seasonal Depression ◽  
Dsm Iv ◽  
The Difference ◽  
Assessment Questionnaire

IntroductionThe validity of the Seasonal Pattern Assessment Questionnaire (SPAQ) in diagnosing Seasonal Affective Disorder is questionable. In 2004 the Seasonal Health Questionnaire (SHQ) was proposed as a more appropriate screening instrument for depression with a seasonal pattern.Objectives/aimsTo compare the performance of the SPAQ, the most commonly used tool for assigning a diagnosis of SAD, with the SHQ, which uses the DSM-IV criteria for recurrent depression with seasonal pattern.MethodsTwo samples of approximately 200 medical students in Tromsø, Norway (69° north) and Ferrara, Italy (44° north), filled in both questionnaires. Prevalence of recurrent depression with seasonal pattern was calculated according to gender and latitude of living, with both instruments. Using SHQ diagnosis as the gold standard, sensitivity and specificity of the SPAQ as a diagnostic instrument was ascertained.ResultsThe prevalence of depression with seasonal pattern measured by SPAQ was 12% in Norway and 14.5% in Italy, the difference was not significant. Prevalence was highest in females in both countries (Norway: males 4.2%, females 14.7%, Italy: males 2.3%, females 18.8%), but the difference was only significant in Italy (p = 0.007). According to SHQ, the corresponding figures in Norway 5.9% and 7.1% (p = 0.77) and in Italy 3.9% and 3% (p = 0.75). The specificity of the SPAQ was 88.8% and the sensitivity was 47.3%.ConclusionCompared to a DSM-IV diagnosis of depression with seasonal pattern as measured by the SHQ, the SPAQ seriously overestimates the prevalence of seasonal depression, especially in women, and the sensitivity is far too low.

Seasonal Affective Disorder in Australia: Is Photoperiod Critical?

1997 ◽  
Vol 31 (2) ◽  
pp. 279-284 ◽  
Author(s):  
Gregory W. Murray ◽  
David A. Hay
Keyword(s):  
Affective Disorder ◽  
Seasonal Affective Disorder ◽  
Survey Design ◽  
Seasonal Pattern ◽  
General Health Questionnaire ◽  
Epidemiological Survey ◽  
Self Report ◽  
Recurrent Depression ◽  
Sampling Frame ◽  
Assessment Questionnaire

Objectives: Seasonal affective disorder (SAD) is a variant of recurrent depression in which episodes are linked to a particular season, typically winter. SAD is understood as the extreme end of a continuum of seasonality in the general population. Photoperiod (the timing and duration of daylight) has been assumed to be aetiologically critical. The present research used a survey design to investigate the assumed centrality of photoperiod for SAD/seasonality in Australia. Two hypotheses were tested: that self-reported seasonality does not increase further from the equator and that seasonality does not stand alone from non-seasonal neurotic complaints. Method: The sampling frame used was adult females on the Australian Twin Registry roll. A sample of 526 women residing across the latitudes of Australia responded to a survey based around the Seasonal Pattern Assessment Questionnaire (SPAQ). The SPAQ asks respondents to retrospectively report on season-related changes in mood and behaviour. The survey also contained three questionnaire measures of neurotic symptoms of anxiety and depression: the General Health Questionnaire (GHQ), the Community Epidemiological Survey for Depression (CES-D) and the State-Trait Anxiety Inventory—Trait (STAI-T). Results: Self-reported seasonality did not correlate with latitude (r=0.01, NS). On the other hand, a substantial relationship was found between seasonality and each of the measures of non-seasonal complaints: GHQ (r=0.35, p<0.001); CES-D (r=0.35, p<0.001); and STAI-T (r=0.30, p<0.001). Conclusions: Within the limitations of a design based on retrospective self-report, the findings of the present study suggest that the diathesis for SAD/seasonality may not be photoperiod-specific. At least in Australia, there is provisional support for the proposal that human seasonality may have a broader psychological component. The findings are discussed in terms of established research into normal mood, trait personality and non-seasonal depression.

Will light brighten the future of the depressed patient?

1997 ◽  
Vol 9 (2) ◽  
pp. 71-76 ◽  
Author(s):  
R.H. Van Den Hoofdakker ◽  
M.C.M. Gordijn
Keyword(s):  
Affective Disorder ◽  
Seasonal Affective Disorder ◽  
Seasonal Pattern ◽  
Bright Light ◽  
Light Treatment ◽  
Psychosocial Variable ◽  
Clear Cut ◽  
Treatment Experiment ◽  
History Of ◽  
Therapeutic Possibilities

The present explosive growth of interest in the therapeutic possibilities of exposure to light was triggered by a patient, Herbert Kern. He suffered from episodic depressive and manic complaints and discovered, by registering these over the years, a seasonal pattern in their occurrence. Discussions with scientists of the NIMH resulted in his participation in a bright light-treatment experiment when he was depressed in the winter of 1980-1981. He recovered.Next, the same group of investigators defined the criteria for a new syndrome, Seasonal Affective Disorder (SAD): a history of major affective disorder (according to the Research Diagnostic Criteria), at least two consecutive years in which the depressions have occurred during fall or winter and remitted in the following spring or summer, and the absence of any clear-cut seasonally changing psychosocial variable, such as work, stress and so on.

scholarly journals Seasonal affective disorder among general practice attenders

2002 ◽  
Vol 180 (5) ◽  
pp. 394-395 ◽  
Author(s):  
Tony Kendrick
Keyword(s):  
Affective Disorder ◽  
Health Care Services ◽  
American Psychiatric Association ◽  
Seasonal Affective Disorder ◽  
Seasonal Pattern ◽  
Care Services ◽  
Primary Health ◽  
Primary Health Care Services ◽  
Dsm Iv ◽  
Assessment Questionnaire

In this issue, Eagles et al report that people suffering from seasonal affective disorder (SAD) are heavy users of primary health care services (Eagles et al, 2002, this issue). Nearly 10% of patients attending practices in Aberdeen screened positive for SAD using the Seasonal Pattern Assessment Questionnaire (SPAQ; Rosenthal et al, 1987), among whom around half of those attending for interview fulfilled DSM–IV (American Psychiatric Association, 1994) criteria for recurrent major depression with seasonal pattern. The patients with SAD had consulted significantly more frequently over a 5-year period, with a variety of symptoms both related and unrelated to SAD, and had received significantly more prescriptions, investigations and referrals than patients found not to fulfil the criteria for SAD.

scholarly journals Seasonal Affective Disorder: An Overview of Assessment and Treatment Approaches

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Sherri Melrose
Keyword(s):  
Affective Disorder ◽  
Seasonal Affective Disorder ◽  
Seasonal Pattern ◽  
Light Therapy ◽  
Early Summer ◽  
Major Depressive ◽  
Assessment And Treatment ◽  
Typical Treatment ◽  
Recurrent Major Depressive Disorder ◽  
Assessment Questionnaire

Seasonal affective disorder or SAD is a recurrent major depressive disorder with a seasonal pattern usually beginning in fall and continuing into winter months. A subsyndromal type of SAD, or S-SAD, is commonly known as “winter blues.” Less often, SAD causes depression in the spring or early summer. Symptoms center on sad mood and low energy. Those most at risk are female, are younger, live far from the equator, and have family histories of depression, bipolar disorder, or SAD. Screening instruments include the Seasonal Pattern Assessment Questionnaire (SPAQ). Typical treatment includes antidepressant medications, light therapy, Vitamin D, and counselling. This paper provides an overview of SAD.

Association of the intronic rs2072621 polymorphism of the X-linked GPR50 gene with affective disorder with seasonal pattern

2012 ◽  
Vol 27 (5) ◽  
pp. 369-371 ◽  
Author(s):  
M. Delavest ◽  
C. Even ◽  
N. Benjemaa ◽  
M.-F. Poirier ◽  
R. Jockers ◽  
...  
Keyword(s):  
Affective Disorder ◽  
Case Control Study ◽  
Seasonal Affective Disorder ◽  
Seasonal Pattern ◽  
Nucleotide Polymorphism ◽  
Gene Encoding ◽  
Single Nucleotide ◽  
G Protein Coupled ◽  
Gender Specific ◽  
Control Study

AbstractThis case-control study found an association between Seasonal Affective Disorder (SAD) and a single nucleotide polymorphism (intronic rs2072621) of the gene encoding GPR50 (an orphan member of the G protein-coupled melatonin receptor subfamily) in females. This may represent a gender-specific risk factor and a molecular link between melatonin and SAD.

scholarly journals Patients’ Experience of Winter Depression and Light Room Treatment

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Cecilia Rastad ◽  
Lennart Wetterberg ◽  
Cathrin Martin
Keyword(s):  
Affective Disorder ◽  
Subjective Experience ◽  
Rating Scale ◽  
Seasonal Affective Disorder ◽  
Social Withdrawal ◽  
Qualitative Content Analysis ◽  
Seasonal Pattern ◽  
Work Capacity ◽  
Semistructured Interview ◽  
Rapid Improvement

Background. There is a need for more knowledge on the effects of light room treatment in patients with seasonal affective disorder and to explore patients’ subjective experience of the disease and the treatment.Methods. This was a descriptive and explorative study applying qualitative content analysis. A purposeful sample of 18 psychiatric outpatients with a major depressive disorder with a seasonal pattern and a pretreatment score ≥12 on the 9-item Montgomery-Åsberg Depression self-rating scale was included (10 women and 8 men, aged 24–65 years). All patients had completed light room treatment (≥7/10 consecutive weekdays). Data was collected two weeks after treatment using a semistructured interview guide.Results. Patients described a clear seasonal pattern and a profound struggle to adapt to seasonal changes during the winter, including deterioration in sleep, daily rhythms, energy level, mood, activity, and cognitive functioning. Everyday life was affected with reduced work capacity, social withdrawal, and disturbed relations with family and friends. The light room treatment resulted in a radical and rapid improvement in all the major symptoms with only mild and transient side effects.Discussion. The results indicate that light room treatment is essential for some patients’ ability to cope with seasonal affective disorder.

The Impact of Seasonal Affective Disorder on Financial Analysts

2017 ◽  
Vol 93 (4) ◽  
pp. 309-333 ◽  
Author(s):  
Kin Lo ◽  
Serena Shuo Wu
Keyword(s):  
Stock Returns ◽  
Affective Disorder ◽  
Seasonal Affective Disorder ◽  
Seasonal Pattern ◽  
Financial Analysts ◽  
Analyst Forecasts ◽  
Equity Returns ◽  
Data Availability ◽  
Forecast Revisions ◽  
The Impact

ABSTRACT We examine the impact of Seasonal Affective Disorder (SAD) on financial analysts. We hypothesize and find that analysts are more pessimistic, less precise, and more asymmetric in their boldness in the fall, as indicated by their forecasts of quarterly earnings. The effects are apparent in all forecast horizons analyzed and robust across multiple specifications. Importantly, pessimism in fall forecast revisions shows analyst-specific persistence, providing a strong indication that the effect is a result of SAD rather than other coincident factors. We also find evidence of a reversal in pessimism in the spring. Additional analyses show that analyst forecasts exhibit less seasonality than equity returns, and that the presence of analyst forecasts in the fall is associated with attenuation in the seasonal pattern in stock returns. Overall, the evidence suggests that SAD affects both financial analysts and equity investors, but the effect on the latter is stronger. JEL Classifications: G11; G12; G14; G41; M41. Data Availability: Data are available from public sources cited in the text.

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