seasonal affective disorder

Summary

Summary: A syndrome characterized by depressions that recur annually at the same time each year, usually during the winter months. Other symptoms include anxiety, irritability, decreased energy, increased appetite (carbohydrate cravings), increased duration of sleep, and weight gain. SAD (seasonal affective disorder) can be treated by daily exposure to bright artificial lights (PHOTOTHERAPY), during the season of recurrence.

Top Publications

  1. Golden R, Gaynes B, Ekstrom R, Hamer R, Jacobsen F, Suppes T, et al. The efficacy of light therapy in the treatment of mood disorders: a review and meta-analysis of the evidence. Am J Psychiatry. 2005;162:656-62 pubmed
    ..84 and 95% confidence interval [CI] of 0.60 to 1.08) and dawn simulation in seasonal affective disorder (five studies; effect size=0.73, 95% CI=0.37 to 1...
  2. Partonen T, Appelberg B, Partinen M. Effects of light treatment on sleep structure in seasonal affective disorder. Eur Arch Psychiatry Clin Neurosci. 1993;242:310-3 pubmed
    Twelve outpatients with seasonal affective disorder (depression, winter type) were treated by 1 h of bright light exposure for five mornings...
  3. Workman J, Nelson R. Potential animal models of seasonal affective disorder. Neurosci Biobehav Rev. 2011;35:669-79 pubmed publisher
    b>Seasonal affective disorder (SAD) is characterized by depressive episodes during winter that are alleviated during summer and by morning bright light treatment. Currently, there is no animal model of SAD...
  4. Terman J, Terman M, Lo E, Cooper T. Circadian time of morning light administration and therapeutic response in winter depression. Arch Gen Psychiatry. 2001;58:69-75 pubmed
    ..Plasma melatonin was sampled in 42 patients with seasonal affective disorder, in the evening or overnight while depressed and after 10 to 14 days of light therapy (10 000 lux for ..
  5. Murray G, Michalak E, Levitt A, Levitan R, Enns M, Morehouse R, et al. Therapeutic mechanism in seasonal affective disorder: do fluoxetine and light operate through advancing circadian phase?. Chronobiol Int. 2005;22:937-43 pubmed
    ..of Lewy's phase delay hypothesis, the present study tested whether effective treatment of winter Seasonal Affective Disorder (SAD) is mediated by advancing of circadian phase...
  6. Yamadera H, Okawa M, Takahashi K. Open study of effects of alprazolam on seasonal affective disorder. Psychiatry Clin Neurosci. 2001;55:27-30 pubmed
    b>Seasonal affective disorder (SAD) differs from depression with melancholic features in atypical symptoms, such as hyperphagia, hypersomnia and weight gain. Moreover, SAD is confined to a certain season of the year...
  7. Magnusson A, Partonen T. The diagnosis, symptomatology, and epidemiology of seasonal affective disorder. CNS Spectr. 2005;10:625-34; quiz 1-14 pubmed
    The operational criteria for seasonal affective disorder (SAD) have undergone several changes since first proposed in 1984...
  8. Neumeister A, Konstantinidis A, Praschak Rieder N, Willeit M, Hilger E, Stastny J, et al. Monoaminergic function in the pathogenesis of seasonal affective disorder. Int J Neuropsychopharmacol. 2001;4:409-20 pubmed
    b>Seasonal affective disorder/winter type (SAD) is characterized by recurrent depressive episodes during autumn and winter alternating with non-depressive episodes during spring and summer...
  9. Schwartz P, Brown C, Wehr T, Rosenthal N. Winter seasonal affective disorder: a follow-up study of the first 59 patients of the National Institute of Mental Health Seasonal Studies Program. Am J Psychiatry. 1996;153:1028-36 pubmed
    The purpose of this study was to characterize the long-term course of patients with seasonal affective disorder. The first 59 patients with winter seasonal affective disorder who had entered winter protocols were retrospectively followed ..

More Information

Publications62

  1. Harmer C, Charles M, McTavish S, Favaron E, Cowen P. Negative ion treatment increases positive emotional processing in seasonal affective disorder. Psychol Med. 2012;42:1605-12 pubmed publisher
    ..HDNI) treatment is an environmental manipulation that has efficacy in randomized clinical trials in seasonal affective disorder (SAD)...
  2. Pääkkönen T, Leppäluoto J, Mäkinen T, Rintamaki H, Ruokonen A, Hassi J, et al. Seasonal levels of melatonin, thyroid hormones, mood, and cognition near the Arctic Circle. Aviat Space Environ Med. 2008;79:695-9 pubmed
    ..Also, serum melatonin and thyrotropin were associated with impaired and fT3 with improved cognitive performance, supporting the decrements in cognitive performance associated with the polar triiodothyronine syndrome. ..
  3. Lewy A, Lefler B, Emens J, Bauer V. The circadian basis of winter depression. Proc Natl Acad Sci U S A. 2006;103:7414-9 pubmed
    The following test of the circadian phase-shift hypothesis for patients with winter depression (seasonal affective disorder, or SAD) uses low-dose melatonin administration in the morning or afternoon/evening to induce phase delays or ..
  4. Koorengevel K, Beersma D, den Boer J, van den Hoofdakker R. Sleep in seasonal affective disorder patients in forced desynchrony: an explorative study. J Sleep Res. 2002;11:347-56 pubmed
    The majority of winter-type seasonal affective disorder (SAD) patients complain of hypersomnia and daytime drowsiness...
  5. Levitan R, Masellis M, Basile V, Lam R, Jain U, Kaplan A, et al. Polymorphism of the serotonin-2A receptor gene (HTR2A) associated with childhood attention deficit hyperactivity disorder (ADHD) in adult women with seasonal affective disorder. J Affect Disord. 2002;71:229-33 pubmed
    Several lines of research point to a possible overlap between seasonal affective disorder (SAD) and attention deficit hyperactivity disorder (ADHD), particularly in females...
  6. Wileman S, Eagles J, Andrew J, Howie F, Cameron I, McCormack K, et al. Light therapy for seasonal affective disorder in primary care: randomised controlled trial. Br J Psychiatry. 2001;178:311-6 pubmed
    ..To evaluate light therapy in primary care. Fifty-seven participants with seasonal affective disorder were randomly allocated to 4 weeks of bright white or dim red light...
  7. Neumeister A, Willeit M, Praschak Rieder N, Asenbaum S, Stastny J, Hilger E, et al. Dopamine transporter availability in symptomatic depressed patients with seasonal affective disorder and healthy controls. Psychol Med. 2001;31:1467-73 pubmed
    During recent years hypotheses about the pathophysiology of seasonal affective disorder/winter type (SAD) have focused monoaminergic mechanisms. There is substantial evidence that serotonergic systems play an important role...
  8. Reid S, Towell A, Golding J. Seasonality, social zeitgebers and mood variability in entrainment of mood. Implications for seasonal affective disorder. J Affect Disord. 2000;59:47-54 pubmed
    ..People high in seasonality appear to be more responsive to external zeitgebers, and this could be linked to their greater variability in mood. The integration of research on mood variability with research on SAD appears to be warranted. ..
  9. Winkler D, Willeit M, Praschak Rieder N, Lucht M, Hilger E, Konstantinidis A, et al. Changes of clinical pattern in seasonal affective disorder (SAD) over time in a German-speaking sample. Eur Arch Psychiatry Clin Neurosci. 2002;252:54-62 pubmed
    The goals of this study are to provide estimates of clinical and demographic variables of patients with seasonal affective disorder (SAD) in Germany and Austria, to compare our results with those of previously published SAD studies, and ..
  10. Eagles J. Seasonal affective disorder. Br J Psychiatry. 2003;182:174-6 pubmed
  11. Sohn C, Lam R. Update on the biology of seasonal affective disorder. CNS Spectr. 2005;10:635-46; quiz 1-14 pubmed
    The etiology and pathophysiology of seasonal affective disorder (SAD) has been linked to the seasons and to light since its first conceptualization...
  12. Enoch M, Goldman D, Barnett R, Sher L, Mazzanti C, Rosenthal N. Association between seasonal affective disorder and the 5-HT2A promoter polymorphism, -1438G/A. Mol Psychiatry. 1999;4:89-92 pubmed
    Genes involved in serotonin metabolism are good candidates for the pathogenesis of seasonal affective disorder (SAD)...
  13. Postolache T, Doty R, Wehr T, Jimma L, Han L, Turner E, et al. Monorhinal odor identification and depression scores in patients with seasonal affective disorder. J Affect Disord. 1999;56:27-35 pubmed
    ..that olfactory deficits may unmask seasonal rhythms in certain individuals, namely those with seasonal affective disorder (SAD)...
  14. Hansen V, Skre I, Lund E. What is this thing called "SAD"? A critique of the concept of Seasonal Affective Disorder. Epidemiol Psichiatr Soc. 2008;17:120-7 pubmed
    b>Seasonal Affective Disorder (SAD) is supposed to be caused by lack of daylight in winter...
  15. Willeit M, Praschak Rieder N, Neumeister A, Zill P, Leisch F, Stastny J, et al. A polymorphism (5-HTTLPR) in the serotonin transporter promoter gene is associated with DSM-IV depression subtypes in seasonal affective disorder. Mol Psychiatry. 2003;8:942-6 pubmed
    Serotonergic mechanisms are thought to play an important role in the pathogenesis of seasonal affective disorder (SAD)...
  16. Lundt L. Modafinil treatment in patients with seasonal affective disorder/winter depression: an open-label pilot study. J Affect Disord. 2004;81:173-8 pubmed
    Hypersomnia is a cardinal symptom of seasonal affective disorder/winter depression. This open-label pilot study assessed modafinil, a novel wake-promoting agent, as treatment for seasonal affective disorder/winter depression...
  17. Partonen T, Treutlein J, Alpman A, Frank J, Johansson C, Depner M, et al. Three circadian clock genes Per2, Arntl, and Npas2 contribute to winter depression. Ann Med. 2007;39:229-38 pubmed
    ..of evidence suggest that the circadian clock contributes to the pathogenesis of winter depression or seasonal affective disorder (SAD)...
  18. Lam R, Levitt A, Levitan R, Enns M, Morehouse R, Michalak E, et al. The Can-SAD study: a randomized controlled trial of the effectiveness of light therapy and fluoxetine in patients with winter seasonal affective disorder. Am J Psychiatry. 2006;163:805-12 pubmed
    Light therapy and antidepressants have shown comparable efficacy in separate studies of seasonal affective disorder treatment, but few studies have directly compared the two treatments...
  19. Friedman S, Even C, Thuile J, Rouillon F, Guelfi J. Night eating syndrome and winter seasonal affective disorder. Appetite. 2006;47:119-22 pubmed
    Night eating syndrome (NES) and winter seasonal affective disorder (SAD) share some features such as snacking for high-carbohydrate/high-fat food with increased weight, emotional distress, circadian disturbances, good response to ..
  20. Andrew J, Wileman S, Howie F, Cameron I, Naji S, Eagles J. Comparison of consultation rates in primary care attenders with and without seasonal affective disorder. J Affect Disord. 2001;62:199-205 pubmed
    There is a lack of published information about the consultation patterns of patients with seasonal affective disorder (SAD) in primary care, when compared with non-seasonal controls (NSCs)...
  21. Terman M, Terman J. Controlled trial of naturalistic dawn simulation and negative air ionization for seasonal affective disorder. Am J Psychiatry. 2006;163:2126-33 pubmed
    ..were assessed over 3 weeks with the Structured Interview Guide for the Hamilton Depression Rating Scale-Seasonal Affective Disorder Version. Posttreatment improvement results were bright light, 57.1%; dawn simulation, 49...
  22. Eagles J. Seasonal affective disorder: a vestigial evolutionary advantage?. Med Hypotheses. 2004;63:767-72 pubmed
    ..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. ..
  23. Kasof J. Cultural variation in seasonal depression: cross-national differences in winter versus summer patterns of seasonal affective disorder. J Affect Disord. 2009;115:79-86 pubmed publisher
    ..seasonally varying levels of ambient sunlight that may underlie regular cycles of mood and behavior in Seasonal Affective Disorder (SAD)...
  24. Timonen M, Nissilä J, Liettu A, Jokelainen J, Jurvelin H, Aunio A, et al. Can transcranial brain-targeted bright light treatment via ear canals be effective in relieving symptoms in seasonal affective disorder? A pilot study. Med Hypotheses. 2012;78:511-5 pubmed publisher
    Bright light therapy (BLT) is widely accepted as first-line treatment of seasonal affective disorder (SAD). However, the mechanism of action of BLT is still widely unknown...
  25. Thorn L, Evans P, Cannon A, Hucklebridge F, Clow A. Seasonal differences in the diurnal pattern of cortisol secretion in healthy participants and those with self-assessed seasonal affective disorder. Psychoneuroendocrinology. 2011;36:816-23 pubmed publisher
    ..salivary cortisol secretion in winter and in summer between two groups; participants with self-assessed seasonal affective disorder (SAD) and age- and sex-matched healthy controls...
  26. Lee H, Rex K, Nievergelt C, Kelsoe J, Kripke D. Delayed sleep phase syndrome is related to seasonal affective disorder. J Affect Disord. 2011;133:573-9 pubmed publisher
    Both delayed sleep phase syndrome (DSPS) and seasonal affective disorder (SAD) may manifest similar delayed circadian phase problems. However, the relationships and co-morbidity between the two conditions have not been fully studied...
  27. ROECKLEIN K, Wong P, Ernecoff N, Miller M, Donofry S, Kamarck M, et al. The post illumination pupil response is reduced in seasonal affective disorder. Psychiatry Res. 2013;210:150-8 pubmed publisher
    Individuals with seasonal affective disorder (SAD) may have a decreased retinal sensitivity in the non-image forming light-input pathway...
  28. Levitan R, Masellis M, Lam R, Kaplan A, Davis C, Tharmalingam S, et al. A birth-season/DRD4 gene interaction predicts weight gain and obesity in women with seasonal affective disorder: A seasonal thrifty phenotype hypothesis. Neuropsychopharmacology. 2006;31:2498-503 pubmed
    ..7-repeat allele (7R) of the dopamine-4 receptor gene (DRD4), weight gain, and obesity in women with seasonal affective disorder (SAD)...
  29. Levitan R, Masellis M, Basile V, Lam R, Kaplan A, Davis C, et al. The dopamine-4 receptor gene associated with binge eating and weight gain in women with seasonal affective disorder: an evolutionary perspective. Biol Psychiatry. 2004;56:665-9 pubmed
    ..of the dopamine-4 receptor gene (DRD4) and increased maximal lifetime body mass index in women with seasonal affective disorder (SAD). In this study, we examined whether binge eating behavior mediated this putative association...
  30. Johansson C, Willeit M, Levitan R, Partonen T, Smedh C, Del Favero J, et al. The serotonin transporter promoter repeat length polymorphism, seasonal affective disorder and seasonality. Psychol Med. 2003;33:785-92 pubmed
    ..association studies of the serotonin transporter promoter repeat length polymorphism (5-HTTLPR), seasonal affective disorder (SAD) and seasonality (seasonal variations in mood and behaviour)...
  31. Rohan K, Sigmon S, Dorhofer D. Cognitive-behavioral factors in seasonal affective disorder. J Consult Clin Psychol. 2003;71:22-30 pubmed
    To longitudinally examine cognitive-behavioral correlates of seasonal affective disorder (SAD), the authors assessed women with a history of SAD and nondepressed, matched controls across fall, winter, and summer...
  32. Turner E, Schwartz P, Lowe C, Nawab S, Feldman Naim S, Drake C, et al. Double-blind, placebo-controlled study of single-dose metergoline in depressed patients with seasonal affective disorder. J Clin Psychopharmacol. 2002;22:216-20 pubmed
    ..Depression ratings using the Structured Interview Guide for the Hamilton Depression Rating Scale-Seasonal Affective Disorder Version were performed at baseline and at 3 and 6 days after each intervention...
  33. Avissar S, Schreiber G, Nechamkin Y, Neuhaus I, Lam G, Schwartz P, et al. The effects of seasons and light therapy on G protein levels in mononuclear leukocytes of patients with seasonal affective disorder. Arch Gen Psychiatry. 1999;56:178-83 pubmed
    ..In this study, patients with seasonal affective disorder (SAD) were measured for mononuclear leukocyte G protein levels while depressed during the winter, ..
  34. Desan P, Weinstein A, Michalak E, Tam E, Meesters Y, Ruiter M, et al. A controlled trial of the Litebook light-emitting diode (LED) light therapy device for treatment of Seasonal Affective Disorder (SAD). BMC Psychiatry. 2007;7:38 pubmed
    ..is relatively concentrated in short wavelengths may enable a more convenient effective therapy for Seasonal Affective Disorder (SAD)...
  35. Willeit M, Sitte H, Thierry N, Michalek K, Praschak Rieder N, Zill P, et al. Enhanced serotonin transporter function during depression in seasonal affective disorder. Neuropsychopharmacology. 2008;33:1503-13 pubmed
    ..5-HTT-mediated inward and outward transport in platelets of drug-free depressed patients suffering from seasonal affective disorder (SAD)...
  36. Lewy A, Rough J, Songer J, Mishra N, Yuhas K, Emens J. The phase shift hypothesis for the circadian component of winter depression. Dialogues Clin Neurosci. 2007;9:291-300 pubmed
    ..The leading hypothesis for winter depression (seasonal affective disorder, or SAD) is the phase shift hypothesis (PSH)...
  37. Johansson C, Smedh C, Partonen T, Pekkarinen P, Paunio T, Ekholm J, et al. Seasonal affective disorder and serotonin-related polymorphisms. Neurobiol Dis. 2001;8:351-7 pubmed
    Disturbances in central serotonergic systems have been hypothesized to be involved in seasonal affective disorder (SAD)...
  38. Rohan K, Roecklein K, Lacy T, Vacek P. Winter depression recurrence one year after cognitive-behavioral therapy, light therapy, or combination treatment. Behav Ther. 2009;40:225-38 pubmed publisher
    The central public health challenge in the management of seasonal affective disorder (SAD) is prevention of depression recurrence each fall/winter season...
  39. Young M, Blodgett C, Reardon A. Measuring seasonality: psychometric properties of the Seasonal Pattern Assessment Questionnaire and the Inventory for Seasonal Variation. Psychiatry Res. 2003;117:75-83 pubmed
    ..Given the long history of its use and some small psychometric and simplicity advantages for the SPAQ, its continued use as a dimensional measure of seasonality is indicated. ..
  40. Johansson C, Willeit M, Smedh C, Ekholm J, Paunio T, Kieseppä T, et al. Circadian clock-related polymorphisms in seasonal affective disorder and their relevance to diurnal preference. Neuropsychopharmacology. 2003;28:734-9 pubmed
    Disturbed circadian rhythms have been observed in seasonal affective disorder (SAD)...
  41. Goel N, Terman M, Terman J. Depressive symptomatology differentiates subgroups of patients with seasonal affective disorder. Depress Anxiety. 2002;15:34-41 pubmed
    Patients with seasonal affective disorder (SAD) may vary in symptoms of their depressed winter mood state, as we showed previously for nondepressed (manic, hypomanic, hyperthymic, euthymic) springtime states [Goel et al., 1999]...
  42. Abou Elseoud A, Nissilä J, Liettu A, Remes J, Jokelainen J, Takala T, et al. Altered resting-state activity in seasonal affective disorder. Hum Brain Mapp. 2014;35:161-72 pubmed publisher
    At present, our knowledge about seasonal affective disorder (SAD) is based mainly up on clinical symptoms, epidemiology, behavioral characteristics and light therapy...
  43. Stephenson K, Schröder C, Bertschy G, Bourgin P. Complex interaction of circadian and non-circadian effects of light on mood: shedding new light on an old story. Sleep Med Rev. 2012;16:445-54 pubmed publisher
    ..Such research could improve therapeutic management of affective disorders and influence the management of societal lighting conditions. ..
  44. Gordijn M, t Mannetje D, Meesters Y. The effects of blue-enriched light treatment compared to standard light treatment in Seasonal Affective Disorder. J Affect Disord. 2012;136:72-80 pubmed publisher
    One of the most frequently investigated hypotheses of the pathophysiology underlying Seasonal Affective Disorder (SAD) is a disturbance of circadian rhythms...
  45. Hillhouse J, Turrisi R, Stapleton J, Robinson J. Effect of seasonal affective disorder and pathological tanning motives on efficacy of an appearance-focused intervention to prevent skin cancer. Arch Dermatol. 2010;146:485-91 pubmed publisher
    ..the robustness of an appearance-focused intervention to prevent skin cancer in individuals reporting seasonal affective disorder (SAD) symptoms and pathological tanning motives. Randomized, controlled clinical trial. College campus...
  46. Flory R, Ametepe J, Bowers B. A randomized, placebo-controlled trial of bright light and high-density negative air ions for treatment of Seasonal Affective Disorder. Psychiatry Res. 2010;177:101-8 pubmed publisher
    ..ions, and the efficacy of two placebo treatments, dim red light and low-density negative ions, for Seasonal Affective Disorder (SAD)...
  47. Palinkas L, Reed H, Reedy K, Do N, Case H, Finney N. Circannual pattern of hypothalamic-pituitary-thyroid (HPT) function and mood during extended antarctic residence. Psychoneuroendocrinology. 2001;26:421-31 pubmed
    ..This model of seasonal variation in thyroid function and mood also has implications for an understanding of potential mechanisms underlying the association between latitude and SAD or S-SAD. ..
  48. Hoekstra R, Fekkes D, van de Wetering B, Pepplinkhuizen L, Verhoeven W. Effect of light therapy on biopterin, neopterin and tryptophan in patients with seasonal affective disorder. Psychiatry Res. 2003;120:37-42 pubmed
    The serotonergic system is believed to play a key role in the pathophysiology of seasonal affective disorder (SAD)...
  49. Rohan K, Roecklein K, Tierney Lindsey K, Johnson L, Lippy R, Lacy T, et al. A randomized controlled trial of cognitive-behavioral therapy, light therapy, and their combination for seasonal affective disorder. J Consult Clin Psychol. 2007;75:489-500 pubmed
    This first controlled psychotherapy trial for seasonal affective disorder (SAD) compared SAD-tailored cognitive-behavioral therapy (CBT), light therapy (LT), and their combination to a concurrent wait-list control...
  50. Michalak E, Murray G, Wilkinson C, Dowrick C, Lam R. A pilot study of adherence with light treatment for seasonal affective disorder. Psychiatry Res. 2007;149:315-20 pubmed
    ..it might be expected that non-adherence would be even more pronounced in LT, a form of intervention for seasonal affective disorder (SAD)...
  51. Michalak E, Tam E, Manjunath C, Levitt A, Levitan R, Lam R. Quality of life in patients with seasonal affective disorder: summer vs winter scores. Can J Psychiatry. 2005;50:292-5 pubmed
    To compare perceived quality of life (QoL) in patients diagnosed with seasonal affective disorder (SAD) during the winter and summer months...
  52. Einat H, Kronfeld Schor N, Eilam D. Sand rats see the light: short photoperiod induces a depression-like response in a diurnal rodent. Behav Brain Res. 2006;173:153-7 pubmed
    ..g., SAD), which in humans is a prevalent disorder, with winter depression episodes and spring/summer remissions. ..
  53. Winkler D, Pjrek E, Iwaki R, Kasper S. Treatment of seasonal affective disorder. Expert Rev Neurother. 2006;6:1039-48 pubmed
    b>Seasonal affective disorder (SAD), winter type, is characterized by the regular annual onset of major depressive episodes during fall or winter, followed by spontaneous remission and sometimes hypomanic or manic episodes during spring ..