Sezonowe zaburzenie afektywne

Sezonowe zaburzenie afektywne
Epidemiologia

Zaburzenia afektywne sezonowe (SAD) charakteryzują się sezonowym występowaniem epizodów depresji, najczęściej w okresie jesienno-zimowym, z częstością występowania wahającą się od 0% do 9,7% w badaniach retrospektywnych. W USA wskaźniki te wynoszą od 1,4% do 9,7%, z najwyższą częstością w stanach o większej szerokości geograficznej, np. 8,9% na Alasce, gdzie subkliniczna postać SAD dotyczy aż 24,9% populacji. W Europie częstość występowania wynosi 1,3-3,0%, a w Azji 0-0,9%. Kobiety są bardziej narażone na rozwój SAD, z relacją płci od 3,5:1 do 9:1, a główny wiek zachorowania to 18-30 lat. U dzieci i młodzieży wskaźnik rozpowszechnienia wynosi 1,7-5,5%. Do czynników ryzyka należą płeć żeńska, młody wiek, wysoka szerokość geograficzna, historia rodzinna zaburzeń nastroju oraz migracja z niższych do wyższych szerokości geograficznych.

Epidemiologia zaburzeń afektywnych sezonowych (SAD)

Zaburzenia afektywne sezonowe (SAD) stanowią istotny problem zdrowia psychicznego, wpływając na nastrój i ogólne samopoczucie, szczególnie w miesiącach o zmniejszonej ekspozycji na światło dzienne. Częstość występowania SAD wykazuje znaczne zróżnicowanie w zależności od zastosowanych metod badawczych, położenia geograficznego oraz charakterystyki badanej populacji.¹²

Rozpowszechnienie geograficzne

Istnieje wyraźna korelacja między występowaniem SAD a odległością od równika. Zaburzenie to występuje częściej w regionach położonych dalej od równika, charakteryzujących się znacznymi wahaniami długości dnia w różnych porach roku.¹² Badania prowadzone w Stanach Zjednoczonych ujawniają zróżnicowane wskaźniki występowania SAD, od 9,7% w New Hampshire do 1,4% na Florydzie.¹³⁴

Zjawisko zwiększonej częstości występowania wraz ze wzrostem szerokości geograficznej jest widoczne w Ameryce Północnej, choć zależność ta nie wykazuje istotności statystycznej w innych częściach świata.¹ Na Alasce stwierdzono wskaźnik występowania SAD na poziomie 8,9%, a jeszcze wyższy wskaźnik 24,9% dla postaci subklinicznej SAD.³ Warto zauważyć, że osoby migrujące z niższych do wyższych szerokości geograficznych są bardziej podatne na rozwój SAD.²

Globalne wskaźniki występowania

Przegląd badań epidemiologicznych wskazuje, że wskaźniki rozpowszechnienia SAD wahają się od 0% do 9,7% w różnych badaniach retrospektywnych.¹² W Ameryce Północnej częstość występowania szacuje się na 1,4-9,7%, w Europie na 1,3-3,0%, a w Azji na 0-0,9%.³

W Stanach Zjednoczonych wskaźniki występowania wahają się od 0,4% do 10% w zależności od zastosowanej metodologii.¹ Według niektórych badań, około 5% dorosłych w USA doświadcza SAD, a objawy typowo utrzymują się przez około 40% roku.²³ Inne źródła wskazują, że SAD może dotykać nawet 11 milionów osób w USA rocznie, a kolejne 25 milionów może cierpieć na łagodniejszą formę tzw. „zimowej chandry”.⁴

W różnych krajach europejskich odnotowano zróżnicowane wskaźniki występowania: w Austrii 2,5% populacji spełnia kryteria specyfikatora sezonowego według DSM-5, a 2,4% spełnia kryteria diagnostyczne SAD.¹ W Irlandii około 20% ludności zmaga się z objawami SAD.²³ W Holandii na zimowe SAD cierpi około 3% populacji.² W Wielkiej Brytanii do 6% dorosłych doświadcza nawracających epizodów dużej depresji o wzorcu sezonowym.¹

Charakterystyka demograficzna pacjentów z SAD

Różnice płciowe

SAD jest diagnozowane częściej u kobiet niż u mężczyzn.¹² Stosunek występowania u kobiet w porównaniu z mężczyznami waha się od 3,5:1 do 9:1 według różnych badań.³ Inne źródła wskazują na stosunek 4:1.¹² Warto jednak zauważyć, że w niektórych badaniach nie stwierdzono statystycznie istotnych różnic między płciami w częstości występowania SAD.¹

Wiek wystąpienia

SAD występuje częściej u młodszych dorosłych niż u osób starszych.¹² Główny wiek wystąpienia pierwszych objawów SAD to przedział między 18 a 30 rokiem życia.¹²³⁴ Z wiekiem obserwuje się zmniejszenie dysproporcji między płciami w zakresie częstości występowania SAD.¹ Ryzyko wystąpienia SAD zmniejsza się wraz z wiekiem.¹

Występowanie u dzieci i młodzieży

SAD zostało zidentyfikowane również u dzieci i nastolatków.¹ Badania pilotażowe dotyczące przypadków SAD u dzieci sugerują wskaźnik rozpowszechnienia między 1,7% a 5,5% u dzieci w wieku od 9 do 19 lat.¹ W porównaniu z uczniami szkół średnich, SAD jest mniej powszechne u dorosłych.¹

Podtypy SAD i ich rozpowszechnienie

Najczęstszą formą SAD jest depresja zimowa, charakteryzująca się nawracającymi epizodami depresji jednobiegunowej, które rozpoczynają się jesienią lub zimą i, jeśli nie są leczone, zazwyczaj ustępują wiosną lub latem.¹² Mniej powszechną formą jest depresja letnia, występująca wiosną lub latem.¹

Badania wskazują, że 10-20% pacjentów z dużą depresją ma sezonowy wzorzec objawów zgodny z SAD.¹ Według niektórych szacunków, 4-6% populacji ogólnej doświadcza depresji zimowej, a kolejne 10-20% ma cechy subkliniczne tego zaburzenia.¹

W badaniu austriackim stwierdzono, że 3,5% badanych spełniało kryteria depresji jesienno-zimowej według kryteriów Kaspera-Rosenthala, a 15,1% spełniało kryteria subsyndromalnego SAD (s-SAD).¹ W innym badaniu stwierdzono, że 12,7% respondentów wykazywało zaburzenia afektywne sezonowe (SAD), 29,0% wykazywało subsyndromalne zaburzenia afektywne sezonowe (s-SAD), a 58,3% nie wykazywało istotnej sezonowej symptomatologii afektywnej.¹

Czynniki ryzyka i zachorowalność

Do głównych czynników ryzyka rozwoju SAD należą:¹²³

Płeć żeńska
Wiek 18-30 lat
Mieszkanie w wyższych szerokościach geograficznych
Historia rodzinna SAD lub innych zaburzeń nastroju
Osobista historia depresji
Migracja z niższych do wyższych szerokości geograficznych
Czynniki psychologiczne (np. wysoki poziom neurotyczności)
Współwystępowanie innych zaburzeń psychicznych (np. zaburzenia lękowe, ADHD, przedmiesiączkowe zaburzenia dysforyczne)

⁴⁵

Warto zauważyć, że pewne grupy etniczne mieszkające na wysokich północnych szerokościach geograficznych mogły się zaadaptować do długiej arktycznej zimy.¹ Badania wskazują również, że osoby, które wyemigrowały do nowego kraju w ciągu ostatnich 10 lat, mogą być bardziej narażone na rozwój SAD.²

Implikacje kliniczne i społeczno-ekonomiczne

SAD wiąże się z istotnym upośledzeniem psychospołecznym i może prowadzić do poważnych konsekwencji zdrowotnych.¹² Wśród pacjentów rekrutowanych do randomizowanych badań leczenia depresji zimowej, prawie 60% nigdy wcześniej nie było leczonych z powodu depresji.¹

Osoby z SAD częściej korzystają z podstawowej opieki zdrowotnej niż grupy kontrolne dopasowane pod względem wieku i płci; pacjenci ci otrzymują również więcej recept i są częściej kierowani do opieki specjalistycznej.¹ Około 6-35% pacjentów wymaga w pewnym momencie hospitalizacji z powodu SAD.¹²

SAD, podobnie jak inne zaburzenia depresyjne, stanowi znaczące zagrożenie dla zdrowia publicznego w USA, o czym świadczy szacowana liczba 1,7 miliona prób samobójczych w 2021 roku i 2,6% wzrost liczby zgonów związanych z samobójstwami w latach 2021-2022.¹ Społeczne konsekwencje SAD są dodatkowo pogłębiane przez absencję w pracy lub szkole, zwiększone wykorzystanie opieki zdrowotnej i podwyższone koszty opieki zdrowotnej.¹

Monitorowanie i nadzór nad SAD

Monitorowanie zaburzeń afektywnych sezonowych obejmuje regularną ocenę stanu pacjenta i skuteczności leczenia. Proces ten składa się z następujących etapów:¹

Ocena częstości i nasilenia objawów
Wykorzystanie skal do obiektywnej oceny
Monitorowanie ryzyka nawrotów
Kontrola potencjalnych powikłań (nieleczony SAD może prowadzić do rozwoju innych form depresji, zwiększonego ryzyka myśli samobójczych i pogorszenia jakości życia)

Regularne monitorowanie stanu pozwala na szybkie wprowadzanie zmian w planie leczenia i kontrolę dynamiki choroby.¹ Ze względu na przewidywalność SAD, możliwe jest wdrożenie środków zapobiegawczych przed rozwinięciem się pełnoobjawowej depresji.²

Perspektywy badawcze

Dane dotyczące globalnego rozpowszechnienia SAD, w tym w Stanach Zjednoczonych, są w dużej mierze dwudziestoletnie i wymagają dalszych badań.¹ W Portugalii brakuje badań epidemiologicznych dotyczących częstości występowania SAD, choć międzynarodowe badania pokazują, że Portugalia jest drugim krajem w Europie o najwyższej częstości występowania zaburzeń psychicznych (22,9%), ustępując jedynie Irlandii Północnej (23,1%).¹

Badania prospektywne populacji, z wyjątkiem jednego, wykazują sezonowe wahania nastroju, z objawami depresyjnymi zwykle osiągającymi szczyt zimą.¹ Rzeczywistość sezonowych wahań nastroju została dokładnie udokumentowana zarówno przez badania retrospektywne, jak i prospektywne.¹

Niektóre badania sugerują, że sezonowa depresja może być niezależna od szerokości geograficznej, pory roku lub światła słonecznego, a wszystkie epizody depresji powinny być traktowane jako duża depresja.¹ Te sprzeczne wyniki podkreślają potrzebę dalszych badań nad etiologią i epidemiologią SAD.

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Materiały źródłowe

#1 Seasonal Affective Disorder – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK568745/
Seasonal affective disorder (SAD) poses a significant challenge to mental health, affecting mood and overall well-being, especially during months with reduced daylight hours. […] Notably, SAD’s prevalence increases with distance from the equator, suggesting a link to environmental light exposure. […] The prevalence of the disorder increases in regions situated further from the equator, characterized by more significant variations in daylight hours across different seasons. […] Research conducted in the US reveals varying prevalence rates of SAD, ranging from 9.7% in New Hampshire to 1.4% in Florida. […] Although the prevalence increases with rising latitudes within North America, this association lacks statistical significance in other parts of the world. […] However, the data on global prevalence, including that of the United States, is 2 decades old and needs further study.
#1 An overview of epidemiological studies on seasonal affective disorder – PubMed
https://pubmed.ncbi.nlm.nih.gov/10721866/
Objective: To review and systematize all epidemiological studies of seasonal affective disorder (SAD). […] The prevalence estimates of SAD across 20 retrospective studies varied from 0% to 9.7%. All prospective population studies, except one, find seasonal variations in mood, depressive symptoms usually peaking in winter. SAD was more prevalent at higher northern latitudes, but the prevalence varied across ethnic groups. SAD has also been identified in children and adolescents. […] The actuality of seasonal variation in mood has been documented thoroughly by both retrospective and prospective studies. In the general population, depressive symptoms peak in winter, and the most extreme form of this disposition, SAD, appears to be a relatively common disorder.
#1 Seasonal Affective Disorder (SAD): Background, Pathophysiology, Epidemiology
https://emedicine.medscape.com/article/2500054-overview
Seasonal affective disorder (SAD) is considered to be a relatively common disorder. The prevalence of SAD tends to vary across populations influenced by latitude and assessment methods, with variations observed between countries such as the United States and Australia. […] The prevalence of SAD appears to be most linked to photoperiod and as such tends to be more prevalent with higher latitudes, though the evidence is not equivocal. […] In the United States, prevalence estimates range from 0.4% to as high as 10% depending on the methodology being used. […] There is significant evidence that people who migrate from lower to higher altitudes are more susceptible to SAD. […] SAD seems to affect women more commonly than men (4:1 ratio) and appears to decrease in prevalence with age. […] Winter-onset SAD is more common (often characterized by atypical depressive symptoms including; hypersomnia, increased appetite, and craving for carbohydrates). On the other hand, spring/summer also seen and is more frequently associated with insomnia and loss of appetite.
#1 Epidemiology and socioeconomic impact of seasonal affective disorder in Austria | European Psychiatry | Cambridge Core
https://www.cambridge.org/core/journals/european-psychiatry/article/epidemiology-and-socioeconomic-impact-of-seasonal-affective-disorder-in-austria/D11256E8897196E86E03DA65AA65E81A
Seasonal affective disorder (SAD) is a subtype of recurrent depressive or bipolar disorder that is characterized by regular onset and remission of affective episodes at the same time of the year. […] The aim of the present study was to provide epidemiological data and data on the socioeconomic impact of SAD in the general population of Austria. […] Out of our subjects, 2.5% fulfilled criteria for the seasonal pattern specifier according to DSM-5 and 2.4% (95% CI = 1.43.5%) were diagnosed with SAD. […] When applying the ICD-10 criteria 1.9% (95% CI = 0.92.8%) fulfilled SAD diagnostic criteria. […] The prevalence of fall-winter depression according to the Kasper-Rosenthal criteria was determined to be 3.5%. […] The criteria was fulfilled by 15.1% for subsyndromal SAD (s-SAD). […] We did not find any statistically significant gender differences in prevalence rates. […] Our data are indicative of the substantial burden of disease and the socioeconomic impact of SAD. […] This epidemiological data shows a lack of gender differences in SAD prevalence.
#1 Management of seasonal affective disorder | The BMJ
https://www.bmj.com/content/340/bmj.c2135
Low mood associated with a certain season (usually winter) is very common. For example, in the UK, up to 6% of adults have recurrent major depressive episodes with seasonal pattern, commonly known as seasonal affective disorder (SAD). […] People with SAD consult in primary care more often than age- and gender-matched control groups; patients also receive more prescriptions and are referred more often to secondary care. […] Around 6-35% of patients require hospitalisation for SAD at some point. […] Some specialists have questioned the value of considering SAD as a separate diagnostic category from non-seasonal depression; and of note it is classified as a subset of recurrent major depressive or bipolar disorder rather than as a separate category by both the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and the World Health Organizations International Statistical Classification of Diseases and Related Health Problems (ICD-10).
#1 Seasonal affective disorder (SAD) – Symptoms & causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/symptoms-causes/syc-20364651
Seasonal affective disorder (SAD) is a type of depression that’s related to changes in seasons seasonal affective disorder (SAD) begins and ends at about the same times every year. […] Seasonal affective disorder is diagnosed more often in women than in men. And SAD occurs more frequently in younger adults than in older adults. […] Factors that may increase your risk of seasonal affective disorder include: […] The specific cause of seasonal affective disorder remains unknown. Some factors that may come into play include: […] Take signs and symptoms of seasonal affective disorder seriously. As with other types of depression, SAD can get worse and lead to problems if it’s not treated. […] There’s no known way to prevent the development of seasonal affective disorder. However, if you take steps early on to manage symptoms, you may be able to prevent them from getting worse over time.
#1 Seasonal affective disorder – wikidoc
https://www.wikidoc.org/index.php/Seasonal_affective_disorder
The prevalence of SAD ranges from 1.5% to 9%, depending on latitude. […] A higher positive correlation has been found with latitude and prevalence of winter SAD. This finding is prominent in the age groups over 35 years. […] The age of onset of SAD is generally between 18 and 30 years. […] In most of the studies, SAD has been diagnosed in younger adults. […] Compared to high-school students, SAD is found to be less prominent in adults. Winter type SAD is related to latitude in adults whereas sociocultural factors play a role in adolescents. […] SAD is more common in women as compared to men. Women are four times as likely as men to be diagnosed with SAD. […] The gender differences in SAD are the same as in non-seasonal depression. […] For assessing the gender-based prevalence of SAD, importance should be given to case criteria such as diagnosis (unipolar vs. bipolar), and birth cohort. […] SAD has no specific racial predilection.
#1 Seasonal sensitivity and psychiatric morbidity: study about seasonal affective disorder | BMC Psychiatry | Full Text
https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-021-03313-z
Winkler and Kasper, in an article in which they gathered 22 studies, point to a prevalence of SAD in temperate countries between 2 and 5%. […] But other studies estimate that the prevalence of SAD in populations located in northern latitudes can approach 10%. […] Reflection of this diversity of results, Magnusson in a review and systematize epidemiological studies of SAD provided prevalence estimates ranging from 1.4 to 9.7% in Northern America, 1.33.0% in Europe and 00.9% in Asia. […] In women, the prevalence tends to be higher than men, with a ratio varying between 3.5: 1 and 9:1 and, in most cases, the first episode of seasonal affective disorder occurs around the age of 30, with a decrease of discrepancy between the sexes with increasing age. […] In this study, according to the criteria defined by Kasper et al., 12.7% of the individuals in the sample showed likely seasonal affective disorder and 29.0% for subsyndromal seasonal affective disorder.
#1 Seasonal Affective Disorders | AAFP
https://www.aafp.org/pubs/afp/issues/1998/0315/p1340.html
Seasonal affective disorder is a pattern of major depressive episodes that occur and remit with changes in seasons. […] Surveys estimate that 4 to 6 percent of the general population experience winter depression, and another 10 to 20 percent have sub-syndromal features. […] Recent studies report that most episodes of SAD occur within unipolar major depressive disorders, although a substantial minority have accompanying hypomanic episodes (bipolar II disorder, according to the DSM-IV), and very few are associated with manic episodes. […] The risk of SAD appears to decrease with age. […] Pilot studies of childhood cases of SAD suggest a prevalence rate between 1.7 and 5.5 percent in children between the ages of nine and 19 years.
#1 Seasonal affective disorder: Epidemiology, clinical features, assessment, and diagnosis – UpToDate
https://www.uptodate.com/contents/seasonal-affective-disorder-epidemiology-clinical-features-assessment-and-diagnosis
Seasonal affective disorder: Epidemiology, clinical features, assessment, and diagnosis […] The most prevalent form of SAD is winter depression, marked by recurrent episodes of unipolar depression that begin in the fall or winter and, if left untreated, generally remit in the following spring or summer. Recognizing the disorder is important because SAD is common and associated with psychosocial impairment. […] Among patients who were recruited for randomized trials studying treatment of winter depression, nearly 60 percent had never been treated for depression. […] Seasonal affective disorder (SAD) is defined as recurrent episodes of major depression, mania, or hypomania with seasonal onset and remission. It is not considered a separate mood disorder; rather, SAD is a subtype of the following mood disorders: Unipolar major depression (major depressive disorder) and Bipolar I disorder.
#1 What Is Seasonal Affective Disorder? – Child Mind Institute
https://childmind.org/article/seasonal-affective-disorder/
Seasonal affective disorder (SAD) is a specific kind of depression that comes and goes with changes in seasons. It has all the same symptoms as major depressive disorder, but it only happens during specific months of the year. […] Most people affected by SAD experience episodes of depression during the fall and winter, as the days get shorter in many parts of the world. […] However, a smaller number of people experience depression during the spring and summer instead. […] Experts arenât certain what causes SAD, but one theory is that decreased sunlight in the winter months may affect the levels of melatonin and serotonin in our brains, which can in turn affect our mood and energy level. […] As in other kinds of depression, a diagnosis is only made if several of these symptoms are present for at least two weeks. Additionally, the pattern of depression coming and going with the seasons must occur for at least two years to be considered SAD.
#1 Seasonal Affective Disorder: Common Questions and Answers | AAFP
https://www.aafp.org/pubs/afp/issues/2020/1201/p668.html
Seasonal affective disorder is a mood disorder that is a subtype or qualifier of major depressive disorder or bipolar disorder in the Diagnostic and Statistical Manual of Mental Disorders. It is characterized by depressive symptoms that occur at a specific time of year (typically fall or winter) with full remission at other times of year (typically spring or summer). Possible risk factors include family history, female sex, living at a more northern latitude, and young adulthood (18 to 30 years of age). […] Studies using interviews and diagnostic criteria in the United States, Canada, and United Kingdom show a lifetime prevalence of 0.5% to 2.4% in the general population. Of patients with major depression, 10% to 20% have a seasonal pattern of symptoms consistent with SAD. […] Two large questionnaire studies have shown that individuals living in more northern latitudes have an increased risk of developing SAD. It is suspected that prevalence increases with increasing latitude, but data are poor, and this conclusion is controversial.
#1 Seasonal sensitivity and psychiatric morbidity: study about seasonal affective disorder | BMC Psychiatry | Full Text
https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-021-03313-z
Seasonal Affective Disorder is a recurrent depressive disorder which usually begins in the fall/winter and enters into remission in the spring/summer, although in some cases may occur in the summer with remission in the autumn-winter. […] Among the respondents, 12.7% showed seasonal affective disorder (SAD), 29.0% showed subsyndromal seasonal affective disorder (s-SAD) and 58.3% did not show significant seasonal affective symptomatology. […] As for psychiatric morbidity, 36.6% of subjects with SAD and 13.8% of those with s-SAD were considered psychiatric cases whereas for subjects without SAD this value was only 3.2%. […] There is a statistically significant association between psychiatric morbidity and seasonal affective disorder. […] Studies on the prevalence of SAD show very different results to which several factors contribute, such as criteria and the evaluation instruments used, the region (latitude, weather conditions) where the studies are carried out or characteristics of the studied sample (gender, age, ethnic groups, acclimatization, attitudes towards mental manifestations, vulnerability to stress).
#1 Seasonal affective disorder (SAD) | Doctor
https://patient.info/doctor/seasonal-affective-disorder-pro
Seasonal affective disorder (SAD) is a seasonal pattern of recurrent major depressive episodes that most commonly occurs during autumn or winter and remits in spring. In some cases, SAD may occur in the summer with remission in the autumn-winter. It can be very disabling for patients, some of whom may require hospitalisation for SAD at some point. […] The prevalence of SAD ranges from 1.5% to 9%, depending on latitude. Possible risk factors include family history, female sex, living at a more northern latitude, and young adulthood (18 to 30 years of age). […] The diagnosis of SAD is based on: Depression cycles on a regular basis during autumn/winter. Full remission of symptoms in spring/summer. Seasonal symptoms for at least two consecutive years. Atypical features, which may or may not be present.
#1 The Diagnosis, Symptomatology, and Epidemiology of Seasonal Affective Disorder | CNS Spectrums | Cambridge Core
https://www.cambridge.org/core/journals/cns-spectrums/article/diagnosis-symptomatology-and-epidemiology-of-seasonal-affective-disorder/CE22D3070B4980C9955808CF27F25D83
The operational criteria for seasonal affective disorder (SAD) have undergone several changes since first proposed in 1984. […] 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. […] Some studies have found that certain ethnic groups who live at high northern latitudes may have adapted to the long arctic winter. […] Magnusson, A. An overview of epidemiological studies on seasonal affective disorder. Acta Psychiatr Scand. 2000;101:176184. […] Kasper, S, Wehr, TA, Bartko, JJ, Gaist, PA, Rosenthal, NE. Epidemiological findings of seasonal changes in mood and behavior. A telephone survey of Montgomery County, Maryland. Arch Gen Psychiatry. 1989;46:823833. […] Rosen, LN, Targum, SD, Terman, M, et al. Prevalence of seasonal affective disorder at four latitudes. Psychiatry Res. 1990;31:131144.
#1 Seasonal affective disorder: Epidemiology, clinical features, assessment, and diagnosis – UpToDate
https://www.uptodate.com/contents/seasonal-affective-disorder-epidemiology-clinical-features-assessment-and-diagnosis/print
Seasonal affective disorder: Epidemiology, clinical features, assessment, and diagnosis […] The term seasonal affective disorder (SAD) describes episodes of major depression, mania, or hypomania that regularly occur during particular seasons. The most prevalent form of SAD is winter depression, marked by recurrent episodes of unipolar depression that begin in the fall or winter and, if left untreated, generally remit in the following spring or summer. Recognizing the disorder is important because SAD is common and associated with psychosocial impairment. In addition, acute treatment is often effective and maintenance treatment can prevent future episodes. Among patients who were recruited for randomized trials studying treatment of winter depression, nearly 60 percent had never been treated for depression.
#1 Seasonal Affective Disorder
https://www.uspharmacist.com/article/seasonal-affective-disorder-1
Seasonal affective disorder (SAD), also referred to as winter blues, represents one of the most prevalent and complicated psychiatric disorders faced by patients today. Approximately 10% of adults in the United States experience SAD, typically enduring it about 40% of the year. […] SAD, along with other depressive disorders, poses a considerable public health threat in the U.S., as evidenced by an estimated 1.7 million suicide attempts in 2021 and a 2.6% rise in suicide-related deaths from 2021 to 2022. […] The societal ramifications of SAD are exacerbated by absenteeism from work or school, increased healthcare utilization, and elevated healthcare expenses. […] Addressing the impact of SAD requires comprehensive strategies incorporating preventive measures, prompt diagnosis, and evidence-based treatments to alleviate its societal and economic toll and enhance overall well-being.
#1 Seasonal Affective Disorder (SAD) – VALINTERMED treatment in Valencia
https://valintermed.com/en/medlibrary/seasonal-affective-disorder/
Monitoring seasonal affective disorder involves regular assessment of the patient’s condition and the effectiveness of treatment: Control stages: Assessment of the frequency and severity of symptoms, use of scales for objective assessment. Forecast: With proper treatment, most patients experience significant improvement, but some are at risk of relapse. Complications: Untreated SAD can lead to the development of other forms of depression, an increased risk of suicidal thoughts, and a deterioration in quality of life. Regular monitoring of the condition allows you to promptly make changes to the treatment plan and control the dynamics of the disease.
#1 Seasonal sensitivity and psychiatric morbidity: study about seasonal affective disorder | BMC Psychiatry | Full Text
https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-021-03313-z
These values are above the upper limits indicated in epidemiological studies based on the SPAQ that refer to the general population prevalence rates of SAD between 0.7 and 12.4%. […] In Portugal, there are no epidemiological studies on the prevalence of SAD, but a international study showed that Portugal is the second country in Europe with the highest prevalence of psychiatric disorders (22.9%) only surpassed by Northern Ireland (23,1%). […] Given these issues, this study reveals that subjects with complaints of mood and behavior changes related to the seasons, inscribed in the concept of SAD and s-SAD demonstrate a very significant number of cases with clinically significant psychiatric morbidity.
#1 What is the
https://www.mdvip.com/about-mdvip/blog/do-you-struggle-winter-blues-take-seasonal-affective-disorder-seriously
Whatâs seasonal affective disorder? Psychology Today sums it up as a type form of episodic depression that affects people during specific times of the year and estimates that about 10 million Americans struggle with it. […] Researchers arenât sure what causes seasonal depression. In a recent study published in Epidemiology, researchers found bouts of major depression increase as we transition from daylight savings time to standard time and surmise that shorter days cause distress and trigger depression. […] Surveys found only 1.4 percent of people living in sunny Florida with seasonal depression symptoms. In New York, 5.7 percent, in Alaska 9.9 percent and in Ireland 20 percent of people struggle with SAD. […] Results from a 2016 study, published in Clinical Psychological Science suggested that seasonal depression is unrelated to latitude, season or sunlight and that all episodes of depression should be treated as a major depression.
#2 Seasonal sensitivity and psychiatric morbidity: study about seasonal affective disorder | BMC Psychiatry | Full Text
https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-021-03313-z
Seasonal Affective Disorder is a recurrent depressive disorder which usually begins in the fall/winter and enters into remission in the spring/summer, although in some cases may occur in the summer with remission in the autumn-winter. […] Among the respondents, 12.7% showed seasonal affective disorder (SAD), 29.0% showed subsyndromal seasonal affective disorder (s-SAD) and 58.3% did not show significant seasonal affective symptomatology. […] As for psychiatric morbidity, 36.6% of subjects with SAD and 13.8% of those with s-SAD were considered psychiatric cases whereas for subjects without SAD this value was only 3.2%. […] There is a statistically significant association between psychiatric morbidity and seasonal affective disorder. […] Studies on the prevalence of SAD show very different results to which several factors contribute, such as criteria and the evaluation instruments used, the region (latitude, weather conditions) where the studies are carried out or characteristics of the studied sample (gender, age, ethnic groups, acclimatization, attitudes towards mental manifestations, vulnerability to stress).
#2 Seasonal Affective Disorder (SAD): Background, Pathophysiology, Epidemiology
https://emedicine.medscape.com/article/2500054-overview
Seasonal affective disorder (SAD) is considered to be a relatively common disorder. The prevalence of SAD tends to vary across populations influenced by latitude and assessment methods, with variations observed between countries such as the United States and Australia. […] The prevalence of SAD appears to be most linked to photoperiod and as such tends to be more prevalent with higher latitudes, though the evidence is not equivocal. […] In the United States, prevalence estimates range from 0.4% to as high as 10% depending on the methodology being used. […] There is significant evidence that people who migrate from lower to higher altitudes are more susceptible to SAD. […] SAD seems to affect women more commonly than men (4:1 ratio) and appears to decrease in prevalence with age. […] Winter-onset SAD is more common (often characterized by atypical depressive symptoms including; hypersomnia, increased appetite, and craving for carbohydrates). On the other hand, spring/summer also seen and is more frequently associated with insomnia and loss of appetite.
#2
https://consensus.app/questions/seasonal-affective-disorder/
Prevalence of SAD varies significantly across different studies and populations. Retrospective studies estimate the prevalence of SAD to range from 0% to 9.7%, with depressive symptoms peaking in winter. […] Seasonal affective disorder (SAD) is a relatively common disorder with depressive symptoms peaking in winter, and seasonal variations in mood are common across various psychiatric illnesses. […] Seasonal affective disorder (SAD) is a recurrent major depressive disorder with symptoms focusing on sad mood and low energy, and is typically treated with antidepressant medications, light therapy, Vitamin D, and counseling. […] Seasonal affective disorder (SAD) is common and responds to phototherapy, with winter depression benefiting from this treatment.
#2 Psychiatry.org – Seasonal Affective Disorder (SAD)
https://www.psychiatry.org/patients-families/seasonal-affective-disorder
Seasonal affective disorder is a form of depression also known as SAD, seasonal depression or winter depression. In the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), this disorder is identified as a type of depression major depressive disorder with seasonal pattern. […] About 5% of adults in the U.S. experience SAD and it typically lasts about 40% of the year. The prevalence of SAD varies with geographical latitude, age and sex. The prevalence increases at higher latitudes with SAD being more common in people living far from the equator where there are fewer daylight hours in the winter. Younger people and women are also at higher risk. […] SAD can be effectively treated in several ways, including light therapy, antidepressant medications, talk therapy or some combination of these.
#2 Seasonal affective disorder – Wikipedia
https://en.wikipedia.org/wiki/Seasonal_affective_disorder
Seasonal affective disorder (SAD) is a mood disorder subset in which people who typically have normal mental health throughout most of the year exhibit depressive symptoms at the same time each year. […] In the United States, the percentage of the population affected by SAD ranges from 1.4% of the population in Florida to 9.9% in Alaska. […] Winter depression is a common slump in the mood of some inhabitants of most of the Nordic countries. […] In Alaska it has been established that there is a SAD rate of 8.9%, and an even greater rate of 24.9% for subsyndromal SAD. […] Around 20% of Irish people are affected by SAD, according to a survey conducted in 2007. The survey also shows women are more likely to be affected by SAD than men. An estimated 3% of the population in the Netherlands experience winter SAD.
#2 Seasonal Affective Disorder (SAD) | Mental Health America
https://mhanational.org/conditions/seasonal-affective-disorder-sad/
Seasonal depression, also known as seasonal affective disorder (SAD) or the âwinter blues,â is a subtype of depression or bipolar disorder that occurs and ends around the same time every year. […] In a given year, about 5 percent of the U.S. population experiences seasonal depression. […] Four out of five people who have seasonal depression are women. […] The main age of onset of seasonal depression is between 20 and 30 years of age, however symptoms can appear earlier. […] The prevalence of seasonal depression is anywhere from 0-10 percent of the population, depending on the geographic region. […] Typically, the further one is from the equator, the more at risk they are for seasonal depression.
#2 Seasonal sensitivity and psychiatric morbidity: study about seasonal affective disorder | BMC Psychiatry | Full Text
https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-021-03313-z
Winkler and Kasper, in an article in which they gathered 22 studies, point to a prevalence of SAD in temperate countries between 2 and 5%. […] But other studies estimate that the prevalence of SAD in populations located in northern latitudes can approach 10%. […] Reflection of this diversity of results, Magnusson in a review and systematize epidemiological studies of SAD provided prevalence estimates ranging from 1.4 to 9.7% in Northern America, 1.33.0% in Europe and 00.9% in Asia. […] In women, the prevalence tends to be higher than men, with a ratio varying between 3.5: 1 and 9:1 and, in most cases, the first episode of seasonal affective disorder occurs around the age of 30, with a decrease of discrepancy between the sexes with increasing age. […] In this study, according to the criteria defined by Kasper et al., 12.7% of the individuals in the sample showed likely seasonal affective disorder and 29.0% for subsyndromal seasonal affective disorder.
#2 Seasonal affective disorder: Epidemiology, clinical features, assessment, and diagnosis – UpToDate
https://www.uptodate.com/contents/seasonal-affective-disorder-epidemiology-clinical-features-assessment-and-diagnosis/print
Seasonal affective disorder: Epidemiology, clinical features, assessment, and diagnosis […] The term seasonal affective disorder (SAD) describes episodes of major depression, mania, or hypomania that regularly occur during particular seasons. The most prevalent form of SAD is winter depression, marked by recurrent episodes of unipolar depression that begin in the fall or winter and, if left untreated, generally remit in the following spring or summer. Recognizing the disorder is important because SAD is common and associated with psychosocial impairment. In addition, acute treatment is often effective and maintenance treatment can prevent future episodes. Among patients who were recruited for randomized trials studying treatment of winter depression, nearly 60 percent had never been treated for depression.
#2 Seasonal Affective Disorder: Common Questions and Answers | AAFP
https://www.aafp.org/pubs/afp/issues/2020/1201/p668.html
Seasonal affective disorder is a mood disorder that is a subtype or qualifier of major depressive disorder or bipolar disorder in the Diagnostic and Statistical Manual of Mental Disorders. It is characterized by depressive symptoms that occur at a specific time of year (typically fall or winter) with full remission at other times of year (typically spring or summer). Possible risk factors include family history, female sex, living at a more northern latitude, and young adulthood (18 to 30 years of age). […] Studies using interviews and diagnostic criteria in the United States, Canada, and United Kingdom show a lifetime prevalence of 0.5% to 2.4% in the general population. Of patients with major depression, 10% to 20% have a seasonal pattern of symptoms consistent with SAD. […] Two large questionnaire studies have shown that individuals living in more northern latitudes have an increased risk of developing SAD. It is suspected that prevalence increases with increasing latitude, but data are poor, and this conclusion is controversial.
#2 The Truth About Seasonal Affective Disorder – Asian Mental Health Collective
https://www.asianmhc.org/the-truth-about-seasonal-affective-disorder/
According to the Pew Research Center, 54% of 24 million Asian Americans living in the U.S. immigrated to the country (Tian et al., 2024). The U.S. Department of Health and Human Services Office of Minority Health (n.d.) states that 10.2% of the Asian American population over the age of 18 experienced serious psychological distress in 2023 a big jump from 1.9% in 2018. […] Studies have looked at patterns that factor in geography, climate and culture, and found that people are possibly more at risk if they: Have moved to a new country within the past 10 years (Kurata et al., 2016, p. 7), Are already experiencing mental distress (Saheer et al., 2013, p. 241), Live in high latitude (non-equatorial) areas with limited exposure to sunlight (Haggarty et al., 2002, p. 382; Kurata et al., 2016, p. 6; Stewart et al., 2014, p. 518).
#2 Seasonal Affective Disorder (SAD): What It Is and How to Treat It » HealthStreet » College of Public Health and Health Professions » University of Florida
https://healthstreet.program.ufl.edu/2017/11/29/seasonal-affective-disorder-sad-what-it-is-and-how-to-treat-it/
Seasonal Affective Disorder, or SAD, is a type of recurrent major depressive disorder in which episodes of depression occur around the same season each year. […] Seasonal affective disorder is estimated to affect 10 million Americans. SAD is four times more common in women than in men. The age of onset is estimated to be between the age of 18 and 30. Some people experience symptoms severe enough to affect quality of life, and 6 percent require hospitalization. […] Treatment approaches to alleviate the symptoms of SAD typically include combinations of antidepressant medication, light therapy, Vitamin D, and counseling.
#2 All about seasonal affective disorder – Mayo Clinic Health System
https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/seasonal-affective-disorder-more
Seasonal affective disorder, or SAD, is a type of depression that is related to the changes in seasons. Symptoms typically appear in the fall, continue through the winter months and eventually go away in the spring or summer. […] People who live in the northern half of the U.S., where daylight hours are shorter and there is less sunlight, are more at risk for SAD. It’s estimated that about 1 in 20 people in the northern half of the U.S. could have symptoms suggestive of SAD. […] On average, SAD will last about five months of the year. Typically, symptoms will develop in October and worsen around the end of daylight saving time, followed by a more drastic decline in November. January and February tend to be the months with the most severe symptoms of depression. […] Bright light therapy is considered an effective treatment for SAD. Research suggests that around half of people who use a bright light therapy box have good results with symptom reduction. […] Because SAD is tied to the changing seasons, the onset can be predicted, which sets a person up to better manage their symptoms. If you have SAD, there are preventive measures that you can put in place and steps you can begin taking before major depression develops.
#3 Seasonal affective disorder – Wikipedia
https://en.wikipedia.org/wiki/Seasonal_affective_disorder
Seasonal affective disorder (SAD) is a mood disorder subset in which people who typically have normal mental health throughout most of the year exhibit depressive symptoms at the same time each year. […] In the United States, the percentage of the population affected by SAD ranges from 1.4% of the population in Florida to 9.9% in Alaska. […] Winter depression is a common slump in the mood of some inhabitants of most of the Nordic countries. […] In Alaska it has been established that there is a SAD rate of 8.9%, and an even greater rate of 24.9% for subsyndromal SAD. […] Around 20% of Irish people are affected by SAD, according to a survey conducted in 2007. The survey also shows women are more likely to be affected by SAD than men. An estimated 3% of the population in the Netherlands experience winter SAD.
#3 Seasonal sensitivity and psychiatric morbidity: study about seasonal affective disorder | BMC Psychiatry | Full Text
https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-021-03313-z
Winkler and Kasper, in an article in which they gathered 22 studies, point to a prevalence of SAD in temperate countries between 2 and 5%. […] But other studies estimate that the prevalence of SAD in populations located in northern latitudes can approach 10%. […] Reflection of this diversity of results, Magnusson in a review and systematize epidemiological studies of SAD provided prevalence estimates ranging from 1.4 to 9.7% in Northern America, 1.33.0% in Europe and 00.9% in Asia. […] In women, the prevalence tends to be higher than men, with a ratio varying between 3.5: 1 and 9:1 and, in most cases, the first episode of seasonal affective disorder occurs around the age of 30, with a decrease of discrepancy between the sexes with increasing age. […] In this study, according to the criteria defined by Kasper et al., 12.7% of the individuals in the sample showed likely seasonal affective disorder and 29.0% for subsyndromal seasonal affective disorder.
#3 Seasonal Affective Disorder
https://www.uspharmacist.com/article/seasonal-affective-disorder-1
Seasonal affective disorder (SAD), also referred to as winter blues, represents one of the most prevalent and complicated psychiatric disorders faced by patients today. Approximately 10% of adults in the United States experience SAD, typically enduring it about 40% of the year. […] SAD, along with other depressive disorders, poses a considerable public health threat in the U.S., as evidenced by an estimated 1.7 million suicide attempts in 2021 and a 2.6% rise in suicide-related deaths from 2021 to 2022. […] The societal ramifications of SAD are exacerbated by absenteeism from work or school, increased healthcare utilization, and elevated healthcare expenses. […] Addressing the impact of SAD requires comprehensive strategies incorporating preventive measures, prompt diagnosis, and evidence-based treatments to alleviate its societal and economic toll and enhance overall well-being.
#3 What is the
https://www.mdvip.com/about-mdvip/blog/do-you-struggle-winter-blues-take-seasonal-affective-disorder-seriously
Whatâs seasonal affective disorder? Psychology Today sums it up as a type form of episodic depression that affects people during specific times of the year and estimates that about 10 million Americans struggle with it. […] Researchers arenât sure what causes seasonal depression. In a recent study published in Epidemiology, researchers found bouts of major depression increase as we transition from daylight savings time to standard time and surmise that shorter days cause distress and trigger depression. […] Surveys found only 1.4 percent of people living in sunny Florida with seasonal depression symptoms. In New York, 5.7 percent, in Alaska 9.9 percent and in Ireland 20 percent of people struggle with SAD. […] Results from a 2016 study, published in Clinical Psychological Science suggested that seasonal depression is unrelated to latitude, season or sunlight and that all episodes of depression should be treated as a major depression.
#3 Seasonal Affective Disorder (SAD) | Mental Health America
https://mhanational.org/conditions/seasonal-affective-disorder-sad/
Seasonal depression, also known as seasonal affective disorder (SAD) or the âwinter blues,â is a subtype of depression or bipolar disorder that occurs and ends around the same time every year. […] In a given year, about 5 percent of the U.S. population experiences seasonal depression. […] Four out of five people who have seasonal depression are women. […] The main age of onset of seasonal depression is between 20 and 30 years of age, however symptoms can appear earlier. […] The prevalence of seasonal depression is anywhere from 0-10 percent of the population, depending on the geographic region. […] Typically, the further one is from the equator, the more at risk they are for seasonal depression.
#3 Seasonal affective disorder – Symptoms, diagnosis and treatment | BMJ Best Practice
https://bestpractice.bmj.com/topics/en-gb/985
Seasonal affective disorder (SAD) is then a sub-type specifier used to describe temporal variations of these disorders. […] Common presentations include the initiation or worsening of depressive symptoms during the autumn or winter months, and full remission during the spring or summer months, or hypo-manic or manic symptoms presenting during spring or summer months. […] Key diagnostic factors include the presence of risk factors, a 2-year period of seasonally related changes in mood, autumn or winter depression, and spring or summer symptom remission. […] Risk factors include exposure to diminished light during winter and increased light during summer, residing at a northern latitude, family history of seasonal affective disorder (SAD), female sex, age 20 to 30 years, psychological factors (e.g., high neuroticism), psychiatric comorbidity (e.g., anxiety, ADHD, premenstrual dysphoric disorders), and alcohol use.
#4 What is the
https://www.mdvip.com/about-mdvip/blog/do-you-struggle-winter-blues-take-seasonal-affective-disorder-seriously
Whatâs seasonal affective disorder? Psychology Today sums it up as a type form of episodic depression that affects people during specific times of the year and estimates that about 10 million Americans struggle with it. […] Researchers arenât sure what causes seasonal depression. In a recent study published in Epidemiology, researchers found bouts of major depression increase as we transition from daylight savings time to standard time and surmise that shorter days cause distress and trigger depression. […] Surveys found only 1.4 percent of people living in sunny Florida with seasonal depression symptoms. In New York, 5.7 percent, in Alaska 9.9 percent and in Ireland 20 percent of people struggle with SAD. […] Results from a 2016 study, published in Clinical Psychological Science suggested that seasonal depression is unrelated to latitude, season or sunlight and that all episodes of depression should be treated as a major depression.
#4 Seasonal Depression – Symptoms, Causes, Treatments
https://www.webmd.com/depression/seasonal-affective-disorder
Seasonal depression, also known as seasonal affective disorder (SAD), is a mood disorder that happens every year at about the same time. It usually starts in fall or winter and ends in spring or early summer. These mood changes may affect how you feel, think, and act. […] SAD may affect 11 million people in the U.S. each year, and 25 million more may have a milder form called the winter blues. […] SAD usually starts in young adulthood and is more common in women (and those identified as female at birth). […] Because SAD that starts in winter is related to the reduced levels of daylight, it’s less often found in countries where there’s plenty of sunshine year-round. […] The main feature of SAD is that your mood and behavior shift along with the calendar. It’s not a separate mood disorder but a type of major depression or bipolar disorder, sometimes called manic depression.
#4 Seasonal Affective Disorder (SAD): What It Is and How to Treat It » HealthStreet » College of Public Health and Health Professions » University of Florida
https://healthstreet.program.ufl.edu/2017/11/29/seasonal-affective-disorder-sad-what-it-is-and-how-to-treat-it/
Seasonal Affective Disorder, or SAD, is a type of recurrent major depressive disorder in which episodes of depression occur around the same season each year. […] Seasonal affective disorder is estimated to affect 10 million Americans. SAD is four times more common in women than in men. The age of onset is estimated to be between the age of 18 and 30. Some people experience symptoms severe enough to affect quality of life, and 6 percent require hospitalization. […] Treatment approaches to alleviate the symptoms of SAD typically include combinations of antidepressant medication, light therapy, Vitamin D, and counseling.
#4 Seasonal Affective Disorder
https://www.uspharmacist.com/article/seasonal-affective-disorder-1
Genetic predisposition also plays a significant role in SAD. Individuals with a history of depression or family members with SAD are at a higher risk of developing the disorder. […] Several factors can increase the risk of developing SAD, including a history of depression, family history of SAD, age, gender, and environmental factors. […] While SAD does not have a cure, there are many ways to manage its symptoms. Treatments may include light therapy, counseling, medication, and lifestyle changes. […] Starting therapy or treatment before the onset of symptoms, based on seasonal patterns, can be beneficial.
#5 Seasonal Affective Disorder: Focus on the Winter Blues
https://www.uspharmacist.com/article/seasonal-affective-disorder-focus-on-the-winter-blues
As the winter months approach, healthcare providers should be aware of a mental health condition that commonly appears at this time of year, known as seasonal affective disorder (SAD). Pharmacists in particular may be helpful in detecting this disorder, which can affect up to 10% of the population in a given year. […] SAD is diagnosed according to the criteria in the American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5). A diagnosis of SAD is made by determining that the depressive symptoms have occurred for at least 2 years during the same season, that the symptoms disappear when the season is over, and that there is no other mental or physical health problem that could be the cause. […] Risk factors for SAD include being female, young, living farther from the equator, and having family members with depression or mood disorders.