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Volf C, Wium-Andersen MK, Wium-Andersen IK, Aagaard PE, Eriksen ES, Osler M, Martiny K. Seasonality and sun exposure in incidence of major depression, bipolar disorder, and first-time use of antidepressant medication. Nord J Psychiatry 2024:1-7. [PMID: 39046274 DOI: 10.1080/08039488.2024.2379848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 05/27/2024] [Accepted: 07/05/2024] [Indexed: 07/25/2024]
Abstract
INTRODUCTION Seasonality in depressive and bipolar disorders, are recognized in the ICD-10/11 and DSM-5 diagnostic systems. The existence of a seasonal pattern of hospital diagnosis of major depression, bipolar disorder and prescription of antidepressant medications has not been evaluated in the Danish population. METHODS We retrieved date and year for all first-time hospital contacts with depression or bipolar disorder between 1999 and 2019, registered in the Danish National Patient Registry. Depression was defined using the ICD-10 F32-F33 codes, and for bipolar disorder the F30 or F31 codes. Date and year of all first-time purchases of antidepressant medications with ATC codes (N06A) between 1999 and 2021 were retrieved from the Danish National Prescription Registry, containing information on all prescribed drugs dispensed at pharmacies since 1995. Data on sunlight hours from 2012 to 2021 were retrieved from the Danish Metrological Institute. RESULTS Incidences of hospital diagnoses as well as purchases of medication varied with month and season. The monthly variations were larger for antidepressant medication and smallest for bipolar disorder. The multiple linear regression analysis showed that number of first-time diagnoses of depression or bipolar disorder did not correlate with season. For antidepressant medication the number of first-time prescriptions was significantly lower in summer compared to the winter season. CONCLUSION This study found a seasonal variation of first-time prescriptions of antidepressant medication. We did not find a seasonal variation in first-time hospital diagnoses. Further research looking into depression severity, polarity of bipolar illness episodes, lag-time for sunlight exposure, and specific parts of the yearly photoperiods should be conducted.
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Affiliation(s)
- Carlo Volf
- Mental Health Centre Copenhagen, Mental Health Services Capital Region of Denmark, Frederiksberg, Denmark
| | | | | | - Peter Elm Aagaard
- Mental Health Centre Copenhagen, Mental Health Services Capital Region of Denmark, Frederiksberg, Denmark
| | - Eskild Soldal Eriksen
- Mental Health Centre Copenhagen, Mental Health Services Capital Region of Denmark, Frederiksberg, Denmark
| | - Merete Osler
- Center for Clinical Research and Prevention (CCRP), Frederiksberg, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Klaus Martiny
- Mental Health Centre Copenhagen, Mental Health Services Capital Region of Denmark, Frederiksberg, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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2
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Chester EM, Kolacz J, Ake CJ, Thornburg J, Chen X, Shea AA, Birgisdóttir BE, Gunnlaugsson G, Vitzthum VJ. Well-being in healthy Icelandic women varies with extreme seasonality in ambient light. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2024; 59:486-494. [PMID: 38296809 DOI: 10.1002/ijop.13112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 12/24/2023] [Indexed: 02/02/2024]
Abstract
Seasonal variation in photoperiod may affect psychosocial and physical well-being in healthy persons. We tested this hypothesis in healthy pre-menopausal women, without a history of mood disorders, living year-round in Reykjavik, Iceland (64.1°N). Participants reported daily self-assessments of well-being throughout a complete ovulatory menstrual cycle in summer and/or winter (70% participated in both seasons). Scores for mood, cognitive acuity, social support, physical health and a composite of these four indicators were each significantly higher in summer than in winter (linear mixed effects models: p < .001 for each model); tiredness did not differ by season. The effect of season was not significantly changed by inclusion of body mass index and/or age as covariates. Some prior studies have been hampered by sparse time sampling, inattention to covariates and/or relying on recalled data. This is to our knowledge the first investigation to test the study hypothesis with daily real-time data spanning complete ovulatory menstrual cycles in each of two seasons. This dense sampling has revealed modest seasonal variation in well-being in healthy women. Daylength (sunlight exposure) is likely a major, but not necessarily sole, factor in these seasonal differences in well-being; temperature is likely less important given Iceland's relatively moderate (for its high latitude) seasonal temperature swings.
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Affiliation(s)
| | - Jacek Kolacz
- Traumatic Stress Research Consortium, Indiana University, Bloomington, IN, USA
- Psychiatry and Behaviorial Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Christine J Ake
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Jonathan Thornburg
- Department of Astronomy and Center for Spacetime Symmetries, Indiana University Bloomington, Bloomington, IN, USA
| | - Xiwei Chen
- Department of Epidemiology and Biostatistics, Indiana University Bloomington, Bloomington, IN, USA
| | - Amanda A Shea
- Department of Science, Biowink, GmbH, Berlin, Germany
| | | | - Geir Gunnlaugsson
- Faculty of Sociology, Anthropology, and Folkloristics, University of Iceland, Reykjavik, Iceland
| | - Virginia J Vitzthum
- Department of Medicine, Centre for Menstrual Cycle and Ovulation Research, University of British Columbia, Vancouver, BC, Canada
- Department of Anthropology, Indiana University, Bloomington, IN, USA
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3
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Dollish HK, Tsyglakova M, McClung CA. Circadian rhythms and mood disorders: Time to see the light. Neuron 2024; 112:25-40. [PMID: 37858331 PMCID: PMC10842077 DOI: 10.1016/j.neuron.2023.09.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/09/2023] [Accepted: 09/20/2023] [Indexed: 10/21/2023]
Abstract
The importance of time is ever prevalent in our world, and disruptions to the normal light/dark and sleep/wake cycle have now become the norm rather than the exception for a large part of it. All mood disorders, including seasonal affective disorder (SAD), major depressive disorder (MDD), and bipolar disorder (BD), are strongly associated with abnormal sleep and circadian rhythms in a variety of physiological processes. Environmental disruptions to normal sleep/wake patterns, light/dark changes, and seasonal changes can precipitate episodes. Moreover, treatments that target the circadian system have proven to be therapeutic in certain cases. This review will summarize much of our current knowledge of how these disorders associate with specific circadian phenotypes, as well as the neuronal mechanisms that link the circadian clock with mood regulation. We also discuss what has been learned from therapies that target circadian rhythms and how we may use current knowledge to develop more individually designed treatments.
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Affiliation(s)
- Hannah K Dollish
- Department of Psychiatry, University of Pittsburgh School of Medicine, 450 Technology Drive, Suite 223, Pittsburgh, PA 15219, USA
| | - Mariya Tsyglakova
- Department of Psychiatry, University of Pittsburgh School of Medicine, 450 Technology Drive, Suite 223, Pittsburgh, PA 15219, USA
| | - Colleen A McClung
- Department of Psychiatry, University of Pittsburgh School of Medicine, 450 Technology Drive, Suite 223, Pittsburgh, PA 15219, USA.
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4
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Shankar A, Deal CK, McCahon S, Callegari K, Seitz T, Yan L, Drown DM, Williams CT. SAD rats: Effects of short photoperiod and carbohydrate consumption on sleep, liver steatosis, and the gut microbiome in diurnal grass rats. Chronobiol Int 2024; 41:93-104. [PMID: 38047486 PMCID: PMC10843721 DOI: 10.1080/07420528.2023.2288223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/22/2023] [Indexed: 12/05/2023]
Abstract
Seasonal affective disorder (SAD) is a recurrent depression triggered by exposure to short photoperiods, with a subset of patients reporting hypersomnia, increased appetite, and carbohydrate craving. Dysfunction of the microbiota - gut - brain axis is frequently associated with depressive disorders, but its role in SAD is unknown. Nile grass rats (Arvicanthis niloticus) are potentially useful for exploring the pathophysiology of SAD, as they are diurnal and have been found to exhibit anhedonia and affective-like behavior in response to short photoperiods. Further, given grass rats have been found to spontaneously develop metabolic syndrome, they may be particularly susceptible to environmental triggers of metabolic dysbiosis. We conducted a 2 × 2 factorial design experiment to test the effects of short photoperiod (4 h:20 h Light:Dark (LD) vs. neutral 12:12 LD), access to a high concentration (8%) sucrose solution, and the interaction between the two, on activity, sleep, liver steatosis, and the gut microbiome of grass rats. We found that animals on short photoperiods maintained robust diel rhythms and similar subjective day lengths as controls in neutral photoperiods but showed disrupted activity and sleep patterns (i.e. a return to sleep after an initial bout of activity that occurs ~ 13 h before lights off). We found no evidence that photoperiod influenced sucrose consumption. By the end of the experiment, some grass rats were overweight and exhibited signs of non-alcoholic fatty liver disease (NAFLD) with micro- and macro-steatosis. However, neither photoperiod nor access to sucrose solution significantly affected the degree of liver steatosis. The gut microbiome of grass rats varied substantially among individuals, but most variation was attributable to parental effects and the microbiome was unaffected by photoperiod or access to sucrose. Our study indicates short photoperiod leads to disrupted activity and sleep in grass rats but does not impact sucrose consumption or exacerbate metabolic dysbiosis and NAFLD.
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Affiliation(s)
- Anusha Shankar
- Institute of Arctic Biology, University of Alaska Fairbanks, Fairbanks AK 99775, USA
- Current: Lab of Ornithology, Cornell University, Ithaca, NY 14850, USA
| | - Cole K. Deal
- Department of Biology, Colorado State University, Fort Collins, CO 80526, USA
| | - Shelby McCahon
- Department of Biology and Wildlife, University of Alaska Fairbanks, Fairbanks AK 99775, USA
| | - Kyle Callegari
- Department of Biology and Wildlife, University of Alaska Fairbanks, Fairbanks AK 99775, USA
| | - Taylor Seitz
- Department of Biology and Wildlife, University of Alaska Fairbanks, Fairbanks AK 99775, USA
| | - Lily Yan
- Department of Psychology, Michigan State University, East Lansing, MI 48824, USA
- Neuroscience Program, Michigan State University, East Lansing, MI 48824, USA
| | - Devin M. Drown
- Institute of Arctic Biology, University of Alaska Fairbanks, Fairbanks AK 99775, USA
- Department of Biology and Wildlife, University of Alaska Fairbanks, Fairbanks AK 99775, USA
| | - Cory T. Williams
- Department of Biology, Colorado State University, Fort Collins, CO 80526, USA
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5
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Ng E, Nestor SM, Rabin JS, Hamani C, Lipsman N, Giacobbe P. Seasonal pattern and depression outcomes from repetitive transcranial magnetic stimulation. Psychiatry Res 2023; 329:115525. [PMID: 37820574 DOI: 10.1016/j.psychres.2023.115525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/29/2023] [Accepted: 10/02/2023] [Indexed: 10/13/2023]
Abstract
Individuals with major depressive disorder (MDD) may exhibit a seasonal pattern. The impact of a seasonal pattern in depressive symptoms on rTMS outcomes is unexplored. A retrospective analysis was performed on patients with MDD receiving open-label high frequency rTMS to the left dorsolateral prefrontal cortex. Having a seasonal pattern was defined as scoring ≥ 12 on the Personal Inventory for Depression and Seasonal Affective Disorder (PIDS). Primary outcomes included improvement in the Hamilton Depression Rating Scale (HAMD) and remission. Secondary analyses included the use of the self-rated Quick Inventory of Depressive Symptomatology (QIDS) to assess for changes in atypical neurovegetative symptoms. Multiple linear regression, multiple logistic regression, and linear mixed effects analyses were performed. 46 % (58/127) of the sample had a seasonal pattern. Seasonal pattern did not significantly influence improvement in HAMD (PIDS < 12, 7.8, SD 5.9; PIDS ≥ 12, 10.4, SD 4.9 or remission (PIDS < 12, 30 %; PIDS ≥ 12, 34 %). There were equivalent degrees of improvement in atypical neurovegetative symptoms over time as assessed using the QIDS. Depression with seasonal pattern was found to respond to rTMS treatment similarly to depression without seasonal pattern, suggesting that this may be a viable treatment for this group.
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Affiliation(s)
- Enoch Ng
- Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON M5T 1R8, Canada
| | - Sean M Nestor
- Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON M5T 1R8, Canada; Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Harquail Centre for Neuromodulation, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada
| | - Jennifer S Rabin
- Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Harquail Centre for Neuromodulation, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Division of Neurology, Department of Medicine, University of Toronto, 6 Queen's Park Crescent West, Toronto, ON M5S 3Hs, Canada; Rehabilitation Sciences Institute, University of Toronto, Toronto, ON M5G 1V7, Canada
| | - Clement Hamani
- Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Harquail Centre for Neuromodulation, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Surgery, University of Toronto, 149 College Street, Toronto, ON M5T 1P5, Canada
| | - Nir Lipsman
- Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Harquail Centre for Neuromodulation, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Surgery, University of Toronto, 149 College Street, Toronto, ON M5T 1P5, Canada
| | - Peter Giacobbe
- Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON M5T 1R8, Canada; Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Harquail Centre for Neuromodulation, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada.
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Bedder RL, Vaghi MM, Dolan RJ, Rutledge RB. Risk taking for potential losses but not gains increases with time of day. Sci Rep 2023; 13:5534. [PMID: 37015952 PMCID: PMC10073197 DOI: 10.1038/s41598-023-31738-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 03/16/2023] [Indexed: 04/06/2023] Open
Abstract
Humans exhibit distinct risk preferences when facing choices involving potential gains and losses. These preferences are believed to be subject to neuromodulatory influence, particularly from dopamine and serotonin. As neuromodulators manifest circadian rhythms, this suggests decision making under risk might be affected by time of day. Here, in a large subject sample collected using a smartphone application, we found that risky options with potential losses were increasingly chosen over the course of the day. We observed this result in both a within-subjects design (N = 2599) comparing risky options chosen earlier and later in the day in the same individuals, and in a between-subjects design (N = 26,720) showing our effect generalizes across ages and genders. Using computational modelling, we show this diurnal change in risk preference reflects a decrease in sensitivity to increasing losses, but no change was observed in the relative impacts of gains and losses on choice (i.e., loss aversion). Thus, our findings reveal a striking diurnal modulation in human decision making, a pattern with potential importance for real-life decisions that include voting, medical decisions, and financial investments.
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Affiliation(s)
- Rachel L. Bedder
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, London, UK
- Wellcome Centre for Human Neuroimaging, University College London, London, UK
| | - Matilde M. Vaghi
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, London, UK
- Wellcome Centre for Human Neuroimaging, University College London, London, UK
- School of Psychology, University of East Anglia, Norwich, UK
| | - Raymond J. Dolan
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, London, UK
- Wellcome Centre for Human Neuroimaging, University College London, London, UK
- State Key Laboratory of Cognitive Neuroscience and Learning, IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Robb B. Rutledge
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, London, UK
- Wellcome Centre for Human Neuroimaging, University College London, London, UK
- Department of Psychology, Yale University, New Haven, USA
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7
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Campbell I, Sharifpour R, Vandewalle G. Light as a Modulator of Non-Image-Forming Brain Functions—Positive and Negative Impacts of Increasing Light Availability. Clocks Sleep 2023; 5:116-140. [PMID: 36975552 PMCID: PMC10047820 DOI: 10.3390/clockssleep5010012] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/17/2023] [Accepted: 03/13/2023] [Indexed: 03/19/2023] Open
Abstract
Light use is rising steeply, mainly because of the advent of light-emitting diode (LED) devices. LEDs are frequently blue-enriched light sources and may have different impacts on the non-image forming (NIF) system, which is maximally sensitive to blue-wavelength light. Most importantly, the timing of LED device use is widespread, leading to novel light exposure patterns on the NIF system. The goal of this narrative review is to discuss the multiple aspects that we think should be accounted for when attempting to predict how this situation will affect the NIF impact of light on brain functions. We first cover both the image-forming and NIF pathways of the brain. We then detail our current understanding of the impact of light on human cognition, sleep, alertness, and mood. Finally, we discuss questions concerning the adoption of LED lighting and screens, which offer new opportunities to improve well-being, but also raise concerns about increasing light exposure, which may be detrimental to health, particularly in the evening.
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8
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Zhang R, Volkow ND. Seasonality of brain function: role in psychiatric disorders. Transl Psychiatry 2023; 13:65. [PMID: 36813773 PMCID: PMC9947162 DOI: 10.1038/s41398-023-02365-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 02/24/2023] Open
Abstract
Seasonality patterns are reported in various psychiatric disorders. The current paper summarizes findings on brain adaptations associated with seasonal changes, factors that contribute to individual differences and their implications for psychiatric disorders. Changes in circadian rhythms are likely to prominently mediate these seasonal effects since light strongly entrains the internal clock modifying brain function. Inability of circadian rhythms to accommodate to seasonal changes might increase the risk for mood and behavior problems as well as worse clinical outcomes in psychiatric disorders. Understanding the mechanisms that account for inter-individual variations in seasonality is relevant to the development of individualized prevention and treatment for psychiatric disorders. Despite promising findings, seasonal effects are still understudied and only controlled as a covariate in most brain research. Rigorous neuroimaging studies with thoughtful experimental designs, powered sample sizes and high temporal resolution alongside deep characterization of the environment are needed to better understand the seasonal adaptions of the human brain as a function of age, sex, and geographic latitude and to investigate the mechanisms underlying the alterations in seasonal adaptation in psychiatric disorders.
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Affiliation(s)
- Rui Zhang
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, 20892-1013, USA.
| | - Nora D. Volkow
- grid.94365.3d0000 0001 2297 5165Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892-1013 USA
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9
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Low circadian amplitude and delayed phase are linked to seasonal affective disorder (SAD). JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
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10
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Wescott DL, Wallace ML, Hasler BP, Klevens AM, Franzen PL, Hall MH, Roecklein KA. Sleep and circadian rhythm profiles in seasonal depression. J Psychiatr Res 2022; 156:114-121. [PMID: 36244199 DOI: 10.1016/j.jpsychires.2022.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 07/09/2022] [Accepted: 10/03/2022] [Indexed: 11/07/2022]
Abstract
Sleep and circadian rhythm disruptions are symptoms of, and hypothesized underlying mechanisms in, seasonal depression. Discrepant observational findings and mixed responses to sleep/circadian-based treatments suggest heterogenous sleep and circadian disruptions in seasonal depression, despite these disruptions historically conceptualized as delayed circadian phase and hypersomnia. This study used a data-driven cluster analysis to characterize sleep/circadian profiles in seasonal depression to identify treatment targets for future interventions. Biobehavioral measures of sleep and circadian rhythms were assessed during the winter in individuals with Seasonal Affective Disorder (SAD), subsyndromal-SAD (S-SAD), or nonseasonal, never depressed controls (total sample N = 103). The following variables were used in the cluster analysis: circadian phase (from dim light melatonin onset), midsleep timing, total sleep time, sleep efficiency, regularity of midsleep timing, and nap duration (all from wrist actigraphy). Sleep and circadian variables were compared across clusters and controls. Despite limited sleep/circadian differences between diagnostic groups, there were two reliable (Jaccard Coefficients >0.75) sleep/circadian profiles in SAD/S-SAD individuals: a 'Disrupted sleep' cluster, characterized by irregular and fragmented sleep and an 'Advanced' cluster, characterized by early sleep and circadian timing and longer total sleep times (>7.5 h). Clusters did not differ by depression severity. Midsleep correlated with DLMO (r = 0.56), irregularity (r = 0.3), and total sleep time (r = -0.27). Sleep and circadian disruptions in seasonal depression are not uniformly characterized by hypersomnia and circadian phase delay. Presence of distinct sleep and circadian subgroups in seasonal depression may predict successful treatment response. Prospective assessment and tailoring of individual sleep and circadian disruptions may reduce treatment failures.
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Affiliation(s)
- Delainey L Wescott
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Meredith L Wallace
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Department of Statistics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Brant P Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Alison M Klevens
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Peter L Franzen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Martica H Hall
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kathryn A Roecklein
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA; Center for the Neural Basis of Behavior, University of Pittsburgh, Pittsburgh, PA, USA
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11
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Vision-Related Quality of Life and Seasonal Affective Disorder in Patients with Glaucoma and Macular Degeneration. Vision (Basel) 2022; 6:vision6020032. [PMID: 35737419 PMCID: PMC9227504 DOI: 10.3390/vision6020032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/07/2022] [Accepted: 06/07/2022] [Indexed: 11/17/2022] Open
Abstract
Seasonal affective disorder (SAD) is characterized by depressive episodes related to changes in the seasons. Patients with severe vision loss are at an increased risk of SAD. This study seeks to determine the extent to which patients with moderate vision loss report symptoms of SAD. In this cross-sectional, comparative case series, the Seasonal Pattern Assessment Questionnaire (SPAQ) and the National Eye Institute Visual Function Questionnaire (VFQ-39) were used to screen 111 patients with age-related macular degeneration (AMD) and/or primary open-angle glaucoma (POAG). A multiple regression analysis was performed to create a predictive model for SAD based on the Global Seasonality Score (GSS) using the VFQ-39. Subjects who reported symptoms of SAD (GSS > 8) had lower vision-related quality of life (composite score: 57.2 versus 73.2, p < 0.001). Exploratory factor analysis revealed that the items on the VFQ-39 split into two distinct dimensions that together accounted for 63.2% of the total variance in the GSS. One group of questions addressed vision-related problems; the other group comprised questions related to the quality of life. Whereas this model successfully identified patients with vision loss at risk of SAD, a model restricted to the questions available on the shorter, widely used VFQ-25 instrument did not reliably identify patients at risk of SAD.
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12
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Höller Y, Urbschat MM, Kristófersson GK, Ólafsson RP. Predictability of Seasonal Mood Fluctuations Based on Self-Report Questionnaires and EEG Biomarkers in a Non-clinical Sample. Front Psychiatry 2022; 13:870079. [PMID: 35463521 PMCID: PMC9030950 DOI: 10.3389/fpsyt.2022.870079] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
Induced by decreasing light, people affected by seasonal mood fluctuations may suffer from low energy, have low interest in activities, experience changes in weight, insomnia, difficulties in concentration, depression, and suicidal thoughts. Few studies have been conducted in search for biological predictors of seasonal mood fluctuations in the brain, such as EEG oscillations. A sample of 64 participants was examined with questionnaires and electroencephalography in summer. In winter, a follow-up survey was recorded and participants were grouped into those with at least mild (N = 18) and at least moderate (N = 11) mood decline and those without self-reported depressive symptoms both in summer and in winter (N = 46). A support vector machine was trained to predict mood decline by either EEG biomarkers alone, questionnaire data from baseline alone, or a combination of the two. Leave-one-out-cross validation with lasso regularization was used with logistic regression to fit a model. The accuracy for classification for at least mild/moderate mood decline was 77/82% for questionnaire data, 72/82% for EEG alone, and 81/86% for EEG combined with questionnaire data. Self-report data was more conclusive than EEG biomarkers recorded in summer for prediction of worsening of depressive symptoms in winter but it is advantageous to combine EEG with psychological assessment to boost predictive performance.
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Affiliation(s)
- Yvonne Höller
- Faculty of Psychology, University of Akureyri, Akureyri, Iceland
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13
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Höller Y, Jónsdóttir ST, Hannesdóttir AH, Ólafsson RP. EEG-responses to mood induction interact with seasonality and age. Front Psychiatry 2022; 13:950328. [PMID: 36016970 PMCID: PMC9396338 DOI: 10.3389/fpsyt.2022.950328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 07/19/2022] [Indexed: 11/13/2022] Open
Abstract
The EEG is suggested as a potential diagnostic and prognostic biomarker for seasonal affective disorder (SAD). As a pre-clinical form of SAD, seasonality is operationalized as seasonal variation in mood, appetite, weight, sleep, energy, and socializing. Importantly, both EEG biomarkers and seasonality interact with age. Inducing sad mood to assess cognitive vulnerability was suggested to improve the predictive value of summer assessments for winter depression. However, no EEG studies have been conducted on induced sad mood in relation to seasonality, and no studies so far have controlled for age. We recorded EEG and calculated bandpower in 114 participants during rest and during induced sad mood in summer. Participants were grouped by age and based on a seasonality score as obtained with the seasonal pattern assessment questionnaire (SPAQ). Participants with high seasonality scores showed significantly larger changes in EEG power from rest to sad mood induction, specifically in the alpha frequency range (p = 0.027), compared to participants with low seasonality scores. Furthermore, seasonality interacted significantly with age (p < 0.001), with lower activity in individuals with high seasonality scores that were older than 50 years but the opposite pattern in individuals up to 50 years. Effects of sad mood induction on brain activity are related to seasonality and can therefore be consider as potential predicting biomarkers for SAD. Future studies should control for age as a confounding factor, and more studies are needed to elaborate on the characteristics of EEG biomarkers in participants above 50 years.
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Affiliation(s)
- Yvonne Höller
- Faculty of Psychology, University of Akureyri, Akureyri, Iceland
| | - Sara Teresa Jónsdóttir
- Faculty of Psychology, University of Akureyri, Akureyri, Iceland.,Faculty of Psychology, University of Iceland, Reykjavík, Iceland
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14
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Hawke LD, Szatmari P, Cleverley K, Courtney D, Cheung A, Voineskos AN, Henderson J. Youth in a pandemic: a longitudinal examination of youth mental health and substance use concerns during COVID-19. BMJ Open 2021; 11:e049209. [PMID: 34716160 PMCID: PMC8561825 DOI: 10.1136/bmjopen-2021-049209] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE This study analyses longitudinal data to understand how youth mental health and substance use are evolving over the course of the COVID-19 pandemic, which is critical to adjusting mental health response strategies. SETTING Participants were recruited from among existing participants in studies conducted in an urban academic hospital in Ontario, Canada. PARTICIPANTS A total of 619 youth aged 14-28 years participated in the study (62.7% girls/young women; 61.4% Caucasian). MEASURES Data on mood, substance use and COVID-19-related worries were collected over four time points, that is, every 2 months beginning in the early stages of the pandemic in April 2020. Latent class analyses were conducted on the longitudinal data to identify distinct groups of youth who have different trajectory profiles of pandemic impact on their mood, substance use and COVID-19-related worries. RESULTS For the majority of participants, mood concerns increased early in the pandemic, declined over Canada's summer months and subsequently increased in autumn. Among the youth with the highest level of mood symptoms at the beginning of the pandemic, increases in mental health concerns were sustained. Substance use remained relatively stable over the course of the pandemic. COVID-19-related worries, however, followed a trajectory similar to that of mood symptoms. Girls/young women, youth living in urban or suburban areas, in larger households, and with poorer baseline mental and physical health are the most vulnerable to mental health concerns and worries during the pandemic. CONCLUSIONS Youth mental health symptom levels and concerns are evolving over the course of the COVID-19 pandemic, in line with the evolution of the pandemic itself, and longitudinal monitoring is therefore required. It is also essential that we engage directly with youth to cocreate pandemic response strategies and mental health service adaptations to best meet the needs of young people.
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Affiliation(s)
- Lisa D Hawke
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Peter Szatmari
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kristin Cleverley
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Darren Courtney
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Amy Cheung
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Aristotle N Voineskos
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Joanna Henderson
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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15
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Roecklein KA, Franzen PL, Wescott DL, Hasler BP, Miller MA, Donofry SD, DuPont CM, Gratzmiller SM, Drexler SP, Wood-Vasey WM, Gamlin PD. Melanopsin-driven pupil response in summer and winter in unipolar seasonal affective disorder. J Affect Disord 2021; 291:93-101. [PMID: 34029883 PMCID: PMC8693789 DOI: 10.1016/j.jad.2021.04.084] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/19/2021] [Accepted: 04/25/2021] [Indexed: 11/30/2022]
Abstract
A retinal subsensitivity to environmental light may trigger Seasonal Affective Disorder (SAD) under low wintertime light conditions. The main aim of this study was to assess the responses of melanopsin-containing retinal ganglion cells in participants (N= 65) diagnosed with unipolar SAD compared to controls with no history of depression. Participants attended a summer visit, a winter visit, or both. Retinal responses to light were measured using the post-illumination pupil response (PIPR) to assess melanopsin-driven responses in the non-visual light input pathway. Linear mixed-effects modeling was used to test a group*season interaction on the Net PIPR (red minus blue light response, percent baseline). We observed a significant group*season interaction such that the PIPR decreased from summer to winter significantly in the SAD group while not in the control group. The SAD group PIPR was significantly lower in winter compared to controls but did not differ between groups in summer. Only 60% of the participants underwent an eye health exam, although all participants reported no history of retinal pathology, and eye exam status was neither associated with outcome nor different between groups. This seasonal variation in melanopsin driven non-visual responses to light may be a risk factor for SAD, and further highlights individual differences in responses to light for direct or indirect effects of light on mood.
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Affiliation(s)
- Kathryn A. Roecklein
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,The Center for the Neural Basis of Cognition, Pittsburgh, Pennsylvania, USA.,Corresponding Author:Kathryn A. Roecklein, Ph.D. Associate Professor Department of Psychology, University of Pittsburgh 210 S. Bouquet Street Pittsburgh, PA 15206 (412) 624-4553
| | - Peter L. Franzen
- Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Delainey L. Wescott
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Brant P. Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Megan A. Miller
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Shannon D. Donofry
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Caitlin M. DuPont
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Sarah M. Gratzmiller
- Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Scott P. Drexler
- Department of Ophthalmology, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - W. Michael Wood-Vasey
- Department of Physics and Astronomy, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Paul D. Gamlin
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA
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16
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Fonte A, Coutinho B. Seasonal sensitivity and psychiatric morbidity: study about seasonal affective disorder. BMC Psychiatry 2021; 21:317. [PMID: 34187417 PMCID: PMC8243845 DOI: 10.1186/s12888-021-03313-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 06/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND 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. In this study the authors evaluated the association between seasonal changes in mood and behavior with psychiatric disturbance. METHOD Descriptive, cross-sectional study. Participants, students attending higher education and vocational courses (N = 324), were evaluated with the Seasonal Pattern Assessment Questionnaire (SPAQ) and the Screening Scale for Mental Health (ER80). RESULTS 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%. CONCLUSIONS There is a statistically significant association between psychiatric morbidity and seasonal affective disorder. This association corroborates the importance of the Seasonal Pattern Assessment Questionnaire in screening for seasonal fluctuations in mood and behavior related disorders, and the clinical need for recognition of these conditions, particularly associated suffering and disabilities.
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Affiliation(s)
- Aníbal Fonte
- Department of Psychiatry and Mental Health / Local Health Unit of the Alto Minho (ULSAM, EPE), Hospital de Santa Luzia, Estrada de Santa Luzia, 4901-858, Viana do Castelo, Portugal. .,Department of Clinical Neuroscience and Mental Health, Faculty of Medicine, University Porto, Porto, Portugal. .,CINTESIS-UP, Hospital de Santa Luzia, Estrada de Santa Luzia, 4901-858, Viana do Castelo, Portugal.
| | - Bruno Coutinho
- Local Health Unit of the Northeast (ULSNE, EPE), Bragança, Portugal
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17
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Palinkas LA, Suedfeld P. Psychosocial issues in isolated and confined extreme environments. Neurosci Biobehav Rev 2021; 126:413-429. [PMID: 33836214 DOI: 10.1016/j.neubiorev.2021.03.032] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 03/22/2021] [Accepted: 03/29/2021] [Indexed: 12/31/2022]
Abstract
PALINKAS, L.A., and P. SUEDFELD. Psychosocial Issues in Isolated and Confined Extreme Environments. NEUROSCI BIOBEHAV REV (1) XXX-XXX, 2020. Psychosocial elements of behavior and performance will significantly impact the outcomes of long duration missions in space, ranging from individual and team decrements to positive benefits associated with successful adaptation. This paper reviews our current understanding of the individual, interpersonal and organizational issues related to living and working in isolated and confined extreme (ICE) environments. Individual issues include changes in emotions and cognitive performance; seasonal syndromes linked to changes in the physical environment; and positive effects of adapting to ICE environments. Interpersonal issues include processes of crew cohesion, tension and conflict; interpersonal relations and social support; the impact of group diversity and leadership styles on small group dynamics; and crew-mission control interactions. Organizational issues include the influence of organizational culture and mission duration on individual and group performance, crew autonomy, and managerial requirements for long duration missions. Improved screening and selection, leadership, coping and interpersonal skills training, and organizational change are key elements to optimizing adjustment to the environment and preventing decrements during and after long duration missions.
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Affiliation(s)
- Lawrence A Palinkas
- Suzanne Dworak Peck School of Social Work, University of Southern California, 669 W. 34(th) Street, Los Angeles, CA, 90089-0411, USA.
| | - Peter Suedfeld
- Department of Psychology, The University of British Columbia, Vancouver, BC, Canada
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18
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Aguglia A, Cuomo A, Amerio A, Bolognesi S, Di Salvo G, Fusar-Poli L, Goracci A, Surace T, Serafini G, Aguglia E, Amore M, Fagiolini A, Maina G. A new approach for seasonal pattern: is it related to bipolarity dimension? Findings from an Italian multicenter study. Int J Psychiatry Clin Pract 2021; 25:73-81. [PMID: 33399494 DOI: 10.1080/13651501.2020.1862235] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The aims of this study were to assess the impact of seasonal pattern on several clinical dimensions in inpatients with a current major depressive episode and to evaluate clinical differences between unipolar and bipolar depression according to seasonal pattern. METHODS Study participants were 300 patients affected by major depressive disorder (MDD) or bipolar disorder (BD) currently experiencing a major depressive episode (MDE) and were recruited at three University Medical Centres in Italy. All study subjects completed several evaluation scales for depressive and hypomanic symptoms, quality of life and functioning, impulsiveness, and seasonal pattern. RESULTS Several differences between BD with and without seasonal pattern, MDD with and without seasonal pattern but in particular between BD and MDD with seasonal pattern were found. Patients with MDE with seasonal pattern had more frequently received a longitudinal diagnosis of BD. CONCLUSIONS A large number of patients with BD and seasonal pattern, but also a considerable number of patients with MDD and seasonal pattern, endorsed manic items during a current MDE. Seasonal pattern should be associated with a concept of bipolarity in mood disorders and not only related to bipolar disorder. A correct identification of seasonal patterns may lead to the implementation of personalised pharmacological treatment approaches.KEY POINTSHigh prevalence of mixed features in mood disorders with seasonal pattern, supporting the need for a dimensional approach to major depressive disorder and bipolar disorder.Significant percentage of patients with a primary diagnosis of major depressive disorder had seasonal pattern.Significant percentage of patients with a primary diagnosis of major depressive disorder reported (hypo)manic symptomatology.
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Affiliation(s)
- Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Alessandro Cuomo
- Department of Molecular Medicine, University of Siena, Siena, Italy
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Mood Disorders Program, Tufs Medical center, Boston, MA, USA
| | - Simone Bolognesi
- Department of Molecular Medicine, University of Siena, Siena, Italy
| | - Gabriele Di Salvo
- Rita Levi Montalcini Department of Neuroscience, University of Turin, University Hospital San Luigi Gonzaga, Turin, Italy
| | - Laura Fusar-Poli
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Arianna Goracci
- Department of Molecular Medicine, University of Siena, Siena, Italy
| | - Teresa Surace
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Eugenio Aguglia
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Andrea Fagiolini
- Department of Molecular Medicine, University of Siena, Siena, Italy
| | - Giuseppe Maina
- Rita Levi Montalcini Department of Neuroscience, University of Turin, University Hospital San Luigi Gonzaga, Turin, Italy
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19
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Ethics analysis of light and vitamin D therapies for seasonal affective disorder. Int J Technol Assess Health Care 2020; 36:549-559. [PMID: 33272336 DOI: 10.1017/s0266462320000884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The aim of this ethics analysis was to highlight the overt and covert value issues with regard to two health technologies (light therapy and vitamin D therapy), the health technology assessment (HTA) and the disease of seasonal affective disorder (SAD). The present ethics analysis served as a chapter of a full HTA report that aimed to assist decision makers concerning the two technologies. METHOD First, we used the revised Socratic approach of Hofmann et al. to build overarching topics of ethical issues, and then, we conducted a hand search and a comprehensive systematic literature search on between 12 and 14 February 2019 in seven databases. RESULTS The concrete ethical issues found concerned vulnerability of the target population and the imperative to treat depressive symptoms for the sake of preventing future harm. Further disease-related ethical issues concerned the questionable nature of SAD as a disease, autonomy, authenticity, and capacity for decision making of SAD patients, and the potential stigma related to the underdiagnosis of SAD, which is contrasted with the concern over unnecessary medicalization. Regarding the interventions and comparators, the ethical issues found concerned their benefit-harm ratios and the question of social inequality. The ethical issues related to the assessment process relate to the choice of comparators and the input data for the selected health economic studies. CONCLUSIONS The concrete ethical issues related to the interventions, the disease, and the assessment process itself were made overt in this ethics analysis. The ethics analysis provided an (additional) value context for making future decisions regarding light and vitamin D therapies.
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20
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Zghoul T. Can we prevent seasonal affective disorder (SAD) with melatonergic agents? BJPSYCH ADVANCES 2020. [DOI: 10.1192/bja.2020.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARYSeasonal affective disorder (SAD) is a recurrent form of major depression, particularly occurring in the winter months with a generally spontaneous remission in spring/summer. The predictable nature of this condition provides a potentially unique opportunity to prevent recurrence in sufferers of SAD. The Cochrane Review discussed here examines the evidence for melatonin and agomelatine in preventing SAD, putting its findings into their clinical context.
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21
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Delavest M, Even C, Benjemaa N, Poirier MF, Jockers R, Krebs MO. Association of the intronic rs2072621 polymorphism of the X-linked GPR50 gene with affective disorder with seasonal pattern. Eur Psychiatry 2020; 27:369-71. [DOI: 10.1016/j.eurpsy.2011.02.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2010] [Revised: 01/05/2011] [Accepted: 02/09/2011] [Indexed: 10/18/2022] Open
Abstract
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.
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22
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Vitale JA, Briguglio M, Galentino R, Dell'Osso B, Malgaroli A, Banfi G, Porta M. Exploring circannual rhythms and chronotype effect in patients with Obsessive-Compulsive Tic Disorder (OCTD): A pilot study. J Affect Disord 2020; 262:286-292. [PMID: 31733921 DOI: 10.1016/j.jad.2019.11.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 09/25/2019] [Accepted: 11/09/2019] [Indexed: 01/26/2023]
Abstract
BACKGROUND The aim of this study was to test, through a chronobiologic approach, the existence of a significant circannual rhythm of tics and obsessive-compulsive symptoms in patients with Obsessive-Compulsive Tic Disorder (OCTD). The chronotype effect on tics and OC symptoms during seasons was also studied. METHODS Patients with a diagnosis of OCTD (N = 37; mean age = 18.78 ± 8.61) underwent four clinical evaluations: Winter (WIN), Spring (SPR), Summer (SUM) and Autumn (AUT). Tics were evaluated through Yale Global Tic Severity Scale (YGTSS) and OC symptoms through Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Patients' chronotype was assessed by the Horne-Ostberg morningness-eveningness questionnaire (MEQ), which categorizes subjects according to the individuals'chronotype, being morning-type, evening-type, and neither-type. RESULTS A statistically significant circannual rhythm was observed for OC symptoms (p = 0.007), with the acrophase occurring between AUT and WIN. Y-BOCS differed along the year (p = 0.0003 and η2p = 0.40) with lower results in SUM compared to WIN (p < 0.05) and AUT (p < 0.01). Tics displayed no circannual rhythm and YGTSS scores were comparable among seasons. Patients were classified as 15 morning-types (40.5%) 15 neither-types (40.5%) and 7 evening-types (19.0%). YGTSS data were similar for all chronotypes while Y-BOCS results were greater during SUM in evening-types than morning-type patients (p < 0.05; 15.7 ± 5.2 vs 3.4 ± 6.0). LIMITATIONS It is essential to investigate the existence of tics and OC symptoms circannual rhythms over the course of more than one year with a larger sample. CONCLUSIONS OC symptoms displayed a significant circannual rhythm and were influenced by patients' chronotype. On the contrary, tics resulted similar among seasons and chronotypes.
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Affiliation(s)
- Jacopo A Vitale
- IRCCS Orthopedic Institute Galeazzi, Laboratory of Movement and Sport Science, 20161, Milan, Italy.
| | - Matteo Briguglio
- IRCCS Orthopedic Institute Galeazzi, Scientific Direction, Via Riccardo Galeazzi, 4 20161, Milan, MI, Italy.
| | - Roberta Galentino
- IRCCS Orthopedic Institute Galeazzi, Tourette's Syndrome and Movement Disorders Centre, 20161, Milan, Italy
| | - Bernardo Dell'Osso
- "Aldo Ravelli" Center for Neurotechnology and Brain Therapeutic, University of Milan, 20142, Milan, Italy; Stanford University, Department of Psychiatry and Behavioral Sciences, Stanford, CA 94305-5717, USA.
| | - Antonio Malgaroli
- Neurobiology of Learning Unit, Vita-Salute San Raffaele University, Milan, Italy.
| | - Giuseppe Banfi
- IRCCS Orthopedic Institute Galeazzi, Scientific Direction, Via Riccardo Galeazzi, 4 20161, Milan, MI, Italy.
| | - Mauro Porta
- IRCCS Orthopedic Institute Galeazzi, Tourette's Syndrome and Movement Disorders Centre, 20161, Milan, Italy
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23
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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.
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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.
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24
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Akram F, Jennings TB, Stiller JW, Lowry CA, Postolache TT. Mood Worsening on Days with High Pollen Counts is associated with a Summer Pattern of Seasonality. Pteridines 2019; 30:133-141. [PMID: 31631951 PMCID: PMC6800045 DOI: 10.1515/pteridines-2019-0016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: Summer/spring-type seasonal affective disorder (S-SAD) is the less common subtype of seasonal affective disorder and evidence regarding potential triggers of S-SAD is scarce. Recent reports support association of airborne-pollen with seasonal exacerbation of depression (mood seasonality) and timing of suicidal behavior. Therefore, we hypothesized that Old Order Amish (OOA) with summer/spring pattern of seasonality (abbreviated as summer pattern) and S-SAD will have significant mood worsening on high pollen days. Methods: A seasonal pattern of mood worsening and SAD parameters were estimated using Seasonal Pattern Assessment Questionnaire (SPAQ). Age- and gender-adjusted ANCOVAs and post hoc analyses were conducted to compare mood worsening on days with high pollen counts between summer-pattern vs no-summer-pattern of mood worsening, S-SAD vs no-S-SAD, winter-pattern vs no-winter-pattern of mood worsening, and W-SAD vs no-W-SAD groups. Results: The prevalence of S-SAD was 0.4%, while 4.5% of individuals had a summer pattern of mood seasonality. A statistically significant difference for mood worsening on high pollen days was observed between summer-pattern vs no-summer-pattern of mood worsening (p = 0.006). The significant association between S-SAD vs no-SAD groups (p = 0.032) for mood worsening on high pollen days did not withstand Bonferroni adjustment for multiple comparisons. No significant association was found for winter-pattern vs no-winter-pattern of mood worsening (p = 0.61) and for W-SAD vs no-W-SAD (p = 0.19) groups. Conclusion: Our results are consistent with previous studies implicating links between aeroallergen exposure and summer pattern of seasonality, but not the winter pattern of seasonality.
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Affiliation(s)
- Faisal Akram
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Tyler B Jennings
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - John W Stiller
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Christopher A Lowry
- Department of Integrative Physiology, Center for Neuroscience, and Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO 80309, USA; Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs Medical Center (RMRVAMC), Aurora, CO, 80045, USA; Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, CO 80045, USA
| | - Teodor T Postolache
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, 21201, USA; Saint Elizabeths Hospital, Psychiatry Residency Training Program, Washington, DC, 20032, USA; Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs Medical Center (RMRVAMC), Aurora, CO, 80045, USA; Amish Research Clinic of the University of Maryland, Lancaster, PA, 17602, USA
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25
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Lukmanji A, Williams JVA, Bulloch AGM, Bhattarai A, Patten SB. Seasonal variation in symptoms of depression: A Canadian population based study. J Affect Disord 2019; 255:142-149. [PMID: 31150944 DOI: 10.1016/j.jad.2019.05.040] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 04/10/2019] [Accepted: 05/22/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND There is no consensus as to whether depressive symptoms vary by season. Using data from the Canadian Community Health Survey (CCHS), the purpose of this study was to evaluate seasonal variation in depressive symptoms in the Canadian household population. METHODS A cross-sectional analysis of data from the CCHS in 2015 and 2016 was used. Mean Patient Health Questionnaire-9 (PHQ-9) scores, and categories defined by 5+ or 10+ cut-points were used for analysis. Seasonal effects were assessed using quadratic terms in regression models, generalized linear models were used for this purpose. Models were stratified by youth ages 12-24 (rounded n ≈ 8000) and adults ages 25+ (rounded n ≈ 45,000). RESULTS Significant seasonal variation was observed for youth (age 12-24) for mean PHQ-9 scores and proportion with scores of 5+. There was evidence of effect modification by age. The youth group had stronger seasonal effects compared to respondents age 25+. Seasonal effect was highly significant for mean PHQ-9 scores (p = 0.009) and 5+ (p = 0.001), but not for 10+ (p = 0.481). LIMITATIONS Use of cross-sectional data limits the capacity to generalize results to the classic definition of Seasonal Affective Disorder. Data surrounding respondent's anti-depressant use was unavailable. CONCLUSIONS Seasonal variation in depressive symptoms is evident in the Canadian population. Higher levels of symptoms were reported in winter months compared to summer months. The seasonal trend is most pronounced in youth specifically those who reported at least mild depressive symptoms, but not in respondents reporting moderate to severe symptoms.
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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
| | - Asmita Bhattarai
- Department of Community Health Sciences, 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; Cuthbertson & Fischer Chair in Pediatric Mental Health, University of Calgary, Canada.
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Nussbaumer‐Streit B, Greenblatt A, Kaminski‐Hartenthaler A, Van Noord MG, Forneris CA, Morgan LC, Gaynes BN, Wipplinger J, Lux LJ, Winkler D, Gartlehner G. Melatonin and agomelatine for preventing seasonal affective disorder. Cochrane Database Syst Rev 2019; 6:CD011271. [PMID: 31206585 PMCID: PMC6578031 DOI: 10.1002/14651858.cd011271.pub3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Seasonal affective disorder (SAD) is a seasonal pattern of recurrent major depressive episodes that most commonly starts in autumn or winter and remits in spring. The prevalence of SAD depends on latitude and ranges from 1.5% to 9%. The predictable seasonal aspect of SAD provides a promising opportunity for prevention in people who have a history of SAD. This is one of four reviews on the efficacy and safety of interventions to prevent SAD; we focus on agomelatine and melatonin as preventive interventions. OBJECTIVES To assess the efficacy and safety of agomelatine and melatonin (in comparison with each other, placebo, second-generation antidepressants, light therapy, psychological therapy or lifestyle interventions) in preventing SAD and improving person-centred outcomes among adults with a history of SAD. SEARCH METHODS We searched Ovid MEDLINE (1950- ), Embase (1974- ), PsycINFO (1967- ) and the Cochrane Central Register of Controlled Trials (CENTRAL) to 19 June 2018. An earlier search of these databases was conducted via the Cochrane Common Mental Disorders Controlled Trial Register (CCMD-CTR) (all years to 11 August 2015). Furthermore, we searched the Cumulative Index to Nursing and Allied Health Literature, Web of Science, the Cochrane Library, the Allied and Complementary Medicine Database and international trial registers (to 19 June 2018). We also conducted a grey literature search and handsearched the reference lists of included studies and pertinent review articles. SELECTION CRITERIA To examine efficacy, we included randomised controlled trials (RCTs) on adults with a history of winter-type SAD who were free of symptoms at the beginning of the study. For adverse events, we intended also to include non-randomised studies. We planned to include studies that compared agomelatine versus melatonin, or agomelatine or melatonin versus placebo, any second-generation antidepressant, light therapy, psychological therapies or lifestyle changes. We also intended to compare melatonin or agomelatine in combination with any of the comparator interventions mentioned above versus the same comparator intervention as monotherapy. DATA COLLECTION AND ANALYSIS Two review authors screened abstracts and full-text publications, abstracted data and assessed risk of bias of included studies independently. We intended to pool data in a meta-analysis using a random-effects model, but included only one study. MAIN RESULTS We identified 3745 citations through electronic searches and reviews of reference lists after deduplication of search results. We excluded 3619 records during title and abstract review and assessed 126 full-text papers for inclusion in the review. Only one study, providing data of 225 participants, met our eligibility criteria and compared agomelatine (25 mg/day) with placebo. We rated it as having high risk of attrition bias because nearly half of the participants left the study before completion. We rated the certainty of the evidence as very low for all outcomes, because of high risk of bias, indirectness, and imprecision.The main analysis based on data of 199 participants rendered an indeterminate result with wide confidence intervals (CIs) that may encompass both a relevant reduction as well as a relevant increase of SAD incidence by agomelatine (risk ratio (RR) 0.83, 95% CI 0.51 to 1.34; 199 participants; very low-certainty evidence). Also the severity of SAD may be similar in both groups at the end of the study with a mean SIGH-SAD (Structured Interview Guide for the Hamilton Depression Rating Scale, Seasonal Affective Disorders) score of 8.3 (standard deviation (SD) 9.4) in the agomelatine group and 10.1 (SD 10.6) in the placebo group (mean difference (MD) -1.80, 95% CI -4.58 to 0.98; 199 participants; very low-certainty evidence). The incidence of adverse events and serious adverse events may be similar in both groups. In the agomelatine group, 64 out of 112 participants experienced at least one adverse event, while 61 out of 113 did in the placebo group (RR 1.06, 95% CI 0.84 to 1.34; 225 participants; very low-certainty evidence). Three out of 112 patients experienced serious adverse events in the agomelatine group, compared to 4 out of 113 in the placebo group (RR 0.76, 95% CI 0.17 to 3.30; 225 participants; very low-certainty evidence).No data on quality of life or interpersonal functioning were reported. We did not identify any studies on melatonin. AUTHORS' CONCLUSIONS Given the uncertain evidence on agomelatine and the absence of studies on melatonin, no conclusion about efficacy and safety of agomelatine and melatonin for prevention of SAD can currently be drawn. The decision for or against initiating preventive treatment of SAD and the treatment selected should consider patient preferences and reflect on the evidence base of all available treatment options.
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Affiliation(s)
- Barbara Nussbaumer‐Streit
- Danube University KremsCochrane Austria, Department for Evidence‐based Medicine and Clinical EpidemiologyDr.‐Karl‐Dorrek‐Str. 30KremsAustria3500
| | - Amy Greenblatt
- Emory UniversityNell Hodgson Woodruff School of NursingAtlantaGeorgiaUSA
| | - Angela Kaminski‐Hartenthaler
- Danube University KremsDepartment for Evidence‐based Medicine and Clinical EpidemiologyDr.‐Karl‐Dorrek‐Strasse 30KremsAustria3500
| | - Megan G Van Noord
- University of California DavisCarlson Health Sciences LibraryDavisCaliforniaUSA
| | - Catherine A Forneris
- University of North Carolina at Chapel HillDepartment of Psychiatry101 Manning Dr., CB# 7160Chapel HillNorth CarolinaUSA27599‐7160
| | - Laura C Morgan
- IBM Watson Health15 Dartford CTChapel HillNorth CarolinaUSA27517
| | - Bradley N Gaynes
- University of North Carolina at Chapel HillDepartment of Psychiatry101 Manning Dr., CB# 7160Chapel HillNorth CarolinaUSA27599‐7160
| | - Jörg Wipplinger
- Danube University KremsDepartment for Evidence‐based Medicine and Clinical EpidemiologyDr.‐Karl‐Dorrek‐Strasse 30KremsAustria3500
| | - Linda J Lux
- RTI International3040 Cornwallis RoadResearch Triangle ParkNorth CarolinaUSA27709
| | - Dietmar Winkler
- Medical University of ViennaDepartment of Psychiatry and PsychotherapyWaehringer Guertel 18‐20ViennaAustria1090
| | - Gerald Gartlehner
- Danube University KremsCochrane Austria, Department for Evidence‐based Medicine and Clinical EpidemiologyDr.‐Karl‐Dorrek‐Str. 30KremsAustria3500
- RTI International3040 Cornwallis RoadResearch Triangle ParkNorth CarolinaUSA27709
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Forneris CA, Nussbaumer‐Streit B, Morgan LC, Greenblatt A, Van Noord MG, Gaynes BN, Wipplinger J, Lux LJ, Winkler D, Gartlehner G. Psychological therapies for preventing seasonal affective disorder. Cochrane Database Syst Rev 2019; 5:CD011270. [PMID: 31124141 PMCID: PMC6533196 DOI: 10.1002/14651858.cd011270.pub3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND 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. The prevalence of SAD ranges from 1.5% to 9%, depending on latitude. The predictable seasonal aspect of SAD provides a promising opportunity for prevention. This is one of four reviews on the efficacy and safety of interventions to prevent SAD; we focus on psychological therapies as preventive interventions. OBJECTIVES To assess the efficacy and safety of psychological therapies (in comparison with no treatment, other types of psychological therapy, second-generation antidepressants, light therapy, melatonin or agomelatine or lifestyle interventions) in preventing SAD and improving person-centred outcomes among adults with a history of SAD. SEARCH METHODS We searched Ovid MEDLINE (1950- ), Embase (1974- ), PsycINFO (1967- ) and the Cochrane Central Register of Controlled Trials (CENTRAL) to 19 June 2018. An earlier search of these databases was conducted via the Cochrane Common Mental Disorders Controlled Trial Register (CCMD-CTR) (all years to 11 August 2015). Furthermore, we searched the Cumulative Index to Nursing and Allied Health Literature, Web of Science, the Cochrane Library, the Allied and Complementary Medicine Database and international trial registers (to 19 June 2018). We also conducted a grey literature search and handsearched the reference lists of included studies and pertinent review articles. SELECTION CRITERIA To examine efficacy, we included randomised controlled trials (RCTs) on adults with a history of winter-type SAD who were free of symptoms at the beginning of the study. To examine adverse events, we intended to include non-randomised studies. We planned to include studies that compared psychological therapy versus no treatment, or any other type of psychological therapy, light therapy, second-generation antidepressants, melatonin, agomelatine or lifestyle changes. We also planned to compare psychological therapy in combination with any of the comparator interventions listed above versus no treatment or the same comparator intervention as monotherapy. DATA COLLECTION AND ANALYSIS Two review authors screened abstracts and full-text publications against the inclusion criteria, independently extracted data, assessed risk of bias, and graded the certainty of evidence. MAIN RESULTS We identified 3745 citations through electronic searches and reviews of reference lists after deduplication of search results. We excluded 3619 records during title and abstract review and assessed 126 articles at full-text review for eligibility. We included one controlled study enrolling 46 participants. We rated this RCT at high risk for performance and detection bias due to a lack of blinding.The included RCT compared preventive use of mindfulness-based cognitive therapy (MBCT) with treatment as usual (TAU) in participants with a history of SAD. MBCT was administered in spring in eight weekly individual 45- to 60-minute sessions. In the TAU group participants did not receive any preventive treatment but were invited to start light therapy as first depressive symptoms occurred. Both groups were assessed weekly for occurrence of a new depressive episode measured with the Inventory of Depressive Syptomatology-Self-Report (IDS-SR, range 0-90) from September 2011 to mid-April 2012. The incidence of a new depressive episode in the upcoming winter was similar in both groups. In the MBCT group 65% of 23 participants developed depression (IDS-SR ≥ 20), compared to 74% of 23 people in the TAU group (risk ratio (RR) 0.88, 95% confidence interval (CI) 0.60 to 1.30; 46 participants; very low quality-evidence).For participants with depressive episodes, severity of depression was comparable between groups. Participants in the MBCT group had a mean score of 26.5 (SD 7.0) on the IDS-SR, and TAU participants a mean score of 25.3 (SD 6.3) (mean difference (MD) 1.20, 95% CI -3.44 to 5.84; 32 participants; very low quality-evidence).The overall discontinuation rate was similar too, with 17% discontinuing in the MBCT group and 13% in the TAU group (RR 1.33, 95% CI 0.34 to 5.30; 46 participants; very low quality-evidence).Reasons for downgrading the quality of evidence included high risk of bias of the included study and imprecision.Investigators provided no information on adverse events. We could not find any studies that compared psychological therapy with other interventions of interest such as second-generation antidepressants, light therapy, melatonin or agomelatine. AUTHORS' CONCLUSIONS The evidence on psychological therapies to prevent the onset of a new depressive episode in people with a history of SAD is inconclusive. We identified only one study including 46 participants focusing on one type of psychological therapy. Methodological limitations and the small sample size preclude us from drawing a conclusion on benefits and harms of MBCT as a preventive intervention for SAD. Given that there is no comparative evidence for psychological therapy versus other preventive options, the decision for or against initiating preventive treatment of SAD and the treatment selected should be strongly based on patient preferences and other preventive interventions that are supported by evidence.
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Affiliation(s)
- Catherine A Forneris
- University of North Carolina at Chapel HillDepartment of Psychiatry101 Manning Dr., CB# 7160Chapel HillNorth CarolinaUSA27599‐7160
| | - Barbara Nussbaumer‐Streit
- Danube University KremsCochrane Austria, Department for Evidence‐based Medicine and Clinical EpidemiologyDr.‐Karl‐Dorrek‐Str. 30KremsAustria3500
| | - Laura C Morgan
- IBM Watson Health15 Dartford CTChapel HillNorth CarolinaUSA27517
| | - Amy Greenblatt
- Emory UniversityNell Hodgson Woodruff School of NursingAtlantaGeorgiaUSA
| | - Megan G Van Noord
- University of California DavisCarlson Health Sciences LibraryDavisCaliforniaUSA
| | - Bradley N Gaynes
- University of North Carolina at Chapel HillDepartment of Psychiatry101 Manning Dr., CB# 7160Chapel HillNorth CarolinaUSA27599‐7160
| | - Jörg Wipplinger
- Danube University KremsDepartment for Evidence‐based Medicine and Clinical EpidemiologyDr.‐Karl‐Dorrek‐Straße 30KremsAustria3500
| | - Linda J Lux
- RTI International3040 Cornwallis RoadResearch Triangle ParkNorth CarolinaUSA27709
| | - Dietmar Winkler
- Medical University of ViennaDepartment of Psychiatry and PsychotherapyWaehringer Guertel 18‐20ViennaAustria1090
| | - Gerald Gartlehner
- Danube University KremsCochrane Austria, Department for Evidence‐based Medicine and Clinical EpidemiologyDr.‐Karl‐Dorrek‐Str. 30KremsAustria3500
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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.
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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
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Lonstein JS, Linning-Duffy K, Yan L. Low Daytime Light Intensity Disrupts Male Copulatory Behavior, and Upregulates Medial Preoptic Area Steroid Hormone and Dopamine Receptor Expression, in a Diurnal Rodent Model of Seasonal Affective Disorder. Front Behav Neurosci 2019; 13:72. [PMID: 31031606 PMCID: PMC6473160 DOI: 10.3389/fnbeh.2019.00072] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 03/25/2019] [Indexed: 01/11/2023] Open
Abstract
Seasonal affective disorder (SAD) involves a number of psychological and behavioral impairments that emerge during the low daytime light intensity associated with winter, but which remit during the high daytime light intensity associated with summer. One symptom frequently reported by SAD patients is reduced sexual interest and activity, but the endocrine and neural bases of this particular impairment during low daylight intensity is unknown. Using a diurnal laboratory rodent, the Nile grass rat (Arvicanthis niloticus), we determined how chronic housing under a 12:12 h day/night cycle involving dim low-intensity daylight (50 lux) or bright high-intensity daylight (1,000 lux) affects males’ copulatory behavior, reproductive organ weight, and circulating testosterone. We also examined the expression of mRNAs for the aromatase enzyme, estrogen receptor 1 (ESR1), and androgen receptor (AR) in the medial preoptic area (mPOA; brain site involved in the sensory and hormonal control of copulation), and mRNAs for the dopamine (DA) D1 and D2 receptors in both the mPOA and nucleus accumbens (NAC; brain site involved in stimulus salience and motivation to respond to reward). Compared to male grass rats housed in high-intensity daylight, males in low-intensity daylight displayed fewer mounts and intromissions when interacting with females, but the groups did not differ in their testes or seminal vesicle weights, or in their circulating levels of testosterone. Males in low-intensity daylight unexpectedly had higher ESR1, AR and D1 receptor mRNA in the mPOA, but did not differ from high-intensity daylight males in D1 or D2 mRNA expression in the NAC. Reminiscent of humans with SAD, dim winter-like daylight intensity impairs aspects of sexual behavior in a male diurnal rodent. This effect is not due to reduced circulating testosterone and is associated with upregulation of mPOA steroid and DA receptors that may help maintain some sexual motivation and behavior under winter-like lighting conditions.
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Affiliation(s)
- Joseph S Lonstein
- Neuroscience Program & Department of Psychology, Michigan State University, East Lansing, MI, United States
| | - Katrina Linning-Duffy
- Neuroscience Program & Department of Psychology, Michigan State University, East Lansing, MI, United States
| | - Lily Yan
- Neuroscience Program & Department of Psychology, Michigan State University, East Lansing, MI, United States
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Nussbaumer‐Streit B, Forneris CA, Morgan LC, Van Noord MG, Gaynes BN, Greenblatt A, Wipplinger J, Lux LJ, Winkler D, Gartlehner G. Light therapy for preventing seasonal affective disorder. Cochrane Database Syst Rev 2019; 3:CD011269. [PMID: 30883670 PMCID: PMC6422319 DOI: 10.1002/14651858.cd011269.pub3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND 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. The prevalence of SAD ranges from 1.5% to 9%, depending on latitude. The predictable seasonal aspect of SAD provides a promising opportunity for prevention. This review - one of four reviews on efficacy and safety of interventions to prevent SAD - focuses on light therapy as a preventive intervention. Light therapy is a non-pharmacological treatment that exposes people to artificial light. Mode of delivery and form of light vary. OBJECTIVES To assess the efficacy and safety of light therapy (in comparison with no treatment, other types of light therapy, second-generation antidepressants, melatonin, agomelatine, psychological therapies, lifestyle interventions and negative ion generators) in preventing SAD and improving patient-centred outcomes among adults with a history of SAD. SEARCH METHODS We searched Ovid MEDLINE (1950- ), Embase (1974- ), PsycINFO (1967- ) and the Cochrane Central Register of Controlled Trials (CENTRAL) to 19 June 2018. An earlier search of these databases was conducted via the Cochrane Common Mental Disorders Controlled Trial Register (CCMD-CTR) (all years to 11 August 2015). Furthermore, we searched the Cumulative Index to Nursing and Allied Health Literature, Web of Science, the Cochrane Library, the Allied and Complementary Medicine Database and international trial registers (to 19 June 2018). We also conducted a grey literature search and handsearched the reference lists of included studies and pertinent review articles. SELECTION CRITERIA For efficacy, we included randomised controlled trials (RCTs) on adults with a history of winter-type SAD who were free of symptoms at the beginning of the study. For adverse events, we also intended to include non-randomised studies. We intended to include studies that compared any type of light therapy (e.g. bright white light, administered by visors or light boxes, infrared light, dawn stimulation) versus no treatment/placebo, second-generation antidepressants, psychological therapies, melatonin, agomelatine, lifestyle changes, negative ion generators or another of the aforementioned light therapies. We also planned to include studies that looked at light therapy in combination with any comparator intervention. DATA COLLECTION AND ANALYSIS Two review authors screened abstracts and full-text publications, independently abstracted data and assessed risk of bias of included studies. MAIN RESULTS We identified 3745 citations after de-duplication of search results. We excluded 3619 records during title and abstract review. We assessed 126 full-text papers for inclusion in the review, but only one study providing data from 46 people met our eligibility criteria. The included RCT had methodological limitations. We rated it as having high risk of performance and detection bias because of lack of blinding, and as having high risk of attrition bias because study authors did not report reasons for dropouts and did not integrate data from dropouts into the analysis.The included RCT compared preventive use of bright white light (2500 lux via visors), infrared light (0.18 lux via visors) and no light treatment. Overall, white light and infrared light therapy reduced the incidence of SAD numerically compared with no light therapy. In all, 43% (6/14) of participants in the bright light group developed SAD, as well as 33% (5/15) in the infrared light group and 67% (6/9) in the non-treatment group. Bright light therapy reduced the risk of SAD incidence by 36%; however, the 95% confidence interval (CI) was very broad and included both possible effect sizes in favour of bright light therapy and those in favour of no light therapy (risk ratio (RR) 0.64, 95% CI 0.30 to 1.38; 23 participants, very low-quality evidence). Infrared light reduced the risk of SAD by 50% compared with no light therapy, but the CI was also too broad to allow precise estimations of effect size (RR 0.50, 95% CI 0.21 to 1.17; 24 participants, very low-quality evidence). Comparison of both forms of preventive light therapy versus each other yielded similar rates of incidence of depressive episodes in both groups (RR 1.29, 95% CI 0.50 to 3.28; 29 participants, very low-quality evidence). Reasons for downgrading evidence quality included high risk of bias of the included study, imprecision and other limitations, such as self-rating of outcomes, lack of checking of compliance throughout the study duration and insufficient reporting of participant characteristics.Investigators provided no information on adverse events. We could find no studies that compared light therapy versus other interventions of interest such as second-generation antidepressants, psychological therapies, melatonin or agomelatine. AUTHORS' CONCLUSIONS Evidence on light therapy as preventive treatment for people with a history of SAD is limited. Methodological limitations and the small sample size of the only available study have precluded review author conclusions on effects of light therapy for SAD. Given that comparative evidence for light therapy versus other preventive options is limited, the decision for or against initiating preventive treatment of SAD and the treatment selected should be strongly based on patient preferences.
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Affiliation(s)
- Barbara Nussbaumer‐Streit
- Danube University KremsCochrane Austria, Department for Evidence‐based Medicine and Clinical EpidemiologyDr.‐Karl‐Dorrek‐Str. 30KremsAustria3500
| | - Catherine A Forneris
- University of North Carolina at Chapel HillDepartment of Psychiatry101 Manning Dr., CB# 7160Chapel HillNorth CarolinaUSA27599‐7160
| | - Laura C Morgan
- IBM Watson Health15 Dartford CTChapel HillNorth CarolinaUSA27517
| | - Megan G Van Noord
- University of California DavisCarlson Health Sciences LibraryDavisCaliforniaUSA
| | - Bradley N Gaynes
- University of North Carolina at Chapel HillDepartment of Psychiatry101 Manning Dr., CB# 7160Chapel HillNorth CarolinaUSA27599‐7160
| | - Amy Greenblatt
- Emory UniversityNell Hodgson Woodruff School of NursingAtlantaGeorgiaUSA
| | - Jörg Wipplinger
- Danube University KremsDepartment for Evidence‐based Medicine and Clinical EpidemiologyDr.‐Karl‐Dorrek‐Straße 30KremsAustria3500
| | - Linda J Lux
- RTI International3040 Cornwallis RoadResearch Triangle ParkNorth CarolinaUSA27709
| | - Dietmar Winkler
- Medical University of ViennaDepartment of Psychiatry and PsychotherapyWaehringer Guertel 18‐20ViennaAustria1090
| | - Gerald Gartlehner
- Danube University KremsCochrane Austria, Department for Evidence‐based Medicine and Clinical EpidemiologyDr.‐Karl‐Dorrek‐Str. 30KremsAustria3500
- RTI International3040 Cornwallis RoadResearch Triangle ParkNorth CarolinaUSA27709
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Gartlehner G, Nussbaumer‐Streit B, Gaynes BN, Forneris CA, Morgan LC, Greenblatt A, Wipplinger J, Lux LJ, Van Noord MG, Winkler D. Second-generation antidepressants for preventing seasonal affective disorder in adults. Cochrane Database Syst Rev 2019; 3:CD011268. [PMID: 30883669 PMCID: PMC6422318 DOI: 10.1002/14651858.cd011268.pub3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND 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. The prevalence of SAD ranges from 1.5% to 9%, depending on latitude. The predictable seasonal aspect of SAD provides a promising opportunity for prevention. This review - one of four reviews on efficacy and safety of interventions to prevent SAD - focuses on second-generation antidepressants (SGAs). OBJECTIVES To assess the efficacy and safety of SGAs (in comparison with other SGAs, placebo, light therapy, melatonin or agomelatine, psychological therapies or lifestyle interventions) in preventing SAD and improving patient-centred outcomes among adults with a history of SAD. SEARCH METHODS We searched Ovid MEDLINE (1950- ), Embase (1974- ), PsycINFO (1967- ) and the Cochrane Central Register of Controlled Trials (CENTRAL) to 19 June 2018. An earlier search of these databases was conducted via the Cochrane Common Mental Disorders Controlled Trial Register (CCMD-CTR) (all years to 11 August 2015). Furthermore, we searched the Cumulative Index to Nursing and Allied Health Literature, Web of Science, the Cochrane Library, the Allied and Complementary Medicine Database and international trial registers (to 19 June 2018). We also conducted a grey literature search and handsearched the reference lists of included studies and pertinent review articles. SELECTION CRITERIA For efficacy, we included randomised controlled trials (RCTs) on adults with a history of winter-type SAD who were free of symptoms at the beginning of the study. For adverse events, we planned to include non-randomised studies. Eligible studies compared a SGA versus another SGA, placebo, light therapy, psychological therapy, melatonin, agomelatine or lifestyle changes. We also intended to compare SGAs in combination with any of the comparator interventions versus placebo or the same comparator intervention as monotherapy. DATA COLLECTION AND ANALYSIS Two review authors independently screened abstracts and full-text publications, extracted data and assessed risk of bias of included studies. When data were sufficient, we conducted random-effects (Mantel-Haenszel) meta-analyses. We assessed statistical heterogeneity by calculating the Chi2 statistic and the Cochran Q. We used the I2 statistic to estimate the magnitude of heterogeneity. We assessed publication bias by using funnel plots.We rated the strength of the evidence using the system developed by the GRADE Working Group. MAIN RESULTS We identified 3745 citations after de-duplication of search results and excluded 3619 records during title and abstract reviews. We assessed 126 full-text papers for inclusion in the review, of which four publications (on three RCTs) providing data from 1100 people met eligibility criteria for this review. All three RCTs had methodological limitations due to high attrition rates.Overall, moderate-quality evidence indicates that bupropion XL is an efficacious intervention for prevention of recurrence of depressive episodes in people with a history of SAD (risk ratio (RR) 0.56, 95% confidence interval (CI) 0.44 to 0.72; 3 RCTs, 1100 participants). However, bupropion XL leads to greater risk of headaches (moderate-quality evidence), insomnia and nausea (both low-quality evidence) when compared with placebo. Numbers needed to treat for additional beneficial outcomes (NNTBs) vary by baseline risks. For a population with a yearly recurrence rate of 30%, the NNTB is 8 (95% CI 6 to 12). For populations with yearly recurrence rates of 50% and 60%, NNTBs are 5 (95% CI 4 to 7) and 4 (95% CI 3 to 6), respectively.We could find no studies on other SGAs and no studies comparing SGAs with other interventions of interest, such as light therapy, psychological therapies, melatonin or agomelatine. AUTHORS' CONCLUSIONS Available evidence indicates that bupropion XL is an effective intervention for prevention of recurrence of SAD. Nevertheless, even in a high-risk population, three out of four people will not benefit from preventive treatment with bupropion XL and will be at risk for harm. Clinicians need to discuss with patients advantages and disadvantages of preventive SGA treatment, and might want to consider offering other potentially efficacious interventions, which might confer a lower risk of adverse events. Given the lack of comparative evidence, the decision for or against initiating preventive treatment of SAD and the treatment selected should be strongly based on patient preferences.Future researchers need to assess the effectiveness and risk of harms of SGAs other than bupropion for prevention of SAD. Investigators also need to compare benefits and harms of pharmacological and non-pharmacological interventions.
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Affiliation(s)
- Gerald Gartlehner
- Danube University KremsCochrane Austria, Department for Evidence‐based Medicine and Clinical EpidemiologyDr.‐Karl‐Dorrek‐Strasse 30KremsAustria3500
- RTI InternationalResearch Triangle ParkNorth CarolinaUSA
| | - Barbara Nussbaumer‐Streit
- Danube University KremsCochrane Austria, Department for Evidence‐based Medicine and Clinical EpidemiologyDr.‐Karl‐Dorrek‐Strasse 30KremsAustria3500
| | - Bradley N Gaynes
- University of North Carolina at Chapel HillDepartment of PsychiatryCB# 7160Chapel HillNorth CarolinaUSA27599‐7160
| | - Catherine A Forneris
- University of North Carolina at Chapel HillDepartment of PsychiatryCB# 7160Chapel HillNorth CarolinaUSA27599‐7160
| | - Laura C Morgan
- IBM Watson Health15 Dartford CTChapel HillNorth CarolinaUSA27517
| | - Amy Greenblatt
- Emory UniversityNell Hodgson Woodruff School of NursingAtlantaGeorgiaUSA
| | - Jörg Wipplinger
- Danube University KremsDepartment for Evidence‐based Medicine and Clinical EpidemiologyDr.‐Karl‐Dorrek‐Straße 30KremsAustria3500
| | - Linda J Lux
- RTI InternationalResearch Triangle ParkNorth CarolinaUSA
| | - Megan G Van Noord
- University of California DavisCarlson Health Sciences LibraryDavisCaliforniaUSA
| | - Dietmar Winkler
- Medical University of ViennaDepartment of Psychiatry and PsychotherapyWaehringer Guertel 18‐20ViennaAustria1090
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La Morgia C, Carelli V, Carbonelli M. Melanopsin Retinal Ganglion Cells and Pupil: Clinical Implications for Neuro-Ophthalmology. Front Neurol 2018; 9:1047. [PMID: 30581410 PMCID: PMC6292931 DOI: 10.3389/fneur.2018.01047] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Accepted: 11/19/2018] [Indexed: 02/02/2023] Open
Abstract
Melanopsin retinal ganglion cells (mRGCs) are intrinsically photosensitive RGCs that mediate many relevant non-image forming functions of the eye, including the pupillary light reflex, through the projections to the olivary pretectal nucleus. In particular, the post-illumination pupil response (PIPR), as evaluated by chromatic pupillometry, can be used as a reliable marker of mRGC function in vivo. In the last years, pupillometry has become a promising tool to assess mRGC dysfunction in various neurological and neuro-ophthalmological conditions. In this review we will present the most relevant findings of pupillometric studies in glaucoma, hereditary optic neuropathies, ischemic optic neuropathies, idiopathic intracranial hypertension, multiple sclerosis, Parkinson's disease, and mood disorders. The use of PIPR as a marker for mRGC function is also proposed for other neurodegenerative disorders in which circadian dysfunction is documented.
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Affiliation(s)
- Chiara La Morgia
- Unità Operativa Complessa Clinica Neurologica, IRCCS Istituto delle Scienze Neurologiche di Bologna, Ospedale Bellaria, Bologna, Italy.,Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
| | - Valerio Carelli
- Unità Operativa Complessa Clinica Neurologica, IRCCS Istituto delle Scienze Neurologiche di Bologna, Ospedale Bellaria, Bologna, Italy.,Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
| | - Michele Carbonelli
- Unità Operativa Complessa Clinica Neurologica, IRCCS Istituto delle Scienze Neurologiche di Bologna, Ospedale Bellaria, Bologna, Italy
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Nussbaumer-Streit B, Pjrek E, Kien C, Gartlehner G, Bartova L, Friedrich ME, Kasper S, Winkler D. Implementing prevention of seasonal affective disorder from patients' and physicians' perspectives - a qualitative study. BMC Psychiatry 2018; 18:372. [PMID: 30477472 PMCID: PMC6260561 DOI: 10.1186/s12888-018-1951-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 11/09/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Seasonal affective disorder (SAD) is a seasonally recurrent type of major depression that has detrimental effects on patients' lives during winter. Little is known about how it affects patients during summer and about patients' and physicians' perspectives on preventive SAD treatment. The aim of our study was to explore how SAD patients experience summers, what type of preventive treatment patients implement, which preventive treatment methods, if any, physicians recommend, and what factors facilitate or hinder implementation/recommendation of SAD prevention. METHODS We conducted 15 semi-structured interviews, ten with adult patients with a history of SAD and five with physicians. Transcripts were analyzed by two researchers using an inductive thematic analysis approach. RESULTS One group of patients was able to enjoy summer and ignore thoughts of the upcoming winter. The other group feared the impending depressive episode in winter, and this fear negatively impacted these patients' well-being during the summer. Preventive treatment was a relevant issue for all patients, and all but one person implemented SAD prevention during summer. We identified six factors that influenced patient use of preventive treatment of SAD. Four factors occur on an individual level (knowledge about disease and preventive treatment options, experience with treatment in acute phase, acceptability of intervention, willingness to take responsibility for oneself), one on an interpersonal level (social and work environment), and one on a structural level (healthcare system). All psychiatrists recommended some kind of preventive intervention, most commonly, lifestyle changes. Four factors influenced psychiatrists in recommending prevention of SAD (patient expectations, disease history and stability, risk/benefit ratio, lack of evidence). CONCLUSIONS Success in the implementation of SAD prevention does not solely depend on the willingness of the patients, but is also influenced by external factors. Raising awareness of SAD among general practitioners and low-level access to mental-health support could help patients find appropriate help sooner. To better guide the optimal treatment choice, comparative effectiveness research on treatments to prevent a new onset in patients with a history of SAD and clinical practice guidelines on SAD are needed.
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Affiliation(s)
- Barbara Nussbaumer-Streit
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
- Department for Evidence-based Medicine and Clinical Epidemiology, Danube-University Krems, Dr.-Karl-Dorrek Strasse 30, 3500 Krems a.d, Donau, Austria
| | - Edda Pjrek
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Christina Kien
- Department for Evidence-based Medicine and Clinical Epidemiology, Danube-University Krems, Dr.-Karl-Dorrek Strasse 30, 3500 Krems a.d, Donau, Austria
| | - Gerald Gartlehner
- Department for Evidence-based Medicine and Clinical Epidemiology, Danube-University Krems, Dr.-Karl-Dorrek Strasse 30, 3500 Krems a.d, Donau, Austria
- RTI International, 3400 Cornwallis Rd, Research Triangle Park, NC USA
| | - Lucie Bartova
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Michaela-Elena Friedrich
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Siegfried Kasper
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Dietmar Winkler
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
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Mc Mahon B, Nørgaard M, Svarer C, Andersen SB, Madsen MK, Baaré WFC, Madsen J, Frokjaer VG, Knudsen GM. Seasonality-resilient individuals downregulate their cerebral 5-HT transporter binding in winter - A longitudinal combined 11C-DASB and 11C-SB207145 PET study. Eur Neuropsychopharmacol 2018; 28:1151-1160. [PMID: 30077433 DOI: 10.1016/j.euroneuro.2018.06.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 05/17/2018] [Accepted: 06/25/2018] [Indexed: 12/18/2022]
Abstract
We have recently shown that the emergence and severity of seasonal affective disorder (SAD) symptoms in the winter is associated with an increase in cerebral serotonin (5-HT) transporter (SERT) binding. Intriguingly, we also found that individuals resilient to SAD downregulate their cerebral SERT binding in the winter. In the present paper, we provide an analysis of the SERT- and 5-HT dynamics as indexed by 5-HT4 receptor (5-HT4R) binding related to successful stress coping. We included 46 11C-DASB positron emission tomography (PET) scans (N = 23, 13 women, age: 26 ± 6 years) and 14 11C-SB207145 PET scans (7 participants, 3 women, age: 25 ± 3 years) from 23 SAD-resilient Danes. Data was collected longitudinally in summer and winter. We found that compared to the summer, raphe nuclei and global brain SERT binding decreased significantly in the winter (praphe = 0.003 and pglobal = 0.003) and the two measures were positively correlated across seasons (summer: R2 = 0.33, p = .004, winter: R2 = 0.24, p = .018). A voxel-based analysis revealed prominent changes in SERT in clusters covering both angular gyri (0.0005 < pcorrected < 0.0016), prefrontal cortices (0.00087 < pcorrected < 0.0039) and the posterior temporal and adjacent occipital cortices (0.0001 < pcorrected < 0.0066). We did not observe changes in 5-HT4R binding, suggesting that 5-HT levels remained stable across seasons. We conclude that resilience to SAD is associated with a global downregulation of SERT levels in winter which serves to keep 5-HT levels across seasons.
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Affiliation(s)
- Brenda Mc Mahon
- Neurobiology Research Unit, Rigshospitalet and Center for Integrated Molecular Brain Imaging, Section 6931, Blegdamsvej 9, 2100 Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
| | - Martin Nørgaard
- Neurobiology Research Unit, Rigshospitalet and Center for Integrated Molecular Brain Imaging, Section 6931, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Claus Svarer
- Neurobiology Research Unit, Rigshospitalet and Center for Integrated Molecular Brain Imaging, Section 6931, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Sofie B Andersen
- Neurobiology Research Unit, Rigshospitalet and Center for Integrated Molecular Brain Imaging, Section 6931, Blegdamsvej 9, 2100 Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Martin K Madsen
- Neurobiology Research Unit, Rigshospitalet and Center for Integrated Molecular Brain Imaging, Section 6931, Blegdamsvej 9, 2100 Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - William F C Baaré
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Kettegårds Allé 30, 2650 Hvidovre, Denmark
| | - Jacob Madsen
- PET and Cyclotron Unit, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Vibe G Frokjaer
- Neurobiology Research Unit, Rigshospitalet and Center for Integrated Molecular Brain Imaging, Section 6931, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Gitte M Knudsen
- Neurobiology Research Unit, Rigshospitalet and Center for Integrated Molecular Brain Imaging, Section 6931, Blegdamsvej 9, 2100 Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
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Thompson LK, Sugg MM, Runkle JR. Adolescents in crisis: A geographic exploration of help-seeking behavior using data from Crisis Text Line. Soc Sci Med 2018; 215:69-79. [PMID: 30216891 DOI: 10.1016/j.socscimed.2018.08.025] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 07/22/2018] [Accepted: 08/22/2018] [Indexed: 12/19/2022]
Abstract
Nearly 3 out of 4 all lifelong mental disorders occur by the age of twenty-four. Remote crisis support holds great potential in filling a critical gap in complementing and expanding access to mental health services for acute episodes of mental distress in adolescents and young adults; yet little is understood about the individual factors that influence help-seeking behavior in this group. Recent evidence suggests technology-based mental health services have high acceptability among youth and may be used to treat anxiety and depression. The objective of this study was to examine county-level help-seeking behavior among adolescents and young adults using Crisis Text Line (CTL). CTL is a free, text-based crisis counseling service that has been available nationally since 2013. Spatial error regression was used to (1) identify the individual-level factors that correlate with help-seeking behavior for depression, anxiety, and suicidal thoughts and (2) to explore the geographic trends in text-based help-seeking behavior between adolescents and young adults across the rural-urban continuum. Increased rates of text-based help-seeking occurred in counties with higher mean household incomes, higher divorce rates, and lower residential stability. Rurality was the strongest predictor for low rates of help-seeking, and this finding is particularly concerning in light of elevated rates of suicide among rural counties. Rural communities, particularly those with low support-seeking behavior and comparatively high suicide rates, should be the target of future research and outreach.
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Affiliation(s)
- Laura K Thompson
- Department of Geography and Planning, Appalachian State University, P.O. Box 32066, Boone, NC, 28608, United States.
| | - Margaret M Sugg
- Department of Geography and Planning, Appalachian State University, P.O. Box 32066, Boone, NC, 28608, United States.
| | - Jennifer R Runkle
- North Carolina Institute for Climate Studies, North Carolina State University, 151 Patton Avenue, Asheville, NC, 28801, United States.
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36
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Sarris J. Herbal medicines in the treatment of psychiatric disorders: 10-year updated review. Phytother Res 2018; 32:1147-1162. [DOI: 10.1002/ptr.6055] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Revised: 01/18/2018] [Accepted: 01/19/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Jerome Sarris
- NICM Health Research Institute, School of Science and Health; Western Sydney University; Westmead NSW Australia
- Department of Psychiatry, The Melbourne Clinic, Professorial Unit, ARCADIA Research Group; The University of Melbourne; Melbourne VIC Australia
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Borgsted C, Ozenne B, Mc Mahon B, Madsen MK, Hjordt LV, Hageman I, Baaré WFC, Knudsen GM, Fisher PM. Amygdala response to emotional faces in seasonal affective disorder. J Affect Disord 2018; 229:288-295. [PMID: 29329062 DOI: 10.1016/j.jad.2017.12.097] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 11/29/2017] [Accepted: 12/31/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Seasonal affective disorder (SAD) is characterized by seasonally recurring depression. Heightened amygdala activation to aversive stimuli is associated with major depressive disorder but its relation to SAD is unclear. We evaluated seasonal variation in amygdala activation in SAD and healthy controls (HC) using a longitudinal design targeting the asymptomatic/symptomatic phases of SAD. We hypothesized increased amygdala activation to aversive stimuli in the winter in SAD individuals (season-by-group interaction). METHODS Seventeen SAD individuals and 15 HCs completed an implicit emotional faces BOLD-fMRI paradigm during summer and winter. We computed amygdala activation (SPM5) to an aversive contrast (angry & fearful minus neutral) and angry, fearful and neutral faces, separately. Season-by-group and main effects were evaluated using Generalized Least Squares. In SAD individuals, we correlated change in symptom severity, assessed with The Hamilton Rating Scale for Depression - Seasonal Affective Disorder version (SIGH-SAD), with change in amygdala activation. RESULTS We found no season-by-group, season or group effect on our aversive contrast. Independent of season, SAD individuals showed significantly lower amygdala activation to all faces compared to healthy controls, with no evidence for a season-by-group interaction. Seasonal change in amygdala activation was unrelated to change in SIGH-SAD. LIMITATIONS Small sample size, lack of positive valence stimuli. CONCLUSIONS Amygdala activation to aversive faces is not increased in symptomatic SAD individuals. Instead, we observed decreased amygdala activation across faces, independent of season. Our findings suggest that amygdala activation to angry, fearful and neutral faces is altered in SAD individuals, independent of the presence of depressive symptoms.
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Affiliation(s)
- Camilla Borgsted
- Neurobiology Research Unit, Rigshospitalet and Center for Integrated Molecular Brain Imaging, Section 6931, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Brice Ozenne
- Neurobiology Research Unit, Rigshospitalet and Center for Integrated Molecular Brain Imaging, Section 6931, Blegdamsvej 9, 2100 Copenhagen, Denmark; Department of Biostatistics, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen, Denmark
| | - Brenda Mc Mahon
- Neurobiology Research Unit, Rigshospitalet and Center for Integrated Molecular Brain Imaging, Section 6931, Blegdamsvej 9, 2100 Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Martin K Madsen
- Neurobiology Research Unit, Rigshospitalet and Center for Integrated Molecular Brain Imaging, Section 6931, Blegdamsvej 9, 2100 Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Liv V Hjordt
- Neurobiology Research Unit, Rigshospitalet and Center for Integrated Molecular Brain Imaging, Section 6931, Blegdamsvej 9, 2100 Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Ida Hageman
- Psychiatric Centre Copenhagen, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - William F C Baaré
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Kettegård Allé 30, 2650 Hvidovre, Denmark
| | - Gitte M Knudsen
- Neurobiology Research Unit, Rigshospitalet and Center for Integrated Molecular Brain Imaging, Section 6931, Blegdamsvej 9, 2100 Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Patrick M Fisher
- Neurobiology Research Unit, Rigshospitalet and Center for Integrated Molecular Brain Imaging, Section 6931, Blegdamsvej 9, 2100 Copenhagen, Denmark.
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Berman G, Muttuvelu D, Berman D, Larsen JI, Licht RW, Ledolter J, Kardon RH. Decreased retinal sensitivity in depressive disorder: a controlled study. Acta Psychiatr Scand 2018; 137:231-240. [PMID: 29336011 DOI: 10.1111/acps.12851] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/18/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare pupil responses in depressed patients with a seasonal pattern, depressed patients without a seasonal pattern and healthy controls as a function of daylight hours on the testing day. METHOD Patients suffering from a major depressive episode were included in wintertime. The pupil light reflex was measured at inclusion and in the following summer using a binocular pupillometer. A protocol of low (1 lux) and high (400 lux) intensity red and blue lights was used to assess rod, cone and melanopsin-containing intrinsic photosensitive retinal ganglion cell input to the pupil reflex. RESULTS The mean group pupil responses associated with a melanopsin-mediated sustained pupil response at 400 lux blue light were significantly reduced in the depressed subjects (N = 39) as compared to the healthy controls (N = 24) (P = 0.023). Across all groups, a reduction in number of daylight hours was significantly associated with a reduction in sustained pupil response (P = 0.007). All groups showed an equal effect of daylight hours on the melanopsin-mediated sustained pupil response. CONCLUSION The melanopsin-mediated sustained pupil contraction to offset of high-intensity blue light is reduced in depressed patients. These results further emphasize the interaction of light exposure with depression.
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Affiliation(s)
- G Berman
- Department of Ophthalmology, Aalborg University Hospital, Aalborg, Denmark
| | - D Muttuvelu
- Department of Ophthalmology, Aalborg University Hospital, Aalborg, Denmark
| | - D Berman
- Department of Ophthalmology, Aalborg University Hospital, Aalborg, Denmark
| | - J I Larsen
- Unit for Psychiatric Research, Aalborg University Hospital, Psychiatry, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - R W Licht
- Unit for Psychiatric Research, Aalborg University Hospital, Psychiatry, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - J Ledolter
- Department of Veterans Affairs Hospital, Iowa City Veterans Affairs Center for Prevention of Visual Loss, Iowa City, IA, USA
| | - R H Kardon
- Department of Veterans Affairs Hospital, Iowa City Veterans Affairs Center for Prevention of Visual Loss, Iowa City, IA, USA.,Department of Ophthalmology and Visual Science, University of Iowa Hospitals and Clinics and Veterans Administration Hospitals, Iowa City, IA, USA
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Basnet S, Merikanto I, Lahti T, Männistö S, Laatikainen T, Vartiainen E, Partonen T. Seasonality, morningness-eveningness, and sleep in common non - communicable medical conditions and chronic diseases in a population. Sleep Sci 2018; 11:85-91. [PMID: 30083295 PMCID: PMC6056070 DOI: 10.5935/1984-0063.20180017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 03/25/2018] [Indexed: 01/08/2023] Open
Abstract
The seasonal pattern for mood and behaviour, the behavioural trait of morningness-eveningness, and sleep are interconnected features, that may serve as etiological factors in the development or exacerbation of medical conditions. Methods: The study was based on a random sample of inhabitants aged 25 to 74 years living in Finland. As part of the national FINRISK 2012 study participants were invited (n=9905) and asked whether the doctor had diagnosed or treated them during the past 12 months for chronic diseases. Results: A total of 6424 participants filled in the first set of questionnaires and 5826 attended the physical health status examination, after which the second set of questionnaires were filled. Regression models were built in which each condition was explained by the seasonal, diurnal and sleep features, after controlling for a range of background factors. Of the chronic diseases, depressive disorder was associated with longer total sleep duration (p<.0001) and poor sleep quality (p<.0001). Of the measurements for health status assessment, none associated with sleep features, but systolic blood pressure yielded significant (p<.0001) associations with both seasonal and diurnal features at large. Conclusion: Sleep quality was the most sensitive probe in yielding associations with chronic diseases in this population-based study. The seasonal variations in mood and social activity, and the ease in getting up and tiredness in the morning were the most sensitive probes in yielding associations with blood pressure and waist circumference. Assessment of sleep quality, seasonal and diurnal features provides thus added value for health surveys of the general population.
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Affiliation(s)
- Syaron Basnet
- National Institute for Health and Welfare (THL), Department of
Public Health Solutions - Helsinki - Finlândia
- University of Helsinki, Department of Public Health, - Helsinki -
Finland
| | - Ilona Merikanto
- National Institute for Health and Welfare (THL), Department of
Public Health Solutions - Helsinki - Finlândia
- University of Helsinki, Department of Psychology, - Helsinki -
Finland
| | - Tuuli Lahti
- National Institute for Health and Welfare (THL), Department of
Public Health Solutions - Helsinki - Finlândia
- University of Helsinki, Department of Psychology, - Helsinki -
Finland
| | - Satu Männistö
- National Institute for Health and Welfare (THL), Department of
Public Health Solutions - Helsinki - Finlândia
| | - Tiina Laatikainen
- National Institute for Health and Welfare (THL), Department of
Public Health Solutions - Helsinki - Finlândia
- University of Eastern Finland,, Institute of Public Health and
Clinical Nutrition, - Kuopio - Finland
- Hospital District of North Karelia, - Joensuu - Finland
| | - Erkki Vartiainen
- National Institute for Health and Welfare (THL), Department of
Public Health Solutions - Helsinki - Finlândia
| | - Timo Partonen
- National Institute for Health and Welfare (THL), Department of
Public Health Solutions - Helsinki - Finlândia
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Tan O, Metin B, Ünsalver BÖ, Sayar GH. Seasonal mood changes in patients with obsessive-compulsive disorder. Psychiatry Res 2017; 258:166-170. [PMID: 27979316 DOI: 10.1016/j.psychres.2016.04.088] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 12/29/2015] [Accepted: 04/25/2016] [Indexed: 11/24/2022]
Abstract
Obsessive-compulsive disorder (OCD) is frequently associated with mood disorders. However, to date, the co-occurrence of OCD with seasonal affective disorder (SAD) has not been investigated. We have aimed to estimate the prevalence of seasonal mood changes in patients with OCD and explore the contribution of seasonality in mood to the severity of OCD. The Seasonal Pattern Assessment Questionnaire (SPAQ), the Yale-Brown Obsession and Compulsion Scale (Y-BOCS), the Hamilton Depression Rating Scale-17 Items (HDRS-17), and the Beck Anxiety Inventory (BAI) were administered to patients with OCD (n=104) and controls (n=125). The degree of seasonality was measured by the Global Seasonality Score (GSS) calculated from the SPAQ. SAD and subsyndromal seasonal affective disorder (S-SAD) were significantly more prevalent in patients with OCD (53%, n=55) than controls (25%, n=31). When patients were assessed in the season in which SAD occurs, depression and compulsions (but not obsessions, OCD or anxiety) were more severe than those assessed in a season during which SAD does not occur. SAD frequently co-occurs with OCD and, given this co-occurrence, depression symptoms in some patients with OCD might be expected to vary on a seasonal basis.
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Affiliation(s)
- Oğuz Tan
- Department of Psychiatry, Uskudar University, Istanbul, Turkey.
| | - Barış Metin
- Department of Psychology and Neurology, Uskudar University, Istanbul, Turkey
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Nussbaumer-Streit B, Winkler D, Spies M, Kasper S, Pjrek E. Prevention of seasonal affective disorder in daily clinical practice: results of a survey in German-speaking countries. BMC Psychiatry 2017; 17:247. [PMID: 28693583 PMCID: PMC5504611 DOI: 10.1186/s12888-017-1403-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 06/27/2017] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Seasonal affective disorder (SAD) is a seasonally recurrent type of major depression. This predictable aspect makes it promising for preventive treatment. However, evidence for the efficacy and harm of preventive treatment of SAD is scarce, as are recommendations from clinical practice guidelines. The aim of this study was to assess the current use of preventive treatment of SAD in clinical practice in German-speaking countries for the first time. METHODS We conducted a postal and web-based survey sent to the heads of all psychiatric institutions listed in the inventory "Deutsches Krankenhaus Adressbuch, 2015" that contains all psychiatric hospitals in Germany, Austria, and Switzerland. RESULTS One hundred institutions (out of 533 institutions, 19%), which treated in total more than 3100 SAD patients in the years 2014/2015, responded. Of those, 81 reported recommending preventive treatment to patients with a history of SAD. There was no consensus on the optimal starting point for preventive treatment. Most of the institutions that implemented prevention of SAD, recommended lifestyle changes (85%), antidepressants (84%), psychotherapy (73%), and light therapy (72%) to their patients. The situation was similar in northern and southern regions. CONCLUSIONS Most hospitals recommended the use of preventive treatment to SAD patients, although evidence on efficacy and harm is limited. A wide variety of interventions were recommended, although guidelines only include recommendations for acute treatment. To assist psychiatrists and patients in future decision making, controlled studies on preventive treatment for SAD that compare different interventions with one another are needed.
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Affiliation(s)
- B. Nussbaumer-Streit
- 0000 0000 9259 8492grid.22937.3dDepartment of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18–20, 1090 Vienna, Austria ,0000 0001 2108 5830grid.15462.34Department for Evidence-based Medicine and Clinical Epidemiology, Danube-University Krems, Dr.-Karl-Dorrek Strasse 30, 3500, Krems a.d. Donau, Austria
| | - D. Winkler
- 0000 0000 9259 8492grid.22937.3dDepartment of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18–20, 1090 Vienna, Austria
| | - M. Spies
- 0000 0000 9259 8492grid.22937.3dDepartment of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18–20, 1090 Vienna, Austria
| | - S. Kasper
- 0000 0000 9259 8492grid.22937.3dDepartment of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18–20, 1090 Vienna, Austria
| | - E. Pjrek
- 0000 0000 9259 8492grid.22937.3dDepartment of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18–20, 1090 Vienna, Austria
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Geoffroy PA, Godin O, Mahee D, Henry C, Aubin V, Azorin JM, Bougerol T, Courtet P, Gard S, Kahn JP, Passerieux C, Leboyer M, Bellivier F, Etain B. Seasonal pattern in bipolar disorders and cardio-vascular risk factors: A study from the FACE-BD cohort. Chronobiol Int 2017; 34:845-854. [PMID: 28537802 DOI: 10.1080/07420528.2017.1324472] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Seasonal pattern (SP) and metabolic syndrome (MetS) are major contributors to poor outcome in bipolar disorders (BD). Patients with seasonal bipolar depression present increased appetite, carbohydrate cravings, weight gain, and hypersomnia, which can increase the development of MetS. MetS also appears to be associated with seasonal mood changes in the general population. This study examines whether a SP in BD is associated with an increased risk of MetS and its sub-components. One thousand four hundred and seventy-one outpatients with BD were systematically enrolled from 2009 to 2016. Inclusion required a disease duration of at least 5 years, with 486 (33%) patients with SP (SP+) and 985 (67%) without (SP-) according to the DSM IV-TR criteria. When using continuous measures of metabolic components, SP+ patients, as compared to SP-, suffered from higher levels for systolic blood pressure (p = 0.01), low-density lipoprotein cholesterol (p = 0.009), fasting glucose (p = 0.007), triglycerides levels (p = 0.03), a larger abdominal circumference (p = 0.02), and a higher body mass index (p = 0.07). In the covariance analysis, adjusted for gender, age, and bipolar subtype, as well as the number of depressive and hypomanic episode, SP+ patients had a significantly higher level of fasting glucose and higher systolic blood pressure. The frequency of MetS did not differ between groups (21.2% in SP- versus 23.9% in SP+). When using categorical definitions for abnormal metabolic components (International Diabetes Federation criteria), there were no differences between groups, except that SP+ patients were more overweight/obese as compared to SP- patients (55.03% versus 46.7%, respectively; p = 0.002) and tended to have more frequently high fasting glucose (18.2% versus 14.3%, respectively; p = 0.07). MetS was frequent in patients with BD, however not associated with SP. Patients with SP appeared more vulnerable to overweight/obesity and presented with higher levels of MetS subcomponents although these parameters were mainly in the normal range. All patients with BD should benefit from early screening and targeted management of cardio-vascular risk factors.
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Affiliation(s)
- Pierre A Geoffroy
- a AP-HP, GH Saint-Louis - Lariboisière - F. Widal, Département de Psychiatrie et de Médecine Addictologique , Paris , France.,b Université Paris Diderot , Sorbonne Paris Cité , Paris , France.,c Inserm, U1144 , Paris , France.,d Fondation FondaMental , Créteil , France
| | - Ophelia Godin
- d Fondation FondaMental , Créteil , France.,e Inserm, U955, Equipe Psychiatrie Translationnelle , Créteil , France.,f Sorbonne Universités, Université Pierre et Marie Curie, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136) , Paris , France.,g INSERM, UMR_S 1136 , F-75013 Paris , France
| | - Diane Mahee
- a AP-HP, GH Saint-Louis - Lariboisière - F. Widal, Département de Psychiatrie et de Médecine Addictologique , Paris , France
| | - Chantal Henry
- d Fondation FondaMental , Créteil , France.,e Inserm, U955, Equipe Psychiatrie Translationnelle , Créteil , France.,h Université Paris Est, Faculté de Médecine , Créteil , France.,j Institut Pasteur, Unité Perception et Mémoire , Paris , France
| | - Valérie Aubin
- d Fondation FondaMental , Créteil , France.,k Service de psychiatrie, Centre hospitalier Princesse-Grace , Avenue Pasteur , Monaco
| | - Jean-Michel Azorin
- d Fondation FondaMental , Créteil , France.,l Pôle de psychiatrie, Hôpital Sainte Marguerite, Assistance Publique Hôpitaux de Marseille, France; Aix-Marseille Université, CNRS , CRN2M UMR 7286 , Marseille , France
| | - Thierry Bougerol
- d Fondation FondaMental , Créteil , France.,m Clinique Universitaire de Psychiatrie, CHU de Grenoble , Grenoble , France
| | - Philippe Courtet
- d Fondation FondaMental , Créteil , France.,n Département d'Urgence et Post Urgence Psychiatrique , CHRU Montpellier, INSERM U1061, Université Montpellier 1 , Montpellier , France
| | - Sébastien Gard
- d Fondation FondaMental , Créteil , France.,o Centre Expert Trouble Bipolaire, Pôle de Psychiatrie Générale Universitaire, Centre Hospitalier Charles Perrens , Bordeaux , France
| | - Jean-Pierre Kahn
- d Fondation FondaMental , Créteil , France.,p Université de Lorraine, CHRU de Nancy et Pôle 6 de Psychiatrie et Psychologie Clinique - Centre Psychothérapique de Nancy , 1 rue du Docteur Archambault, Laxou Cedex , France
| | - Christine Passerieux
- d Fondation FondaMental , Créteil , France.,q Université de Versailles Saint-Quentin, Centre Hospitalier de Versailles, Service de Psychiatrie Adulte , Le Chesnay , France
| | - Marion Leboyer
- d Fondation FondaMental , Créteil , France.,e Inserm, U955, Equipe Psychiatrie Translationnelle , Créteil , France.,h Université Paris Est, Faculté de Médecine , Créteil , France.,i AP-HP, Hôpitaux Universitaires Henri Mondor, DHU Pepsy, Pôle de Psychiatrie et d'Addictologie , Créteil , France
| | - Frank Bellivier
- a AP-HP, GH Saint-Louis - Lariboisière - F. Widal, Département de Psychiatrie et de Médecine Addictologique , Paris , France.,b Université Paris Diderot , Sorbonne Paris Cité , Paris , France.,c Inserm, U1144 , Paris , France.,d Fondation FondaMental , Créteil , France
| | - Bruno Etain
- a AP-HP, GH Saint-Louis - Lariboisière - F. Widal, Département de Psychiatrie et de Médecine Addictologique , Paris , France.,b Université Paris Diderot , Sorbonne Paris Cité , Paris , France.,c Inserm, U1144 , Paris , France.,d Fondation FondaMental , Créteil , France
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Pereira JC, Pradella Hallinan M, Alves RC. Secondary to excessive melatonin synthesis, the consumption of tryptophan from outside the blood-brain barrier and melatonin over-signaling in the pars tuberalis may be central to the pathophysiology of winter depression. Med Hypotheses 2017; 98:69-75. [DOI: 10.1016/j.mehy.2016.11.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 11/27/2016] [Indexed: 12/17/2022]
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Armbruster D, Brocke B, Strobel A. Winter is coming: Seasonality and the acoustic startle reflex. Physiol Behav 2016; 169:178-183. [PMID: 27940142 DOI: 10.1016/j.physbeh.2016.11.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 11/28/2016] [Accepted: 11/28/2016] [Indexed: 11/16/2022]
Abstract
Circannual rhythms and seasonality have long been in the interest of research. In humans, seasonal changes in mood have been extensively investigated since a substantial part of the population experiences worsening of mood during winter. Questions remain regarding accompanying physiological phenomena. We report seasonal effects on the acoustic startle response in a cross-sectional (n=124) and a longitudinal sample (n=23). Startle magnitudes were larger in winter (sample 1: p=0.026; sample 2: p=0.010) compared to summer months. Although the findings need to be replicated they may have implications regarding the timing of startle experiments.
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Affiliation(s)
- Diana Armbruster
- Personality and Individual Differences, Institute of Psychology I, Technische Universität Dresden, Dresden, Germany.
| | - Burkhard Brocke
- Personality and Individual Differences, Institute of Psychology I, Technische Universität Dresden, Dresden, Germany
| | - Alexander Strobel
- Personality and Individual Differences, Institute of Psychology I, Technische Universität Dresden, Dresden, Germany
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Abstract
OBJECTIVE We evaluated whether the association between Adult Attention-Deficit/Hyperactivity Disorder (ADHD) and Seasonal Affective Disorder (SAD) was mediated by the circadian rhythm. METHOD Data of 2239 persons from the Netherlands Study of Depression and Anxiety (NESDA) were used. Two groups were compared: with clinically significant ADHD symptoms (N = 175) and with No ADHD symptoms (N = 2064). Sleep parameters were sleep-onset and offset times, mid sleep and sleep duration from the Munich Chronotype Questionnaire. We identified the prevalence of probable SAD and subsyndromal SAD using the Seasonal Pattern Assessment Questionnaire (SPAQ). Clinically significant ADHD symptoms were identified by using a T score>65 on the Conners Adult ADHD Rating Scale. RESULTS The prevalence of probable SAD was estimated at 9.9% in the ADHD group (vs. 3.3% in the No ADHD group) and of probable s-SAD at 12.5% in the ADHD group (vs 4.6% in the No ADHD group). Regression analyses showed consistently significant associations between ADHD symptoms and probable SAD, even after adjustment for current depression and anxiety, age, sex, education, use of antidepressants and benzodiazepines (B = 1.81, p < 0.001). Late self-reported sleep onset was an important mediator in the significant relationship between ADHD symptoms and probable SAD, even after correction for confounders (total model effects: B = 0.14, p ≤ 0.001). CONCLUSION Both seasonal and circadian rhythm disturbances are significantly associated with ADHD symptoms. Delayed sleep onset time in ADHD may explain the increase in SAD symptoms. Treating patients with SAD for possible ADHD and delayed sleep onset time may reduce symptom severity in these complex patients.
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46
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Macoveanu J, Fisher PM, Madsen MK, Mc Mahon B, Knudsen GM, Siebner HR. Bright-light intervention induces a dose-dependent increase in striatal response to risk in healthy volunteers. Neuroimage 2016; 139:37-43. [PMID: 27318214 DOI: 10.1016/j.neuroimage.2016.06.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 06/13/2016] [Accepted: 06/14/2016] [Indexed: 02/01/2023] Open
Abstract
Bright-light interventions have successfully been used to reduce depression symptoms in patients with seasonal affective disorder, a depressive disorder most frequently occurring during seasons with reduced daylight availability. Yet, little is known about how light exposure impacts human brain function, for instance on risk taking, a process affected in depressive disorders. Here we examined the modulatory effects of bright-light exposure on brain activity during a risk-taking task. Thirty-two healthy male volunteers living in the greater Copenhagen area received 3weeks of bright-light intervention during the winter season. Adopting a double-blinded dose-response design, bright-light was applied for 30minutes continuously every morning. The individual dose varied between 100 and 11.000lx. Whole-brain functional MRI was performed before and after bright-light intervention to probe how the intervention modifies risk-taking related neural activity during a two-choice gambling task. We also assessed whether inter-individual differences in the serotonin transporter-linked polymorphic region (5-HTTLPR) genotype influenced the effects of bright-light intervention on risk processing. Bright-light intervention led to a dose-dependent increase in risk-taking in the LA/LA group relative to the non-LA/LA group. Further, bright-light intervention enhanced risk-related activity in ventral striatum and head of caudate nucleus in proportion with the individual bright-light dose. The augmentation effect of light exposure on striatal risk processing was not influenced by the 5-HTTLPR-genotype. This study provides novel evidence that in healthy non-depressive individuals bright-light intervention increases striatal processing to risk in a dose-dependent fashion. The findings provide converging evidence that risk processing is sensitive to bright-light exposure during winter.
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Affiliation(s)
- Julian Macoveanu
- Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital, Hvidovre, Denmark; Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Psychiatric Center Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
| | - Patrick M Fisher
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Martin K Madsen
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Brenda Mc Mahon
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Psychiatric Center Copenhagen, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Gitte M Knudsen
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Hartwig R Siebner
- Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital, Hvidovre, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
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Sandman N, Merikanto I, Määttänen H, Valli K, Kronholm E, Laatikainen T, Partonen T, Paunio T. Winter is coming: nightmares and sleep problems during seasonal affective disorder. J Sleep Res 2016; 25:612-619. [PMID: 27174375 DOI: 10.1111/jsr.12416] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 03/21/2016] [Indexed: 12/18/2022]
Abstract
Sleep problems, especially nightmares and insomnia, often accompany depression. This study investigated how nightmares, symptoms of insomnia, chronotype and sleep duration associate with seasonal affective disorder, a special form of depression. Additionally, it was noted how latitude, a proxy for photoperiod, and characteristics of the place of residence affect the prevalence of seasonal affective disorder and sleep problems. To study these questions, data from FINRISK 2012 study were used. FINRISK 2012 consists of a random population sample of Finnish adults aged 25-74 years (n = 4905) collected during winter from Finnish urban and rural areas spanning the latitudes of 60°N to 66°N. The Seasonal Pattern Assessment Questionnaire was used to assess symptoms of seasonal affective disorder. Participants with symptoms of seasonal affective disorder had significantly increased odds of experiencing frequent nightmares and symptoms of insomnia, and they were more often evening chronotypes. Associations between latitude, population size and urbanicity with seasonal affective disorder symptoms and sleep disturbances were generally not significant, although participants living in areas bordering urban centres had less sleep problems than participants from other regions. These data show that the prevalence of seasonal affective disorder was not affected by latitude.
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Affiliation(s)
- Nils Sandman
- Genomics and Biomarkers Unit, National Institute for Health and Welfare, Helsinki, Finland. .,Department of Psychology and Speech Language Pathology, Centre for Cognitive Neuroscience, Turku Brain and Mind Centre, University of Turku, Turku, Finland.
| | - Ilona Merikanto
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland.,Department of Biosciences, University of Helsinki, Helsinki, Finland
| | - Hanna Määttänen
- Department of Psychology and Speech Language Pathology, Centre for Cognitive Neuroscience, Turku Brain and Mind Centre, University of Turku, Turku, Finland
| | - Katja Valli
- Department of Psychology and Speech Language Pathology, Centre for Cognitive Neuroscience, Turku Brain and Mind Centre, University of Turku, Turku, Finland.,Department of Cognitive Neuroscience and Philosophy, School of Bioscience, University of Skövde, Skövde, Sweden
| | - Erkki Kronholm
- Department of Health, National Institute for Health and Welfare, Turku, Finland
| | - Tiina Laatikainen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Hospital District of North Karelia, Joensuu, Finland
| | - Timo Partonen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Tiina Paunio
- Genomics and Biomarkers Unit, National Institute for Health and Welfare, Helsinki, Finland.,Department of Psychiatry, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
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Basnet S, Merikanto I, Lahti T, Männistö S, Laatikainen T, Vartiainen E, Partonen T. Seasonal variations in mood and behavior associate with common chronic diseases and symptoms in a population-based study. Psychiatry Res 2016; 238:181-188. [PMID: 27086231 DOI: 10.1016/j.psychres.2016.02.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 12/10/2015] [Accepted: 02/15/2016] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to assess how seasonality is associated with some of the most common non-communicable diseases (NCDs) in the general Finnish population. The global seasonality score (GSS) was used to measure the magnitude of seasonality in 4689 participants, in addition to which they reported the extent to which the seasonal variations in mood and behavior were experienced as a problem. Regression models and the odds ratios were adopted to analyze the associations adjusted for a range of covariates. Seventy percent of the participants had seasonal variations in sleep duration, social activity, mood, or energy level, and forty percent those in weight and appetite. Angina pectoris and depression were significantly associated with seasonality throughout the analysis. Hypertension, high cholesterol levels, diabetes, other (than rheumatoid) joint diseases and other (than depressive) psychological illnesses were significantly associated with experiencing a problem due to the seasonal variations, with an increase in the GSS, and with seasonal affective disorder and its subsyndromal form. The co-occurrence of the seasonal variations in mood and behavior with certain common NCDs warrants future research to have insights into the etiology and potentially shared pathways and mechanisms of action.
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Affiliation(s)
- Syaron Basnet
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland; Department of Behavioral Sciences and Philosophy, University of Turku, Finland
| | - Ilona Merikanto
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland; Department of Biosciences, University of Helsinki, Helsinki, Finland; Orton Orthopaedics Hospital, Helsinki, Finland
| | - Tuuli Lahti
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland; Department of Behavioral Sciences and Philosophy, University of Turku, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Satu Männistö
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Tiina Laatikainen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Erkki Vartiainen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Timo Partonen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland.
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Mc Mahon B, Andersen SB, Madsen MK, Hjordt LV, Hageman I, Dam H, Svarer C, da Cunha-Bang S, Baaré W, Madsen J, Hasholt L, Holst K, Frokjaer VG, Knudsen GM. Seasonal difference in brain serotonin transporter binding predicts symptom severity in patients with seasonal affective disorder. Brain 2016; 139:1605-14. [DOI: 10.1093/brain/aww043] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 01/28/2016] [Indexed: 11/14/2022] Open
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O'Hare C, O'Sullivan V, Flood S, Kenny RA. Seasonal and meteorological associations with depressive symptoms in older adults: A geo-epidemiological study. J Affect Disord 2016; 191:172-9. [PMID: 26655862 DOI: 10.1016/j.jad.2015.11.029] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 10/22/2015] [Accepted: 11/11/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Given increased social and physiological vulnerabilities, older adults may be particularly susceptible to environmental influences on mood. Whereas the impact of season on mood is well described for adults, studies rarely extend to elders or include objective weather data. We investigated the impact of seasonality and meteorological factors on risk of current depressive symptoms in older adults. METHODS We used data on 8027 participants from the first wave of The Irish Longitudinal Study of Ageing, a population-representative cohort of adults aged 50+. Depressive symptoms were recorded using the Centre for Epidemiological Studies Depression Scale. Season was defined according to the World Meteorological Organisation. Data on climate over the preceding thirty years, and temperature and rain over the preceding month, were provided by the Irish Meteorological Service and linked using Geographic Information Systems techniques to participant's geo-coded locations at a resolution of one kilometre. RESULTS The highest levels of depressive symptoms were reported in winter and the lowest in spring (mean 6.56 [CI95% 6.09, 7.04] vs. 5.81 [CI95%: 5.40, 6.22]). In fully adjusted linear regression models, participants living in areas with higher levels of rainfall in the preceding and/or current calendar month had greater depressive symptoms (0.04 SE 0.02; p=0.039 per 10mm additional rainfall per month) while those living in areas with sunnier climates had fewer depressive symptoms (-2.67 SE 0.88; p=0.003 for every additional hour of average annual daily sunshine). LIMITATIONS This was a cross-sectional analysis thus causality cannot be inferred; monthly rain and temperature averages were available only on a calendar month basis while monthly local levels of sunshine data were not available. CONCLUSIONS Environmental cues may influence mood in older adults and thus have relevance for the recognition and treatment of depression in this age group.
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Affiliation(s)
- Celia O'Hare
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Ireland.
| | | | - Stephen Flood
- New Zealand Climate Change Research Institute, School of Geography Environment and Earth Sciences, Victoria University, Wellington 6012, New Zealand
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Ireland
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