Seasonal variations in mental disorders in the general population of a country with a maritime climate: findings from the Netherlands mental health survey and incidence study

Seeking help for mental health during the COVID-19 pandemic: A longitudinal analysis of adults' experiences with digital technologies and services

The COVID-19 pandemic brought about dramatic changes in how patients access healthcare from its outset. Lockdown restrictions and remote working led to a proliferation of digital technologies and services, which also impacted mental health provisions. Against the backdrop of new and changing support services, along with an unprecedented emphasis on mental health, relatively little is known about how adults sought out and received support for their mental health during this period. With a sample of 27,574 adults assessed longitudinally online over 12 months of the pandemic in the UK, we analysed reports of help-seeking for mental health, as well as sources of treatment or support and the perceived helpfulness of treatments received. We observed that the proportions of participants who reported seeking help remained relatively consistent throughout the 12-month period (ranging from 12.6% to 17.0%). Online talking therapies were among the most frequently sought sources (15.3%), whereas online self-guided treatments were among the least frequently sought sources (5%). Telephone lines, both NHS and non-governmental, had marked treatment 'gaps'. These treatment gaps, where individuals sought treatment but did not receive it, were especially evident for men and older adults. Our findings underscore online talking therapies as being a widely-sought and helpful source of mental health support. This is important given the current global need for accessible treatment options.

Chan-Chuang and resistance exercise for drug rehabilitation: a randomized controlled trial among Chinese male methamphetamine users

Objective

To examine the health benefits of Chan-Chuang and resistance exercise.

Methods

We deployed an 8-week randomized controlled trial, in which 76 male methamphetamine users were allocated to control (n = 25), Chan-Chuang (n = 26), and residence exercise groups (n = 25). Our primary outcomes were drug craving, mental wellbeing, sleep quality, heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP). Our secondary outcomes were body mass index (BMI), vital capacity, grip strength, balance, and vertical jump.

Results

Chan-Chuang exercise resulted in reduced HR, DBP, and MAP, along with improvements in vital capacity, grip strength, and balance compared to the control group. Resistance exercise reduced SBP and MAP, and also improved vital capacity, grip strength, balance, and vertical jump.

Conclusion

These findings may support the role of Chan-Chuang and resistance exercise in maintaining the physical fitness of methamphetamine users at mandatory detention centers.

A Systematic Review on the Impact of Seasonality on Severe Mental Illness Admissions: Does Seasonal Variation Affect Coercion?

Coercion in psychiatry is associated mainly with involuntary admissions. The purpose of this study was to investigate the associations between hospital admissions of patients suffering from affective and schizophrenic disorders and seasonality. A systematic literature search using PubMed, Scopus and Google Scholar was conducted, including studies with affective and schizophrenia disorder admissions, published from October 1992 to August 2020. A total of 31 studies were included in the review. Four broad severe mental illness admission categories were identified regarding seasonality: affective disorders, schizophrenia disorders, involuntary admission affective disorders and involuntary admission schizophrenia disorders. There was clear and strong evidence for spring and summer peaks for severe mental illness admissions; data provided for age, gender and involuntary admissions was limited. Seasonality may have a significant effect on the onset and exacerbation of psychopathology of severe mental illness and should be considered as a risk factor in psychiatric admissions, violence and the risk of mental health coercion. A better understanding of the impact of seasonality on severe mental illness will help professionals to provide the best practices in mental health services in order to reduce and prevent psychiatric hospitalizations (especially involuntary admissions) resulting in further coercive measures.

The effects of weather on depressive symptoms in patients after cardiac surgery

Patients with cardiovascular disease have depression more often than the general population does. The aim of the study was to detect the associations between the psychological state and weather variables in patients who underwent coronary artery bypass grafting or valve surgery. The prospective study was performed during 2008-2012 in Kaunas, Lithuania. The psychological state of 233 patients was assessed by using the Symptom Checklist-90-Revised instrument. The assessment was carried out at 1.5 months, 1 year, and 2 years after the surgery. A sample of 531 measurements of psychological states was used. To investigate the relationships between psychological scores and daily weather variables, a mixed linear model was used adjusting for sex, the type of surgery, age, the marital status, the presence of arterial hypertension, diabetes, major depressive disorders, dysthymic disorders, agoraphobia, smoking before surgery, and myocardial infarction in the anamnesis. The mean somatisation score and air temperature on the second day prior to the survey were found to have a negative correlation in the multivariate model. Lower mean scores of anxiety and depression were linked to hotter days (air temperature >16.25°C on the second day) that did not occur in July or August. During colder days (air temperature <0.35°C), a higher mean score of anxiety and phobic anxiety was observed. A higher mean score of somatizations, depression, and anxiety was seen on the second day after the day with wind speed ≤2.85 kt and on the day after the day with relative humidity <66%. Both a decrease and an increase in daily atmospheric pressure were associated with a higher depression score. Our results confirm that among patients after open heart surgery, psychosomatic complaints are related to some weather changes. The obtained results can help to determine the complexity of weather patterns linked to poorer psychological health.

Robust Parental Preferences in Mental Health Screening in Youth From a Multinational Online Survey

Importance

Screening youth for mental disorders may assist in prevention, promote early identification, and reduce related lifetime impairment and distress.

Objective

The goal was to survey parents about their comfort and preferences for pediatric mental health screening, as well as factors associated with these preferences.

Design

The online survey was available July 11-14, 2021 on Prolific Academic. Analyses were conducted from November 2021 to November 2022.

Setting

Online survey.

Participants

The survey was administered to English-speaking parents with at least one 5-21-year old child at home. The sample included 972 parents, aged 21 and older, from the United States ( n =265), United Kingdom ( n =282), Canada ( n =171), and Other Countries ( n =254).

Exposures

None.

Main Outcomes/Measures

Parental preferences regarding the screening content, implementation preferences, and screener reviewing preferences of pediatric mental health screening were assessed in a novel survey. Mixed effects logistic models were employed to evaluate factors that influence parental comfort levels.

Results

Parents, aged 21 to 65 ( M =39.4; 62.3% female), supported annual mental health screening for their child and preferred reviewing the screening results with professional staff (e.g., physicians). Parents preferred parent-report over child self-reports, though they were generally comfortable with both options. Despite slight variations based on country of residence, screening topic, and child's age, parents were generally comfortable discussing all 21 topics. The greatest comfort was with sleep problems; the least comfort was with firearms, gender identity, suicidality, and substance use/abuse.

Conclusions/Relevance

Our data indicated that parents support annual parent- and child self-report mental health screening in primary care settings, but comfort levels differ according to various factors, such as screening topic. Parents preferred screening to occur in the healthcare office and to discuss screening results with professional staff. In addition to parental need for expert guidance, the growing awareness of child mental health needs highlights the importance of addressing mental health concerns early via regular mental health screenings.

KEY POINTS

Question: What are parents' attitudes towards pediatric mental health screening in primary care settings?Findings: The vast majority of parents surveyed online ( N=972) expressed comfort with the screening of children for mental health concerns in the primary care setting. Variations in comfort were noted in relation to age of child and topics included. Parents expressed a preference for parent report over child report, as well as for reviewing screening results with professional medical staff. These findings were robust to the country of residence (e.g., United States, Canada, United Kingdom). Meaning: Our findings document parental preferences that should be incorporated to enhance the feasibility of mental health screening in primary care settings.

Different trajectories of depression, anxiety and anhedonia symptoms in the first 12 months of the COVID-19 pandemic in a UK longitudinal sample

BACKGROUND

While studies from the start of the COVID-19 pandemic have described initial negative effects on mental health and exacerbating mental health inequalities, longer-term studies are only now emerging.

METHOD

In total, 34 465 individuals in the UK completed online questionnaires and were re-contacted over the first 12 months of the pandemic. We used growth mixture modelling to identify trajectories of depression, anxiety and anhedonia symptoms using the 12-month data. We identified sociodemographic predictors of trajectory class membership using multinomial regression models.

RESULTS

Most participants had consistently low symptoms of depression or anxiety over the year of assessments (60%, 69% respectively), and a minority had consistently high symptoms (10%, 15%). We also identified participants who appeared to show improvements in symptoms as the pandemic progressed, and others who showed the opposite pattern, marked symptom worsening, until the second national lockdown. Unexpectedly, most participants showed stable low positive affect, indicating anhedonia, throughout the 12-month period. From regression analyses, younger age, reporting a previous mental health diagnosis, non-binary, or self-defined gender, and an unemployed or a student status were significantly associated with membership of the stable high symptom groups for depression and anxiety.

CONCLUSIONS

While most participants showed little change in their depression and anxiety symptoms across the first year of the pandemic, we highlight the divergent responses of subgroups of participants, who fared both better and worse around national lockdowns. We confirm that previously identified predictors of negative outcomes in the first months of the pandemic also predict negative outcomes over a 12-month period.

Mental and physical health and well-being of canadian employees who were working from home during the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic has drastically changed various aspects of our lives, including how we work. Since the start of the pandemic, numerous organizations in Canada have mandated their employees to work from home (WFH) on a full-time basis. The rapid rise in the number of remote workers and the possibility for WFH continuing in the future signifies the importance of understanding the health and well-being of employees working from home over the course of the pandemic in Canada. We present the findings of two surveys (initial and 6-month follow-up) to examine the health and well-being of WFH employees during the COVID-19 pandemic in Canada. We analyzed the changes in mental and physical health and well-being of employees who were working from home between two time points during the pandemic.

METHODS

Initial survey was completed between October 2020 and December 2020 (n = 1617); follow-up survey was completed between May 2021 and June 2021 (n = 382). We calculated the frequencies for survey questions involving demographics, WFH preferences, workstation setup training, employment situation, provision of hardware technologies, provision and usage of software technologies, and organization's return to work plan. We conducted Wilcoxon signed-rank tests to analyze the within-individual changes in mental and physical health and well-being of the 382 respondents who completed both the initial and follow-up surveys.

RESULTS

Our analyses showed significant changes in various aspects of employee mental and physical health and well-being. Burnout, stress, general mental health, and job insecurity levels significantly decreased between the two time periods. Work-related sedentary behaviour reduced over time; however, the average proportion of time spent sitting during work hours was more than 80% in both surveys. Employees received more help and feedback from their colleagues and experienced a better sense of community with their co-workers over time.

CONCLUSION

The findings can inform workers and organizations on the changes in mental and physical health and well-being of employees working from home during the pandemic. By understanding the changes in worker health and well-being, employers can develop effective strategies and implement policies that help protect employees' health and well-being.

Smoking, distress and COVID-19 in England: Cross-sectional population surveys from 2016 to 2020

Changes in the prevalence of psychological distress among smokers during the COVID-19 pandemic in England may exacerbate existing health inequalities. This study examined the prevalence of psychological distress among smokers following the onset of the pandemic compared with previous years. Cross-sectional data came from a representative survey of smokers (18+) in England (n = 2,927) between April-July in 2016, 2017 and 2020. Logistic regressions estimated the associations between past-month distress across 2016/2017 and 2020, and age. Weighted proportions, chi-squared statistics and stratified logistic regression models were used to compare the distributions of moderate and severe distress, respectively, within socio-demographic and smoking characteristics in 2016/2017 and 2020. Between the combined April-July 2016 and 2017 sample and April-July 2020 the prevalence of moderate and severe distress among past-year smokers increased (2016/2017: moderate 20.66%, 19.02-22.43; severe 8.23%, 7.16-9.47; 2020: moderate 28.79%, 95%CI 26.11-31.60; OR = 2.08, 95%CI 1.34-3.25; severe 11.04%, 9.30-13.12; OR = 2.16, 1.13-4.07). While there was no overall evidence of an interaction between time period and age, young (16-24 years) and middle-age groups (45-54 years) may have experienced greater increases in moderate distress and older age groups (65+ years) increases in severe distress. There were increases of moderate distress among more disadvantaged social grades and both moderate and severe distress among women and those with low cigarette addiction. Between April-July 2016/2017 and April-July 2020 in England there were increases in both moderate and severe distress among smokers. The distribution of distress among smokers differed between 2016/2017 and 2020 and represents a widening of inequalities.

Do psychiatric diseases follow annual cyclic seasonality?

Seasonal affective disorder (SAD) famously follows annual cycles, with incidence elevation in the fall and spring. Should some version of cyclic annual pattern be expected from other psychiatric disorders? Would annual cycles be similar for distinct psychiatric conditions? This study probes these questions using 2 very large datasets describing the health histories of 150 million unique U.S. citizens and the entire Swedish population. We performed 2 types of analysis, using “uncorrected” and “corrected” observations. The former analysis focused on counts of daily patient visits associated with each disease. The latter analysis instead looked at the proportion of disease-specific visits within the total volume of visits for a time interval. In the uncorrected analysis, we found that psychiatric disorders’ annual patterns were remarkably similar across the studied diseases in both countries, with the magnitude of annual variation significantly higher in Sweden than in the United States for psychiatric, but not infectious diseases. In the corrected analysis, only 1 group of patients—11 to 20 years old—reproduced all regularities we observed for psychiatric disorders in the uncorrected analysis; the annual healthcare-seeking visit patterns associated with other age-groups changed drastically. Analogous analyses over infectious diseases were less divergent over these 2 types of computation. Comparing these 2 sets of results in the context of published psychiatric disorder seasonality studies, we tend to believe that our uncorrected results are more likely to capture the real trends, while the corrected results perhaps reflect mostly artifacts determined by dominantly fluctuating, health-seeking visits across a given year. However, the divergent results are ultimately inconclusive; thus, we present both sets of results unredacted, and, in the spirit of full disclosure, leave the verdict to the reader.

Should we expect psychiatric disorders to show a cyclic annual pattern? This study reveals that psychiatric diseases’ annual patterns were remarkably similar across the studied diseases in both the US and Sweden, with the magnitude of annual variation significantly higher in Sweden than in the US for psychiatric, but not infectious, diseases.

Mental health responses to the COVID-19 pandemic: a latent class trajectory analysis using longitudinal UK data

BACKGROUND

The mental health of the UK population declined at the onset of the COVID-19 pandemic. Convenience sample surveys indicate that recovery began soon after. Using a probability sample, we tracked mental health during the pandemic to characterise mental health trajectories and identify predictors of deterioration.

METHODS

This study was a secondary analysis of five waves of the UK Household Longitudinal Study (a large, national, probability-based survey that has been collecting data continuously since January, 2009) from late April to early October, 2020 and pre-pandemic data taken from 2018-19. Mental health was assessed using the 12-item General Health Questionnaire (GHQ-12). We used latent class mixed models to identify discrete mental health trajectories and fixed-effects regression to identify predictors of change in mental health.

FINDINGS

Mental health was assessed in 19 763 adults (≥16 years; 11 477 [58·1%] women and 8287 [41·9%] men; 3453 [17·5%] participants from minority ethnic groups). Mean population mental health deteriorated with the onset of the pandemic and did not begin improving until July, 2020. Latent class analysis identified five distinct mental health trajectories up to October 2020. Most individuals in the population had either consistently good (7437 [39·3%] participants) or consistently very good (7623 [37·5%] participants) mental health across the first 6 months of the pandemic. A recovering group (1727 [12·0%] participants) showed worsened mental health during the initial shock of the pandemic and then returned to around pre-pandemic levels of mental health by October, 2020. The two remaining groups were characterised by poor mental health throughout the observation period; for one group, (523 [4·1%] participants) there was an initial worsening in mental health that was sustained with highly elevated scores. The other group (1011 [7·0%] participants) had little initial acute deterioration in their mental health, but reported a steady and sustained decline in mental health over time. These last two groups were more likely to have pre-existing mental or physical ill-health, to live in deprived neighbourhoods, and be of Asian, Black or mixed ethnicity. Infection with SARS-CoV-2, local lockdown, and financial difficulties all predicted a subsequent deterioration in mental health.

INTERPRETATION

Between April and October 2020, the mental health of most UK adults remained resilient or returned to pre-pandemic levels. Around one in nine individuals had deteriorating or consistently poor mental health. People living in areas affected by lockdown, struggling financially, with pre-existing conditions, or infection with SARS-CoV-2 might benefit most from early intervention.

FUNDING

None.

Weather sensitivity associated with quality of life in patients with fibromyalgia

Background

Fibromyalgia is characterized by chronic widespread pain, and more than half of patients with fibromyalgia report that weather-related variables aggravate their symptoms. However, the differences in actual symptoms have not been measured between those with and without weather sensitivity. The present study aimed to investigate whether weather sensitivity associated with the minimal clinically important difference values of quality of life in patients with fibromyalgia, between those with and without weather sensitivity.

Methods

Sixty-four consecutive outpatients with fibromyalgia on their first visit to our tertiary center were included. Weather sensitivity was measured using self-perceived symptoms. Pain intensity was measured using the 0–10 Numerical Rating Scale (NRS). Quality of life was measured using the Euro Quality of life-5 Dimensions-3 level (EQ-5D-3L) scale. The variables were subjected to univariable and multivariable analysis using the EQ-5D-3L scale.

Results

The mean age of the patients was 50 years. Forty-eight patients (75%) were women. The mean EQ-5D-3L score was 0.55. Thirty-seven patients (58%) reported weather sensitivity. In univariable analysis, the welfare recipient, weather sensitivity, and NRS values were associated with EQ-5D-3L scale scores. In multivariable analysis, NRS value and weather sensitivity were independently associated with EQ-5D-3L scale scores. The NRS and EQ-5D-3L scale scores were significantly worse in those with weather sensitivity than those without weather sensitivity. The difference in NRS values was less than 1.5 points between groups. The differences in EQ-5D-3L scale scores were 0.16 points between groups.

Conclusions

Weather sensitivity was significantly associated with quality of life in patients with fibromyalgia. There was an association with weather sensitivity and the minimal clinically important difference values of quality of life in patients with fibromyalgia. The presence of weather sensitivity could have a key role in the quality of life in patients with fibromyalgia.

Supplementary Information

The online version contains supplementary material available at 10.1186/s41927-021-00185-4.

Quasi-experimental evaluation of text-based crisis patterns in youth following Hurricane Florence in the Carolinas, 2018

IMPORTANCE

Crisis text lines have proven to be an effective and low-cost means for delivering texting-based mental health support to youth. Yet there has been limited research examining the use of these services in capturing the psychological impact on youth affected by a weather-related disaster.

OBJECTIVE

This ecologic study examined changes in help-seeking behavior for adolescents and young adults in North and South Carolina, USA, before and after Hurricane Florence (2018).

DESIGN AND MAIN OUTCOMES

A retrospective, interrupted time-series design was used to examine pre- and post-hurricane changes in crisis text volume among youth help seekers in the Carolinas for the following outcomes: (1) text for any reason; (2) stress & anxiety; (3) depression; and (4) suicidal thoughts.

RESULTS

Results showed an immediate and sustained increase in crisis texts for stress/anxiety and suicidal thoughts in the six weeks following Florence. Overall, an immediate 15% increase in crisis texts for anxiety/stress (SE = 0.05, p = .005) and a 17% increase in suicidal thoughts (SE = 0.07, p = .02) occurred during the week of the storm. Text volume for anxiety/stress increased 17% (SE = 0.08, p = .005) and 23% for suicidal ideation (SE = 0.08, p = .01) in the 6-week post-hurricane period. Finally, forecast models revealed observed text volume for all mental health outcomes was higher than expected in the 6 weeks post-Florence.

CONCLUSIONS AND RELEVANCE

A low-cost, crisis texting platform provided 24/7 mental health support available to young people in the Carolinas impacted by Hurricane Florence. These findings highlight a new application for text-based crisis support services to address the mental health consequences in youth following a weather-related disaster, as well as the potential for these types of crisis platforms to measure situational awareness in impacted communities.

Diet, Exercise, Lifestyle, and Mental Distress among Young and Mature Men and Women: A Repeated Cross-Sectional Study

Customization of mental health therapies needs to consider the differences in degree of brain maturity between young (18–29 years) and mature (30 years or older) adults as well as brain morphology among men and women. The aim of this study was to identify the significant dietary and lifestyle contributors to mental distress in these sub-populations. Independent repeated cross-sectional sampling was performed for over a 5-year period (2014–2019) to collect data from different populations at different time-points and seasons. A backward stepwise regression analysis was used on 2628 records. Mental distress in young women was associated with high consumption of caffeine and fast-food, and it was negatively correlated with moderate-high levels of exercise as well as frequent breakfast consumption. Mature women shared several common factors with young women; however, high fruit consumption was negatively associated with mental distress. For young men, high exercise, moderate consumption of dairy, and moderate-high intake of meat were negatively associated with mental distress. In addition, high fast-food and caffeine consumption were positively associated with mental distress in young men. For mature men, strong negative associations between higher education, moderate intake of nuts and mental distress surfaced. Our results support the need to customize dietary and lifestyle recommendations to improve mental wellbeing.

Using behavioral rhythms and multi-task learning to predict fine-grained symptoms of schizophrenia

Schizophrenia is a severe and complex psychiatric disorder with heterogeneous and dynamic multi-dimensional symptoms. Behavioral rhythms, such as sleep rhythm, are usually disrupted in people with schizophrenia. As such, behavioral rhythm sensing with smartphones and machine learning can help better understand and predict their symptoms. Our goal is to predict fine-grained symptom changes with interpretable models. We computed rhythm-based features from 61 participants with 6,132 days of data and used multi-task learning to predict their ecological momentary assessment scores for 10 different symptom items. By taking into account both the similarities and differences between different participants and symptoms, our multi-task learning models perform statistically significantly better than the models trained with single-task learning for predicting patients' individual symptom trajectories, such as feeling depressed, social, and calm and hearing voices. We also found different subtypes for each of the symptoms by applying unsupervised clustering to the feature weights in the models. Taken together, compared to the features used in the previous studies, our rhythm features not only improved models' prediction accuracy but also provided better interpretability for how patients' behavioral rhythms and the rhythms of their environments influence their symptom conditions. This will enable both the patients and clinicians to monitor how these factors affect a patient's condition and how to mitigate the influence of these factors. As such, we envision that our solution allows early detection and early intervention before a patient's condition starts deteriorating without requiring extra effort from patients and clinicians.

Seasonality of mood and affect in a large general population sample

Mood and behaviour are thought to be under considerable influence of the seasons, but evidence is not unequivocal. The purpose of this study was to investigate whether mood and affect are related to the seasons, and what is the role of neuroticism in this association. In a national internet-based crowdsourcing project in the Dutch general population, individuals were invited to assess themselves on several domains of mental health. ANCOVA was used to test for differences between the seasons in mean scores on the Positive and Negative Affect Schedule (PANAS) and Quick Inventory of Depressive Symptomatology (QIDS). Within-subject seasonal differences were tested as well, in a subgroup that completed the PANAS twice. The role of neuroticism as a potential moderator of seasonality was examined. Participants (n = 5,282) scored significantly higher on positive affect (PANAS) and lower on depressive symptoms (QIDS) in spring compared to summer, autumn and winter. They also scored significantly lower on negative affect in spring compared to autumn. Effect sizes were small or very small. Neuroticism moderated the effect of the seasons, with only participants higher on neuroticism showing seasonality. There was no within-subject seasonal effect for participants who completed the questionnaires twice (n = 503), nor was neuroticism a significant moderator of this within-subjects effect. The findings of this study in a general population sample participating in an online crowdsourcing study do not support the widespread belief that seasons influence mood to a great extent. For, as far as the seasons did influence mood, this only applied to highly neurotic participants and not to low-neurotic participants. The underlying mechanism of cognitive attribution may explain the perceived relation between seasonality and neuroticism.

Seasonality and schizophrenia: a comprehensive overview of the seasonal pattern of hospital admissions and potential drivers

Schizophrenia is a severe neuropsychiatric disorder with heterogeneous aetiology mostly affecting younger people and causing immense disability. Seasonal patterns may be observed in schizophrenia hospital admissions with possible association with changing climatic parameters and socio-demographic characteristics. This study critically reviewed studies that have assessed seasonal variations of hospital admissions for schizophrenia and/or explored an association with climate parameters and/or other potential factors. Following PRISMA guidelines, a systematic literature search was conducted using electronic databases (e.g. MEDLINE, Science Direct, PsycINFO, Pub Med) from inception to February 29, 2020. Thirty five papers were identified, of which only six (17.1%) examined evidence for a seasonal pattern or monthly excess of hospital admissions and the remaining twenty nine (82.9%) assessed climatic and socio-demographic attributes relating to the seasonal pattern or increased hospitalisation for schizophrenia. While most studies reported a summer peak in hospital admission rates, other studies reported a winter peak. Most of the evidence indicated that higher temperatures (> 28 °C) were positively correlated with schizophrenia admission rates. The individual effects of other climatic parameters (e.g. relative humidity, rainfall, atmospheric pressure, sunlight) were less frequently assessed. Males, people of 21-60 years old, and those married were more vulnerable to climatic variability specifically to higher temperatures. Further studies using large sample sizes, analysis of a wide range of interacting environmental variables and sophisticated statistical approaches are needed to better understand the underlying mechanisms involved. This will also provide more reliable statistical evidence that will help in the prevention and better management of cases.

Effects of vitamin D supplementation on depression and some involved neurotransmitters

BACKGROUND

Low vitamin D levels are associated with a dysregulated hypothalamic-pituitary-adrenal (HPA) axis and depression but a causal relationship has not been established. This study aimed to evaluate the effects of vitamin D supplementation on depression severity, serum 25(OH)D, and some neurotransmitters in patients with mild to moderate depression.

METHODS

An 8-week double-blind randomized clinical trial was conducted on 56 subjects with mild to moderate depression, aged 43.0 ± 1.15yrs. The patients were randomly allocated into two groups: intervention (50,000 IU cholecalciferol/2wks) and control (placebo). Biochemical parameters (serum 25(OH)D, iPTH, oxytocin and platelet serotonin), and depression severity (Beck Depression Inventory-II (BDI-II¹)) were initially and finally assessed.

RESULTS

Following intervention, significant changes were observed in the intervention group compared to the controls: 25(OH)D concentrations increased (+40.83±28.57 vs. +5.14±23.44 nmol/L, P<0.001) and BDI scores decreased (-11.75±6.40 vs. -3.61±10.40, P = 0.003). Oxytocin concentrations were significantly reduced in controls (-6.49±13.69 ng/mL, P = 0.01), but between -group differences were insignificant. Within- and between-group differences of platelet serotonin concentrations were not significant; however, the increment in controls was higher (+0.86±10.82 vs. +0.26±9.38 ng/mL, P = 0.83).

LIMITATIONS

Study duration may not reflect the long-term effects of vitamin D on depression. It seems necessary to assess tryptophan-hydroxylasetypes1&2 in relation to vitamin D in serotonin pathways.

CONCLUSIONS

Eight-week supplementation with 50,000 IU/2wks vitamin D, elevated 25(OH)D concentration of subjects with mild to moderate depression and significantly improved their depression severity. However, there was no evidence that the anti-depressive effect of vitamin D supplementation is mediated by the measured neurotransmitters.

Exploring circannual rhythms and chronotype effect in patients with Obsessive-Compulsive Tic Disorder (OCTD): A pilot study

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 η²_p = 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.

Seasonality and symptoms of depression: A systematic review of the literature

AIMS

Lay opinions and published papers alike suggest mood varies with the seasons, commonly framed as higher rates of depression mood in winter. Memory and confirmation bias may have influenced previous studies. We therefore systematically searched for and reviewed studies on the topic, but excluded study designs where explicit referrals to seasonality were included in questions, interviews or data collection.

METHODS

Systematic literature search in Cochrane database, DARE, Medline, Embase, PsychINFO and CINAHL, reporting according to the PRISMA framework, and study quality assessment using the Newcastle-Ottawa scale. Two authors independently assessed each study for inclusion and quality assessment. Due to large heterogeneity, we used a descriptive review of the studies.

RESULTS

Among the 41 included studies, there was great heterogeneity in regards to included symptoms and disorder definitions, operationalisation and measurement. We also observed important heterogeneity in how definitions of 'seasons' as well as study design, reporting and quality. This heterogeneity precluded meta-analysis and publication bias analysis. Thirteen of the studies suggested more depression in winter. The remaining studies suggested no seasonal pattern, seasonality outside winter, or inconclusive results.

CONCLUSIONS

The results of this review suggest that the research field of seasonal variations in mood disorders is fragmented, and important questions remain unanswered. There is some support for seasonal variation in clinical depression, but our results contest a general population shift towards lower mood and more sub-threshold symptoms at regular intervals throughout the year. We suggest future research on this issue should be aware of potential bias by design and take into account other biological and behavioural seasonal changes that may nullify or exacerbate any impact on mood.

Seasonal mood changes in patients with obsessive-compulsive disorder

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.

Brain Arousal Regulation in Carriers of Bipolar Disorder Risk Alleles

OBJECTIVES

Recent genome-wide association studies identified a number of chromosomal risk loci for bipolar disorder (BD, 'manic-depressive illness'). According to the vigilance regulation model, the regulation of brain arousal (referred to as 'vigilance') when assessed via EEG is an emerging biomarker linked to the pathogenesis of manic and depressive episodes. On this basis, the present study aimed to assess whether carriers of BD risk alleles differ in brain arousal regulation.

METHODS

Healthy participants of the population-based Leipzig Health Care Study (LIFE) underwent a 20-min eyes-closed resting EEG paradigm. Brain arousal was assessed applying the computer-based Vigilance Algorithm Leipzig (VIGALL). The primary sample (n = 540) was genotyped for ten of the most reliable BD risk variants, of which two qualified for replication (n = 509).

RESULTS

Primary sample analyses revealed Bonferroni-adjusted significance for rs1006737 in CACNA1C (encoding a calcium channel subunit), with risk allele carriers exhibiting relatively steep brain arousal declines. Further, carriers of two risk alleles of rs472913 at 1p32.1 showed generally lower brain arousal levels for the duration of the resting paradigm. However, both associations failed replication.

CONCLUSION

Although our initial findings are in line with the vigilance regulation model and convincing in view of the previously reported notable role of ion channelopathies in BD, our results do not provide consistent evidence for a link between BD risk variants and brain arousal regulation. Several between-sample differences may account for this inconsistency. The molecular genetics of brain arousal regulation remain to be clarified.

Seasonal Variation of Rectal Foreign Bodies: Data from Nationwide Inpatient Sample

Background:

Seasonality is noted in various aspects of human behavior and functioning which have led to an increasing interest in their seasonality in the recent years.

Aims:

We aimed to examine the seasonal variation in the incidence of rectal foreign bodies in the US using a large inpatient database.

Methods:

We used the Nationwide Inpatient Sample database to identify patients aged ≥18 years admitted with a primary diagnosis of the rectal foreign body from 2009 to 2011. We used the Edward's recognition and estimation of cyclic trend method to study the seasonal variation of the incidence of rectal foreign body and Z-test to compare the seasonal incidences.

Results:

A total of 3359 hospitalizations with primary diagnosis of the rectal foreign body were reported from 2009 to 2011. The peak incidence of rectal foreign bodies was seen in October (peak/low ratio 1.20, 95% confidence interval [CI]: 1.10–1.32).

Conclusion:

Data on seasonal variation of rectal foreign bodies are extremely limited. Further studies would be required to verify whether our findings of a higher incidence in the fall season are reflective of acute changes in the length of the days, climate, sleep-wake cycle, or decreased sexual intercourse at this time of the year. High suspicion at this time of the year may help promptly diagnose and avoid unnecessary investigations.

Seasonal variations in mood and behavior associate with common chronic diseases and symptoms in a population-based study

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.

Do pharmaceuticals bioaccumulate in marine molluscs and fish from a coastal lagoon?

The bioaccumulation of 20 pharmaceuticals in cockle (Cerastodema glaucum), noble pen shell (Pinna nobilis), sea snail (Murex trunculus), golden grey mullet (Liza aurata) and black goby (Gobius niger) was evaluated, considering their distribution throughout the Mar Menor lagoon and their variations in spring and autumn 2010. The analytical procedure was adapted for the different matrices as being sensitive and reproducible. Eighteen out of the 20 compounds analysed were found at low ngg(-1) in these species throughout the lagoon. Hydrochlorothiazide and carbamazepine were detected in all species considered. The bioaccumulation of pharmaceuticals was heterogeneous in the lagoon, with a higher number of pharmaceuticals being detected in fish (18) than in wild molluscs (8), particularly in golden grey mullet muscle (16). В-blockers and psychiatric drugs were preferentially bioccumulated in fish and hydrochlorothiazide was also confirmed in caged clams. The higher detection frequency and concentrations found in golden grey mullet suggested that mugilids could be used as an indicator of contamination by pharmaceuticals in coastal areas. To the best of our knowledge, this is the first study that shows data about hydrochlorothiazide, levamisole and codeine in wild marine biota.

Seasonal and meteorological associations with depressive symptoms in older adults: A geo-epidemiological study

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.

Dietary protein ingested before and during short photoperiods makes an impact on affect-related behaviours and plasma composition of amino acids in mice

In mammals, short photoperiod is associated with high depression- and anxiety-like behaviours with low levels of the brain serotonin and its precursor tryptophan (Trp). Because the brain Trp levels are regulated by its ratio to large neutral amino acids (Trp:LNAA) in circulation, this study elucidated whether diets of various protein sources that contain different Trp:LNAA affect depression- and anxiety-like behaviours in C57BL/6J mice under short-day conditions (SD). In the control mice on a casein diet, time spent in the central area in the open field test (OFT) was lower in the mice under SD than in those under long-day conditions (LD), indicating that SD exposure induces anxiety-like behaviour. The SD-induced anxiety-like behaviour was countered by an α-lactalbumin diet given under SD. In the mice that were on a gluten diet before transition to SD, the time spent in the central area in the OFT under SD was higher than that in the SD control mice. Alternatively, mice that ingested soya protein before the transition to SD had lower immobility in the forced swim test, a depression-like behaviour, compared with the SD control. Analysis of Trp:LNAA revealed lower Trp:LNAA in the SD control compared with the LD control, which was counteracted by an α-lactalbumin diet under SD. Furthermore, mice on gluten or soya protein diets before transition to SD exhibited high Trp:LNAA levels in plasma under SD. In conclusion, ingestion of specific proteins at different times relative to photoperiodic transition may modulate anxiety- and/or depression-like behaviours, partially through changes in plasma Trp:LNAA.

The impact of assertive outreach teams on hospital admissions for psychosis: a time series analysis

Although the assertive outreach model was developed in the United States and imported to the United Kingdom to date, there is only limited evidence to support its wide-scale implementation within the United Kingdom. This is the first study to have combined a large dataset with this type of research method to explore the impact of assertive outreach teams on hospital admissions. The introduction and expansion of assertive outreach teams was associated with reducing hospital admissions for people with psychosis. This study found a consistent summer peak in hospital admissions which community and in-patient mental health nurses should take account of and plan for. Ever since the Mental Health Policy Implementation Policy Guide paved the way for the introduction of the Assertive Outreach Treatment (AOT) model in England, the impact of this approach has been the subject of considerable debate but limited evaluation. To date, most of the evidence supporting this model has originated from outside the United Kingdom. A central aim of the AOT was to reduce the need for in-patient treatment. We aimed to assess the impact of the AOT model on hospital admissions for people with psychosis in England. Interrupted time series analysis was used in this study to evaluate the impact of the policy change. Following the introduction of the AOT model, a statistically significant reduction in hospital admissions for psychosis was found. In addition, we observed a repeated, annual summer peak in admissions. This study adds to the international evidence which supports the effectiveness of the AOT model in reducing hospital admissions for people with severe mental health problems. We offer five suggested implications for mental health nurses and clients based on our findings.

Seasonal distribution of pharmaceuticals in marine water and sediment from a Mediterranean coastal lagoon (SE Spain)

The seasonal variations in the occurrence and distribution of pharmaceuticals were evaluated in seawater and sediment of Mar Menor lagoon from spring 2010 to winter 2011. A total of 20 pharmaceuticals in seawater and 14 in sediments were found at concentrations from low ngL(-)(1) up to 168ngL(-)(1) (azithromycin) in seawater and from low ngg(-1) up to 50.3ngg(-1) (xylazine) in sediments. Azithromycin, xylazine and metoprolol were the most ubiquitous compounds in seawater since they were found in all seawater samples collected. Seven compounds were quantified in both matrices: clarithromycin, erythromycin, hydrochlorothiazide, irbesartan, losartan, salicylic acid and valsartan. Seasonal distribution profiles revealed different sources of pollutants associated to both, El Albujón watercourse (which receives the input of a WWTP) and other non-controlled discharges, into the lagoon. In summer the highest concentrations in seawater for most of the pharmaceuticals were detected close to main touristic nuclei, probably as consequence of sources such as the excretion from bathers and/or other non-controlled discharges, these being significantly higher than in autumn and winter for antibiotics. On the contrary, the mean concentration of lorazepam was significantly higher in colder seasons than in warmer ones. Sulfamethoxazole, erythromycin and especially clarithromycin showed hazard quotients higher than 1 in seawater at some areas of this lagoon indicating a potential risk to aquatic organisms in such specific areas.

Daily weather variables and affective disorder admissions to psychiatric hospitals

Numerous studies have reported that admission rates in patients with affective disorders are subject to seasonal variation. Notwithstanding, there has been limited evaluation of the degree to which changeable daily meteorological patterns influence affective disorder admission rates. A handful of small studies have alluded to a potential link between psychiatric admission rates and meteorological variables such as environmental temperature (heat waves in particular), wind direction and sunshine. We used the Kruskal-Wallis test, ARIMA and time-series regression analyses to examine whether daily meteorological variables--namely wind speed and direction, barometric pressure, rainfall, hours of sunshine, sunlight radiation and temperature--influence admission rates for mania and depression across 12 regions in Ireland over a 31-year period. Although we found some very weak but interesting trends for barometric pressure in relation to mania admissions, daily meteorological patterns did not appear to affect hospital admissions overall for mania or depression. Our results do not support the small number of papers to date that suggest a link between daily meteorological variables and affective disorder admissions. Further study is needed.

Season of birth in obsessive-compulsive disorder

BACKGROUND

Effects of season of birth (SOB) have been documented in numerous neuropsychiatric disorders. To date, few studies have evaluated this issue in obsessive-compulsive disorder (OCD). The aim of this study was to investigate the birth seasonality in OCD.

METHODS

This study was based on Taiwan National Health Insurance Research Database. Data for the birth-year period 1956-1991 were extracted for analysis (273,837 males and 292,207 females). The International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM), code 300.3 was used as the diagnosis of OCD. Birth seasonality was compared between the OCD patients (519 males and 528 females) and the general population.

RESULTS

The birth distributions across the 12 months were significantly different between the OCD patients and the general population (P-value for the Walter & Elwood's test = .04). A significant decrease of births from March to July and an excess from August to November in OCD patients as compared to the general population was noted (the relative risk of these months vs. the rest months of the year: 0.85 (95% CI 0.74-0.96) and 1.19 (95% CI 1.05-1.36). Effects of SOB in OCD were present in males (P-value for the Walter & Elwood's test = .03) but not in females.

CONCLUSION

The findings support an effect of SOB in people with OCD, especially for men.

Seasonal variation of depressive symptoms in unipolar major depressive disorder

OBJECTIVES

Retrospective and cross-sectional studies of seasonal variation of depressive symptoms in unipolar major depression have yielded conflicting results. We examined seasonal variation of mood symptoms in a long-term prospective cohort - the Collaborative Depression Study (CDS).

METHODS

The sample included 298 CDS participants from five academic centers with a prospectively derived diagnosis of unipolar major depression who were followed for at least ten years of annual or semi-annual assessments. Generalized linear mixed models were utilized to investigate the presence of seasonal patterns. In a subset of 271 participants followed for at least 20 years, the stability of a winter depressive pattern was assessed across the first two decades of follow-up.

RESULTS

A small increase in proportion of time depressed was found in the months surrounding the winter solstice, although the greatest symptom burden was seen in December through April with a peak in March. The relative burden of winter depressive symptoms in the first decade demonstrated no relationship to that of the second decade. The onset of new episodes was highest October through January, peaking in January.

CONCLUSIONS

There exists a small but statistically significant peak in depressive symptoms from the month of the winter solstice to the month of the spring equinox. However, the predominance of winter depressive symptoms did not appear stable over the long-term course of illness.

Seasonal obsessive-compulsive disorder

A case of obsessive-compulsive disorder (OCD) with seasonal variation in symptoms of 10-years duration is reported because of its rarity. The phenomenology of the observed disorder was obsessions related to dirt and contamination resulting in washing compulsions with onset in October and complete resolution in April-May every year. The patient responded to phototherapy along with exposure and response prevention therapy and pharmacotherapy.

Self-attributed seasonality of mood and behavior: a report from the Netherlands study of depression and anxiety

BACKGROUND

Seasonal changes in mood and behavior are considered to be common in the general population and in patients with psychiatric disorders. However, in several studies this seasonality could not be demonstrated. The present study examined self-attributed seasonality of depressive symptoms among patients with a lifetime diagnosis of a depressive disorder (D), an anxiety disorder (A), a comorbid depressive and anxiety disorder (DA), and healthy controls (HC).

METHODS

The CIDI was used to establish diagnoses according to DSM-IV criteria in 2,168 participants of the Netherlands Study of Depression and Anxiety (NESDA). The Seasonal Pattern Assessment Questionnaire (SPAQ) was administered to assess variation in mood and behavior.

RESULTS

Of the 2,168 participants 53.5% reported seasonality of mood. Highest percentages of low mood were seen in the winter months. Although all groups showed this pattern of lowered mood during the winter months, D, A, and DA were significantly (P < .001) more likely to experience seasonality is this respect. This was also shown for seasonal changes in energy, social activities, sleeping, eating, weight and for the Global Seasonality Score. A limitation of this study was the cross-sectional design.

CONCLUSIONS

Seasonal variation in mood and behavior was demonstrated for both participants with a lifetime diagnosis of depression and/or anxiety disorder and for healthy controls, but patients with anxiety and/or depression were more likely to experience this seasonal variation. Clinicians should take into account that the time of the year could influence the feelings of well- and ill-being of their patients.

The effects of daily weather variables on psychosis admissions to psychiatric hospitals

Several studies have noted seasonal variations in admission rates of patients with psychotic illnesses. However, the changeable daily meteorological patterns within seasons have never been examined in any great depth in the context of admission rates. A handful of small studies have posed interesting questions regarding a potential link between psychiatric admission rates and meteorological variables such as environmental temperature (especially heat waves) and sunshine. In this study, we used simple non-parametric testing and more complex ARIMA and time-series regression analysis to examine whether daily meteorological patterns (wind speed and direction, barometric pressure, rainfall, sunshine, sunlight and temperature) exert an influence on admission rates for psychotic disorders across 12 regions in Ireland. Although there were some weak but interesting trends for temperature, barometric pressure and sunshine, the meteorological patterns ultimately did not exert a clinically significant influence over admissions for psychosis. Further analysis is needed.

Seasonality in seeking mental health information on Google

BACKGROUND

Population mental health surveillance is an important challenge limited by resource constraints, long time lags in data collection, and stigma. One promising approach to bridge similar gaps elsewhere has been the use of passively generated digital data.

PURPOSE

This article assesses the viability of aggregate Internet search queries for real-time monitoring of several mental health problems, specifically in regard to seasonal patterns of seeking out mental health information.

METHODS

All Google mental health queries were monitored in the U.S. and Australia from 2006 to 2010. Additionally, queries were subdivided among those including the terms ADHD (attention deficit-hyperactivity disorder); anxiety; bipolar; depression; anorexia or bulimia (eating disorders); OCD (obsessive-compulsive disorder); schizophrenia; and suicide. A wavelet phase analysis was used to isolate seasonal components in the trends, and based on this model, the mean search volume in winter was compared with that in summer, as performed in 2012.

RESULTS

All mental health queries followed seasonal patterns with winter peaks and summer troughs amounting to a 14% (95% CI=11%, 16%) difference in volume for the U.S. and 11% (95% CI=7%, 15%) for Australia. These patterns also were evident for all specific subcategories of illness or problem. For instance, seasonal differences ranged from 7% (95% CI=5%, 10%) for anxiety (followed by OCD, bipolar, depression, suicide, ADHD, schizophrenia) to 37% (95% CI=31%, 44%) for eating disorder queries in the U.S. Several nonclinical motivators for query seasonality (such as media trends or academic interest) were explored and rejected.

CONCLUSIONS

Information seeking on Google across all major mental illnesses and/or problems followed seasonal patterns similar to those found for seasonal affective disorder. These are the first data published on patterns of seasonality in information seeking encompassing all the major mental illnesses, notable also because they likely would have gone undetected using traditional surveillance.

Impact of seasonal and lunar cycles on psychological symptoms in the ED: an empirical investigation of widely spread beliefs

OBJECTIVES

This study evaluates the impacts of seasonal and lunar cycles on anxiety and mood disorders, panic and suicidal ideation in patients consulting the emergency department (ED) with a complaint of unexplained chest pain (UCP).

METHODS

Patients with UCP were recruited from two EDs. Psychiatric diagnoses were evaluated with the Anxiety Disorders Interview Schedule for DSM-IV.

RESULTS

Significant seasonal effects were observed on panic and anxiety disorders, with panic more frequently encountered during spring [odds ratio (OR)=1.378, 95% confidence interval (CI)=1.002-1.896] and anxiety disorders during summer (OR=1.586, 95% CI=1.037-2.425). Except for one significant finding, no significant effects of lunar cycles were observed. These findings encourage ED professionals and physicians to abandon their beliefs about the influence of lunar cycles on the mental health of their patients. Such unfounded beliefs are likely to be maintained by self-fulfilling prophecies.

Intra-regional assortative sociality may be better explained by social network dynamics rather than pathogen risk avoidance

Fincher & Thornhill's (F&T's) model is not entirely supported by common patterns of affect behaviors among people who live under varying climatic conditions and among people who endorse varying levels of (Western) religiosity and conservative political ideals. The authors' model is also unable to account for intra-regional heterogeneity in assortative sociality, which, we argue, can be better explained by a framework that emphasizes the differential expression of fundamental social cues for maintaining distinct social network structures.

Seasonality in depressive and anxiety symptoms among primary care patients and in patients with depressive and anxiety disorders; results from the Netherlands Study of Depression and Anxiety

BACKGROUND

Little is known about seasonality of specific depressive symptoms and anxiety symptoms in different patient populations. This study aims to assess seasonal variation of depressive and anxiety symptoms in a primary care population and across participants who were classified in diagnostic groups 1) healthy controls 2) patients with a major depressive disorder, 3) patients with any anxiety disorder and 4) patients with a major depression and any anxiety disorder.

METHODS

Data were used from the Netherlands Study of Depression and Anxiety (NESDA). First, in 5549 patients from the NESDA primary care recruitment population the Kessler-10 screening questionnaire was used and data were analyzed across season in a multilevel linear model. Second, in 1090 subjects classified into four groups according to psychiatric status according to the Composite International Diagnostic Interview, overall depressive symptoms and atypical versus melancholic features were assessed with the Inventory of Depressive Symptoms. Anxiety and fear were assessed with the Beck Anxiety Inventory and the Fear questionnaire. Symptom levels across season were analyzed in a linear regression model.

RESULTS

In the primary care population the severity of depressive and anxiety symptoms did not show a seasonal pattern. In the diagnostic groups healthy controls and patients with any anxiety disorder, but not patients with a major depressive disorder, showed a small rise in depressive symptoms in winter. Atypical and melancholic symptoms were both elevated in winter. No seasonal pattern for anxiety symptoms was found. There was a small gender related seasonal effect for fear symptoms.

CONCLUSIONS

Seasonal differences in severity or type of depressive and anxiety symptoms, as measured with a general screening instrument and symptom questionnaires, were absent or small in effect size in a primary care population and in patient populations with a major depressive disorder and anxiety disorders.

Seasonal variations in sleep problems at latitude 63°-65° in Norway: The Nord-Trondelag Health Study, 1995-1997

Most studies on seasonal variability in sleep have asked participants if they think their sleep quality varies with the seasons, which reveals the research hypothesis to the participants. To date, the hypothesis of seasonal variation in sleep has not been tested in a large population-based fully blinded study. The aim of the current study was to investigate monthly variations in sleep problems in a geographic region of Norway with large seasonal differences in daytime light. Using data from a general health survey, the authors had access to information on sleep in the general population, collected across the seasons over 2 years without linking sleep to seasonal variation. In all, 43,045 participants (mean age, 44.6 years) of the Nord-Trøndelag Health Study, 1995-1997 (referred to as "HUNT-2"), provided reports of insomnia symptoms and time in bed in all months except July. The mean prevalence of insomnia symptoms was 12.4%. No evidence of a seasonal variation on reports of insomnia symptoms or time in bed was found. These null findings are in marked contrast to previous seasonality studies of sleep. Previous studies reporting seasonal variations in sleep and insomnia might have been subject to publication biases and lack of blinding to the research hypothesis.

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

Background– Seasonal Affective Disorder (SAD) is supposed to be caused by lack of daylight in winter. Yet the population of Northern Norway, living without sun for two winter months, does not spontaneously complain about depression during the dark period.Aims– To summarize research bearing upon the validity of the concept of SAD.Method– Review of relevant literature concerning the epidemiology of SAD and the questionnaire developed to measure it in general populations, the Seasonal Pattern Assessment Questionnaire (SPAQ).Results– Large population studies from northern Norway do not point to a higher prevalence of depression in winter than expected in any other general population. The psychometric properties of SPAQ are rather poor, and the diagnosis of SAD based on SPAQ bears little relationship to a meaningful concept of depression.Conclusions– Seasonal Affective Disorder is not a valid medical construct. Instead, “Recurrent depression with seasonal pattern” as defined in the DSM-IV and the ICD-10 should be used as terms. However, more research is needed to establish whether it is at all fruitful to single out such a subtype of recurrent depression.

Declaration of Interest: None.

Does the weather make us sad? Meteorological determinants of mood and depression in the general population

It is a common and well-spread belief that people feel more depressed when the weather is bad. However, whether meteorological factors such as temperature, sunshine and rainfall can actually account for variations in the prevalence of depression in the general population has yet to be investigated. We aimed to assess the influence of weather conditions on the seasonal variation of depression observed in the general population. We used data from a large-scale depression-screening programme in the south of the Netherlands. Seasonal prevalence of DSM-IV classified major depression and sad mood in a sample of 14,478 participants from the general population was calculated, and linked to mean daily temperature, duration of sunshine and duration of rainfall in logistic regression analyses. The prevalence of major depression and sad mood showed seasonal variation, with peaks in the summer and fall. Weather conditions were not associated with mood, and did not explain the seasonal variation we found. We conclude that, contrary to popular belief, weather conditions and sad mood or depression do not seem to be associated. Future studies might use daily measures of well-being as outcome.

A socio-relational framework of sex differences in the expression of emotion

Despite a staggering body of research demonstrating sex differences in expressed emotion, very few theoretical models (evolutionary or non-evolutionary) offer a critical examination of the adaptive nature of such differences. From the perspective of a socio-relational framework, emotive behaviors evolved to promote the attraction and aversion of different types of relationships by advertising the two most parsimonious properties of reciprocity potential, or perceived attractiveness as a prospective social partner. These are the individual's (a) perceived capacity or ability to provide expedient resources, or to inflict immediate harm onto others, and their (b) perceived trustworthiness or probability of actually reciprocating altruism (Vigil 2007). Depending on the unique social demands and relational constraints that each sex evolved, individuals should be sensitive to advertise "capacity" and "trustworthiness" cues through selective displays of dominant versus submissive and masculine versus feminine emotive behaviors, respectively. In this article, I introduce the basic theoretical assumptions and hypotheses of the framework, and show how the models provide a solid scaffold with which to begin to interpret common sex differences in the emotional development literature. I conclude by describing how the framework can be used to predict condition-based and situation-based variation in affect and other forms of expressive behaviors.

Seasonal vegetative and affective symptoms in the Finnish general population: testing the dual vulnerability and latitude effect hypotheses

BACKGROUND

Prior studies identified a seasonal pattern in symptoms of depression in clinical and population-based samples. The aims of our study were to estimate the prevalence rates of routine seasonal variations in mood and behavior and of current depressive symptoms in the Finnish general population over 30 years, and to find differences, if any, between the northern and southern regions of residence.

METHODS

5749 participants aged 30-97 (3156 women and 2593 men) were interviewed face to face and attended a health status examination. We included the modified Seasonal Pattern Assessment Questionnaire and the modified Beck Depression Inventory (BDI) for the analysis.

RESULTS

85% of the sample, representative of a general population, had seasonal variations in mood and behavior; 9% of the sample scored high on both scales, thus having the routine seasonal variations together with a current self-report of winter depression. Scoring high on the former scale yielded the odds ratio of 3.12 for scoring high on the BDI. Neither the global seasonality score nor the BDI sum score was associated with latitude. No significant differences in affective symptoms were found by the latitude. The seasonal variation in sleep duration (P<0.001) was more prevalent in the northern regions.

LIMITATIONS

The seasonal variations were assessed with a self-report only.

CONCLUSIONS

A seasonal pattern in mood and behaviors was detected in a general population. Implications of our findings include the assessment of the seasonal variations as a risk factor of depressive illness.

Seasonality is associated with anxiety and depression: the Hordaland health study

BACKGROUND

The purpose of this study was to assess how seasonal changes in mood and behaviour were associated with depression and anxiety symptoms in a sample from a general population, and to investigate how prevalence figures were affected by month of questionnaire completion.

METHODS

The target population included all individuals in the Hordaland county (Norway) born 1953-57 (N=29,400). In total, 8598 men (57% response rate) and 9983 women (70% response rate) attended the screening station. Half of the men (randomly chosen) and all of the women were offered a questionnaire to fill in with items on seasonality. This was measured using the Global Seasonality Score (GSS), a central component of the Seasonal Pattern Assessment Questionnaire (SPAQ). The Hospital Anxiety and Depression Scale (HADS) was used to measure anxiety and depression. Both questionnaires were completed by 2980 men (68.9%) and 8074 women (80.9%).

RESULTS

Seasonality was positively associated with levels of both anxiety and depression regardless of the season the interview took place. In subjects with a low/moderate degree of seasonality there were modestly higher levels of depressive symptoms during November through March than the other months.

LIMITATIONS

We had a substantial number of non-responders.

CONCLUSIONS

Our results raise the possibility of seasonality being a separate dimensional trait associated with both anxiety and depression.

Sensitivity to seasonal changes in panic disorder patients

It has been suggested that symptoms of panic disorder may be significantly affected by seasonal factors including weather changes, although few studies have explored the issue. The purpose of the present paper was to investigate clinical data to examine sensitivity of panic disorder patients to seasonal changes and seasonal fluctuation of panic disorder symptoms. A self-rating questionnaire consisting of the Seasonal Pattern Assessment Questionnaire (SPAQ) and additional self-rating questions were analyzed in 146 Japanese patients (50 male, 96 female) with panic disorder (DSM-IV) at an outpatient clinic for anxiety disorder. The average of the Global Seasonality Scores (GSS) was 12.5+/-4.7 and 25.3% of the patients were suggested to suffer from seasonal affective disorder, according to the GSS. Frequency of the panic attack was found to fluctuate seasonally, with peaks in August and December (P=0.005 and 0.01, chi2 test). The present results indicate that panic disorder patients may be more sensitive to seasonal and meteorological factors than the general population and become more fragile in a specific season or months. This might assist in the development of preventive measures for the frequent recurrence of symptoms in panic disorder.