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Andreeva GF, Gorbunov VM. Basic Aspects of Seasonal Cardiovascular Mortality. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2021. [DOI: 10.20996/1819-6446-2021-02-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The review demonstrates the main aspects of seasonal cardiovascular mortality. Climatic factors, including seasonal weather changes, have a significant impact on the biosphere. People are also characterized by the seasonal dynamics of the activity of many organs and systems, biochemical parameters, and mortality. Cardiovascular mortality is also characterized by seasonal fluctuations: in winter it is maximum, in summer it is minimal. The same patterns are characteristic of mortality from cardiovascular diseases (myocardial infarction, stroke, cardiac arrhythmias, etc.). The article presents the basic patterns of seasonal cardiovascular mortality in various climatic zones, the cardiovascular mortality of countries located in the equatorial and subequatorial climatic region. In addition, the mortality displacement phenomenon, the paradox of winter mortality. The main trends in changes in cardiovascular mortality over a long period of time are demonstrated. The paper discusses some of the mechanisms that underlie the dynamics of cardiovascular mortality during the year: seasonal fluctuations in the level of vitamin D, lipids in the blood plasma, changes in hemodynamic parameters, the effects of microbial and viral infections in the cold season, etc. In addition, data on seasonal the dynamics of risk factors for cardiovascular diseases is considered: an increase in body weight, a physical activity decrease, a change in the nutrition structure in the winter, the seasonal dynamics of depression, anxiety, hostility, the relationship of seasonal cardiovascular mortality with socio-economic, demographic and other factors. In conclusion, the main ways of development and prevention of seasonal CV cardiovascular mortality M, taking into account modern technologies at the international level, for state health departments, for specific patients, are demonstrated.
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Affiliation(s)
- G. F. Andreeva
- National Medical Research Center for Therapy and Preventive Medicine
| | - V. M. Gorbunov
- National Medical Research Center for Therapy and Preventive Medicine
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2
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Oren DA, Zulman DM, Needham WE, Berman RM, Anand A, Charney DS. Visual Impairment and Patterns of Winter Seasonal Depression: Seeing the Light? JOURNAL OF VISUAL IMPAIRMENT & BLINDNESS 2019. [DOI: 10.1177/0145482x0109500404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Dan A. Oren
- VA Connecticut Healthcare System, and associate professor, Department of Psychiatry, Yale School of Medicine, Mailstop 116A, 950 Campbell Avenue, West Haven, CT 06516
| | | | - Walter E. Needham
- VA Connecticut Healthcare System, Mailstop 116B, 950 Campbell Avenue, West Haven, CT 06516
| | | | - Amit Anand
- Department of Psychiatry, Yale School of Medicine, Mailstop 116A, 950 Campbell Avenue, West Haven, CT 06516
| | - Dennis S. Charney
- Mood and Anxiety Intramural Programs, National Institute of Mental Health, Bldg. 10, Rm. 4N-224, 10 Center-Drive, Bethesda, MD 20892-1381
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Juvani S, Isola A, Kyngäs H. The northern physical environment and the well-being of the elderly aged over 65 years. Int J Circumpolar Health 2016; 64:246-56. [PMID: 16050318 DOI: 10.3402/ijch.v64i3.17988] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The purpose was to describe the significance of the physical environment in supporting the well-being of the elderly aged over 65 years. The aim was to produce knowledge that will complement the knowledge-base of gerontologic nursing. STUDY DESIGN The study was qualitative. Thirty-nine home-dwelling elderly persons aged over 65 were interviewed. METHODS The interviews (n = 39) were conducted with the thematic method. The data were analysed with methods of inductive content analysis. RESULTS The main threats of the northern physical environment to the well-being of the elderly are seasonal variation, temperature, snow, light variation and distances. The supportive characteristics of the northern environment are the natural environment, space, familiarity with the physical space, cleanliness and safety. CONCLUSION The characteristics of the northern physical environment seem to be significant for both urban and rural elderly people living in the northern part of Finland. The different aspects of the natural environment provide opportunities to relax, meet other people and do physical exercise, all of which are important factors of health promotion.
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Affiliation(s)
- Satu Juvani
- Department of Nursing and Health Administration, University of Oulu, Finland.
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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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Seasonality of depression referrals in older people. Community Ment Health J 2014; 50:336-8. [PMID: 23959607 DOI: 10.1007/s10597-013-9609-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Accepted: 05/19/2013] [Indexed: 10/26/2022]
Abstract
Seasonal affective disorder is becoming more widely recognised as a prevalent mood disorder in the adult population. However, few studies have investigated the link between sunlight exposure and mood in the elderly. Referrals to the community Mental Health Care for Older People (MHCOP) in the Hackney and City area, were screened for the number of patients referred with depression in three separate years (2007, 2009 and 2011) in order to determine whether more referrals were made to the service during darker months of the year (October to March) than in the lighter months of the year (April to September). When data from the three years was combined, we found no significant increase in the number of referrals to the MHCOP in the darker months (Chi squared value 1.375, p value (2 tailed) 0.2409). We observed no statistically significant seasonal pattern of referrals, this suggests that depression in older people is not more prevalent in darker months of the year.
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Experienced poor lighting contributes to the seasonal fluctuations in weight and appetite that relate to the metabolic syndrome. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2009; 2009:165013. [PMID: 19936126 PMCID: PMC2778831 DOI: 10.1155/2009/165013] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/06/2009] [Accepted: 05/06/2009] [Indexed: 01/19/2023]
Abstract
We tested which environmental, social, lifestyle, and health related factors of the individual contribute to the seasonal variations in mood and behavior and whether these influence the risks of the metabolic syndrome and major depressive disorder, both conditions having a high prevalence in industrialized populations. 5480 individuals, representative of the general population aged 30 and over in Finland, were assessed for metabolic syndrome using the ATP-III criteria, gave a self-report of seasonal variations in mood and behavior, and were interviewed for mood, anxiety, and alcohol use disorders using the DSM-IV criteria. The seasonal variations in mood and behavior have a metabolic factor composed of weight and appetite, and greater loadings on this factor increased the risk of metabolic syndrome (odds ratio of 1.18, 95% confidence interval of 1.10 to 1.26). Self-reports of lighting experienced as poor at home contributed to scores on the metabolic factor (t = 4.20, P < .0001). Lighting conditions and their dynamics may serve as a measure for intervention in order to influence the seasonal metabolic signals and in the end to prevent the metabolic syndrome.
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Küller R, Ballal S, Laike T, Mikellides B, Tonello G. The impact of light and colour on psychological mood: a cross-cultural study of indoor work environments. ERGONOMICS 2006; 49:1496-507. [PMID: 17050390 DOI: 10.1080/00140130600858142] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The aim of the study was to determine whether indoor lighting and colour would have any systematic impact on the mood of people working indoors. Earlier studies have mostly focused either on light, colour or windows in laboratory settings. The present study was carried out in real work environments at different seasons and in countries with different latitudes. A total of 988 persons completed all parts of the study. In the countries situated far north of the equator there was a significant variation in psychological mood over the year that did not occur in the countries closer to the equator. When all four countries were considered together, it became evident that the light and colour of the workplace itself also had an influence on the mood of persons working there. The workers' mood was at its lowest when the lighting was experienced as much too dark. The mood then improved and reached its highest level when the lighting was experienced as just right, but when it became too bright the mood declined again. On the other hand, the illuminance as measured in objective terms, showed no significant impact on mood at any time of the year. The relationship between mood and the distance to the nearest window was bimodal. The results also indicate that the use of good colour design might contribute to a more positive mood. It is suggested that in future research light and colour should be studied as parts of the more complex system making up a healthy building.
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Affiliation(s)
- Rikard Küller
- Department of Environmental Psychology, School of Architecture, Lund Institute of Technology, Lund, Sweden
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Abstract
The operational criteria for seasonal affective disorder (SAD) have undergone several changes since first proposed in 1984. SAD is currently included as a specifier of either bipolar or recurrent major depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The International Classification of Diseases, Tenth Edition has provisional diagnostic criteria for SAD. The most characteristic quality of SAD is that the symptoms usually present during winter and remit in the spring. Furthermore, the symptoms tend to remit when the patients are exposed to daylight or bright light therapy. The cognitive and emotional symptoms are as in other types of depression but the vegetative symptoms are the reverse of classic depressive vegetative symptoms, namely increased sleep and increased appetite. SAD is a common condition, but the exact prevalence rates vary between different studies and countries and is consistently found to be more common in women and in youth. SAD probably possibly occurs in children although not as commonly as in young adults. Some studies have found that certain ethnic groups who live at high northern latitudes may have adapted to the long arctic winter.
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Affiliation(s)
- Andres Magnusson
- Department of Psychiatry, Aker University Hospital, Oslo, Norway.
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Eagles JM. Seasonal affective disorder: a vestigial evolutionary advantage? Med Hypotheses 2005; 63:767-72. [PMID: 15488644 DOI: 10.1016/j.mehy.2004.07.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2004] [Accepted: 07/09/2004] [Indexed: 10/26/2022]
Abstract
The typical symptoms of recurrent winter depression include lowered mood, lethargy, hypersomnia, social withdrawal, decreased libido, increased appetite and weight gain. Mild hypomania often occurs in spring and summer. It is argued that this pattern of attenuated hibernation constituted an adaptive evolutionary mechanism which enhanced the likelihood of reproductive success, most notably for females, among populations living at temperate latitudes. Women were more likely to become pregnant in the summer and thus to give birth at a time of year when their babies had a higher chance of survival. Winter depression symptoms also promoted healthier pregnancies and gave rise to enhanced female-male pair-bonding which improved the survival chances of both mothers and babies. Hypomania in spring and summer also served to increase the likelihood of procreation at the optimal time of year. In the modern era, it is probable that recurrent winter depression is becoming a reproductive disadvantage.
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Affiliation(s)
- J M Eagles
- Royal Cornhill Hospital, Block A, Clerkseat Building, Cornhill Road, Aberdeen AB25 2ZH, UK.
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McConville C, McQuaid M, McCartney A, Gilmore W. Mood and behaviour problems associated with seasonal changes in Britain and Ireland. Int J Soc Psychiatry 2002; 48:103-14. [PMID: 12182505 DOI: 10.1177/002076402128783154] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Research from across the world has shown that rates of seasonal mood disturbances may vary according to such factors as geographical location, age and gender. Little is known of the nature of these problems within representative community samples in UK and Ireland. AIMS In two studies we examined the extent to which winter disrupts mood and behaviour among random samples of British and Irish adults. METHODS In the first study, 533 adults randomly chosen from electoral data from four towns spread across 50-58 degrees N completed the Seasonal Pattern Assessment Questionnaire (SPAQ). In the second study, 498 adults from two towns in Northern Ireland (54 degrees N) completed the SPAQ. RESULTS Although the combined response rate across the two studies was low (20.5%), the prevalence rates were similar to several other western European sites. The rate of SAD and S-SAD averaged across the six centres as determined from strict SPAQ criteria, was 6.7% and 10.5% respectively. There was some variability in rates from town to town, with one Northern Irish town presenting rates more associated with areas at much lower latitudes, although most differences between towns were not significant. As in most other studies, females of reproductive age tended to supply the higher number of incidences. CONCLUSION This report from community samples across six sites confirms earlier suggestions that rates of seasonal disturbance in mood and behaviour deserve serious consideration by mental health practitioners throughout the region.
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Affiliation(s)
- Chris McConville
- School of Psychology, University of Ulster, Coleraine, Co. Londonderry
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Morken G, Lilleeng S, Linaker OM. Seasonal variation in suicides and in admissions to hospital for mania and depression. J Affect Disord 2002; 69:39-45. [PMID: 12103450 DOI: 10.1016/s0165-0327(00)00373-6] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The influence of seasons on mood disorders is controversial. OBJECTIVE To examine monthly variations in admissions for mania and depressions including variations with sex and age and correlations with frequencies of suicides. METHODS All admissions for mania or depression (N=4341) in a population of 1,800,000 with 35,285 admissions in the years 1992-1996 were analysed. All 14,503 suicides in Norway the years 1969-1996 were also analysed. RESULTS Admissions for depression had a significant monthly variation for women (chi(2)=29.78, df=11, P<0.005) with the highest peak in November and for men (chi(2)=19.69, df=11, P<0.05) with the highest peak in April. Among women increasing age correlated negatively with the range of monthly observed/expected ratios (r(s)=-0.943, N=6, P<0.01) and with a of maximal monthly observed/expected ratio (r(s)=-0.943, N=6, P<0.01). Among men suicides correlated with admissions for depression (r=0.647, N=12, P<0.05) and mania (r=0.678, N=12, P<0.05). LIMITATIONS The time of admission to hospital are not identical to onset of affective episode. The study was done retrospectively. No sociocultural or physical environmental data were investigated. CONCLUSION A hypothesis of an influence of seasons on mood disorders is supported. Younger women seem to be especially vulnerable.
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Affiliation(s)
- Gunnar Morken
- Østmarka Hospital, Department of Psychiatry and Behavioural Medicine, The Medical Faculty, The Norwegian University of Science and Technology, Trondheim, Norway.
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Strauss-Blasche G, Ekmekcioglu C, Leibetseder V, Melchart H, Marktl W. Seasonal variation in effect of spa therapy on chronic pain. Chronobiol Int 2002; 19:483-95. [PMID: 12025937 DOI: 10.1081/cbi-120002878] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
This study sought to investigate whether the effects of spa therapy are subject to seasonal variation as suggested by conventional spa therapy research. A total of 268 female (age 31-90 yr) and 119 male (age 35-85 yr) patients with noninflammatory chronic pain were studied. Patients stayed at an Austrian spa for 3 wk and received 2-4 treatments per day, including mudpacks, massages, and exercise therapy. In different groups of patients for 2 yr, pain (self-assessed by questionnaire and Likert scales) and associated variables (mood, fatigue) were measured at the beginning, end, and 6 wk after spa therapy. Data were analyzed by multivariate analysis of covariance controlling for possible group differences between seasons and cosinor analysis. The effect of spa therapy on pain was seasonally dependent; short-term decrease of pain was best between April and June and medium-term decrease of pain was best between October and November, with a second minor peak in fall and spring, respectively. The magnitude of the seasonal variation was greater for back (approximately 30%) than for joint (approximately 20%) pain. Positive mood also improved most between April and June. The observed semi-annual variations of pain do not correspond to the well-known annual change in many physiological and psychological variables. The results suggest that the effects of spa therapy and possibly other related treatments, such as physical and alternative therapies, are subject to seasonal variation.
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Abstract
A prospective panel study was conducted to measure seasonality of mood in a random community sample in Melbourne, Australia (N = 245). Based on research into the structure of human mood, it was predicted that a lowering of mood in winter relative to summer would be observed in positive affect (PA) and behavioral engagement (BE), but not negative affect (NA). These variables were measured across summer and winter for 3 years. Consistent with the majority of research in the Northern Hemisphere, analyses on the entire sample found evidence of a small prospective season effect on the BE scale (explaining 2.1% of variance in BE scores). Also, as expected, no season effect was seen on the NA scale. In the entire sample, the season effect was not significant for PA, but joint factor analysis of the BE, PA, and NA scales confirmed that the season effect seen in the BE scale was largely due to items that were pure measures of PA. Winter pattern seasonality was both reliable across measures and significantly more marked among the subgroup of respondents who self-identified winter pattern of mood on the Seasonal Pattern Assessment Questionnaire.
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Affiliation(s)
- G Murray
- Department of Psychology, University of Melbourne, Parkville, Victoria, Australia.
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Abstract
BACKGROUND The relative shortage of light during the decreasing photoperiod may compromise well-being. Earlier studies suggest that bright-light exposure may be of help to alleviate winter-bound symptoms. METHODS We carried out a field study with exposure to bright light on office employees during winter. RESULTS Repeated bright-light exposure improved vitality and reduced depressive symptoms. The benefit was observed not only in healthy subjects with season-dependent symptoms but also in those not having the seasonal variation. CONCLUSIONS Bright-light exposure during winter appears to be effective at improving the health-related quality of life and alleviating distress in healthy subjects. CLINICAL IMPLICATIONS Administration of bright light is a useful option to improve vitality and mood among subjects working indoors in wintertime. LIMITATIONS OF STUDY: Our field setting used self-reports, not interviews, for the assessment of outcome.
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Affiliation(s)
- T Partonen
- Department of Psychiatry, University of Helsinki, Helsinki, Finland.
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Eagles JM, Wileman SM, Cameron IM, Howie FL, Lawton K, Gray DA, Andrew JE, Naji SA. Seasonal affective disorder among primary care attenders and a community sample in Aberdeen. Br J Psychiatry 1999; 175:472-5. [PMID: 10789281 DOI: 10.1192/bjp.175.5.472] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND There are no large published studies of the prevalence of seasonal affective disorder (SAD) among UK populations. AIM To determine the prevalence of SAD among patients attending a general practitioner (GP). METHOD Patients aged 16-64 consulting their GPs in Aberdeen during January were screened with the Seasonal Pattern Assessment Questionnaire (SPAQ). SPAQs were also mailed to 600 matched patients, who had not consulted their GP during January. Surgery attenders who fulfilled SPAQ criteria for SAD were invited for interview to determine whether they met criteria for SAD in DSM-IV and the Structured Interview Guide for the Hamilton Rating Scale for Depression--Seasonal Affective Disorder Version (SIGH-SAD). RESULTS Of 6161 surgery attenders, 4557 (74%) completed a SPAQ; 442 (9.7%) were SPAQ cases of SAD. Rate of caseness on the SPAQ did not differ between surgery attenders and non-attenders. Of 223 interviewed SPAQ cases of SAD, 91 (41%) also fulfilled DSM-IV and SIGH-SAD criteria. CONCLUSIONS There is a high prevalence of SAD among patients attending their GPs in January in Aberdeen; this is likely to reflect a similar rate in the community.
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Rosner R, Frick U, Beutler LE, Daldrup R. Depressionsverläufe in unterschiedlichen Psychotherapieformen - Modellierung durch Hierarchische Lineare Modelle (HLM). ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 1999. [DOI: 10.1026//0084-5345.28.2.112] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Bislang wurden in der Psychotherapieforschung vornehmlich Therapieergebnisse und nicht Therapieverläufe untersucht. Dies hat neben inhaltlichen auch methodische Gründe, da die in der Psychotherapieforschung üblicherweise kurzen Zeitreihen statistisch aufwendiger handzuhaben sind. In dieser Studie wurden die BDI-Verläufe von 63 unipolar depressiven Patienten mithilfe Hierarchischer Linearer Modelle (HLM) untersucht. Die Patienten hatten randomisiert an einer von drei ambulant durchgeführten Psychotherapieformen (Kognitive Verhaltenstherapie, Gestalttherapie und unterstützende selbstadministrierte Bibliotherapie) mit je zwanzig wöchentlichen Sitzungen teilgenommen. Neben dem Einfluß der Therapieform auf den Verlauf wurden auch differentielle Effekte nach Geschlecht und Schweregrad untersucht. Schwer depressive Patienten zeigten eine schnellere Verbesserung als weniger depressive Patienten. Während über alle Patienten hinweg kein globaler Vorteil für eine der Therapieformen sicherbar war, zeigte sich bei den schwer depressiven Patienten ein günstigerer Verlauf unter Verhaltenstherapie im Vergleich zur Gestalttherapie, sowie unter Gestalttherapie im Vergleich zur selbstdirektiven Therapie.
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Affiliation(s)
- Rita Rosner
- Institut für Psychologie, Ludwig-Maximilians-Universität München
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Abstract
Seasonal affective disorder (SAD) is a form of recurrent depressive or bipolar disorder, with episodes that vary in severity. Seasonal patterns of depressive episodes are common, but SAD seems to be less common than such patterns suggest. SAD was at first believed to be related to abnormal melatonin metabolism, but later findings did not support this hypothesis. Studies of brain serotonin function support the hypothesis of disturbed activity. The short-allele polymorphism for serotonin transporter is more common in patients with SAD than in healthy people. Atypical depressive symptoms commonly precede impaired functioning, and somatic symptoms are frequently the presenting complaint at visits to family physicians. The best treatment regimens include 2500 Ix of artificial light exposure in the morning. When patients seem to have no response or to prefer another treatment, antidepressants should be considered.
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Affiliation(s)
- T Partonen
- Department of Psychiatry, University of Helsinki, National Public Health Institute, Finland.
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