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seasonal affective disorder

depressive disorder with seasonal pattern, regulary recurring depressive episodes that most commonly occur in autumn & winter & remit in spring & summer [4] Pathology: 1) increased melatonin ? 2) reduced levels of serotonin ? [2] Clinical manifestations: 1) episodes of major depression that have a regular temporal relationship with a particular time of year, generally winter 2) at least 2 episodes, with remission in other seasons Differential diagnosis: 1) major depression 2) bipolar disorder 3) anxiety disorder Management: 1) light therapy 2) cognitive behavioral therapy [6] 3) antidepressant [3,4,5], SSRI [1]

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affect major depression

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affective disorder

References

  1. Medical Knowledge Self Assessment Program (MKSAP) 11, 14, American College of Physicians, Philadelphia 1998, 2006
  2. Prescriber's Letter 12(1):4, 2005 Seasonal Affective Disorder Light Therapy Product Comparison Chart Detail-Document#: 210106 (subscription needed) http://www.prescribersletter.com
  3. Lam RW et al, The Can-SAD study: A randomized controlled trial of the effectiveness of light therapy and fluoxetine in patients with winter seasonal affective disorder. Am J Psychiatry 2006; 163:805
  4. Modell JG, Rosenthal NE, Harriett AE, Krishen A, Asgharian A, Foster VJ, Metz A, Rockett CB, Wightman DS. Seasonal affective disorder and its prevention by anticipatory treatment with bupropion XL. Biol Psychiatry. 2005 Oct 15;58(8):658-67. PMID: 16271314
  5. Prescriber's Letter 13(9): 2006 Drug Treatment of Seasonal Affective Disorder (SAD) Detail-Document#: 220904 (subscription needed) http://www.prescribersletter.com
  6. Rohan KJ et al. Randomized trial of cognitive-behavioral therapy versus light therapy for seasonal affective disorder: Acute outcomes. Am J Psychiatry 2015 Apr 10 PMID: 25859764 http://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2015.14101293 - Rohan KJ, Mahon JN, Evans M et al Randomized Trial of Cognitive-Behavioral Therapy Versus Light Therapy for Seasonal Affective Disorder: Acute Outcomes. Am J Psychiatry. 2015 Sep 1;172(9):862-9. PMID: 25859764 - Rohan KJ et al Outcomes One and Two Winters Following Cognitive-Behavioral Therapy or Light Therapy for Seasonal Affective Disorder. Am J Psychiatry 2015 Nov PMID: 26539881 http://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.2015.15060773?journalCode=ajp