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S easonal A ffective D isorder JB Leiknes. Seasonal Affective Disorder. Mood disorder People who are normally happy experience depressive symptoms during winter months “Winter-blues” or “winter depression” More prevalent in nordic countries
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Seasonal Affective Disorder JB Leiknes
Seasonal Affective Disorder • Mood disorder • People who are normally happy experience depressive symptoms during winter months • “Winter-blues” or “winter depression” • More prevalent in nordic countries • First described by scholar Jordanes in the 6th century in his book Getica1 • Most prevalent during winter months but can occur during other seasons [Reverse Seasonal Affective Disorder]
Classification of SAD • In order to qualify as SAD a diagnosis must meet 4 criteria2: • Depressive periods at a particular time of year • Relapse into depression or mania/hypomania at a particular time of year • Pattern of depression lasting two or more years with no nonseasonal major depressive episodes during the same period • The instances of depression following a seasonal pattern must outnumber other instances of depression throughout patient's life
Etiology • Believed to be light-related • Evidence: effectiveness of light-therapy3 • Serotonin polymorphisms4 • Association between SAD and the shorter allele of the serotonin transporter promoter repeat length polymorphism (5-HTTLPR) • Mutation in the gene expressing melanopsin • Photopigment found in retina, participates in circadian rhythm
Treatment • Primarily concerning winter-based SAD • Light therapy • Bright light therapy/dawn simulation5 • Medication • Timed administration of the hormone melatonin • Main theory behind treatment is adjustment of circadian rhythm via use of light or hormones/medicaments to mimic or induce the body's own mechanisms of circadian rhythm
Cultural Impact • Light cafés • Commercially available bright-lights
Sources 1 – [Wikipedia] Jordanes' Getica – http://en.wikipedia.org/wiki/Getica_(Jordanes) 2 – [Mayo Clinic] Depression - Seasonal Affective Disorder (SAD) – http://www.mayoclinic.com/health/seasonal-affective-disorder/DS00195/DSECTION=symptoms 3 – [American Journal of Psychiatry] The Can-SAD Study: A Randomized Controlled Trial of the Effectiveness of Light Therapy and Fluoxetine in Patients With Winter Seasonal Affective Disorder – http://ajp.psychiatryonline.org/cgi/content/abstract/163/5/805 4 – [Neurobiology of Disease] Seasonal Affective Disorder and Serotonin-Related Polymorphisms – http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WNK-457VFDV-13&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=cdf40c7c01f51290364ab7709dbeacf4 5 – [Biological Psychiatry] Dawn simulation and bright light in the treatment of SAD: a controlled study – http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T4S-43RJ7CF-8&_coverDate=08%2F01%2F2001&_alid=509264218&_rdoc=1&_fmt=&_orig=search&_qd=1&_cdi=4982&_sort=d&view=c&_acct=C000022721&_version=1&_urlVersion=0&_userid=489256&md5=c2dc9bcba4a21f35f9482ab0fd10cd1a