Seasonal Affective Disorder

1

• Seasonal Affective Disorder
• JB Leiknes

2
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

3
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

4
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

5
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

6
Cultural Impact

• Light cafés
• Commercially available bright-lights

7
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/DSECTIONsympt
  oms
• 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/abst
  ract/163/5/805
• 4 Neurobiology of Disease Seasonal Affective
  Disorder and Serotonin-Related Polymorphisms
  http//www.sciencedirect.com/science?_obArticleUR
  L_udiB6WNK-457VFDV-13_user10_rdoc1_fmt_or
  igsearch_sortdviewc_acctC000050221_version
  1_urlVersion0_userid10md5cdf40c7c01f5129036
  4ab7709dbeacf4
• 5 Biological Psychiatry Dawn simulation and
  bright light in the treatment of SAD a
  controlled study http//www.sciencedirect.com/sc
  ience?_obArticleURL_udiB6T4S-43RJ7CF-8_coverDa
  te082F012F2001_alid509264218_rdoc1_fmt_o
  rigsearch_qd1_cdi4982_sortdviewc_acctC0
  00022721_version1_urlVersion0_userid489256m
  d5c2dc9bcba4a21f35f9482ab0fd10cd1a