Depressive symptomatology differentiates subgroups of patients with seasonal affective disorder
Depressive symptomatology differentiates subgroups of patients with seasonal affective disorder
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DOI：
10.1002/da.1083
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发表时间：
2002-01-01
影响因子：
7.4
通讯作者：
Terman, JS
中科院分区：
文献类型：
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作者：
Goel, N;Terman, M;Terman, JS
患有季节性情感障碍（SAD）的患者可能在其抑郁的冬季睡眠状态的症状方面有所不同，正如我们先前对非抑郁（躁狂、轻躁狂、情绪亢进、情绪正常）的春季状态所示的那样[Goel等人，1999年]。在抑郁症期间识别这种差异可能有助于预测治疗效果的差异或分析疾病的发病机制。在一项横断面分析中，我们确定了165例双相情感障碍（I，II）或重度抑郁症（MDD）患者在抑郁时是否表现出不同的症状特征，这两种疾病都具有季节性模式。评估采用汉密尔顿抑郁评定量表-季节性情感障碍版本（SIGH-SAD）的结构化访谈指南，其中包括一组非典型症状的项目。我们使用多变量方差分析和判别分析，根据非季节性抑郁症的类别确定了SAD的亚组差异。双相情感障碍（I型和II型）患者比MDD患者更抑郁（SIGH-SAD评分更高），并表现出更多的精神激动和社交退缩。双相I型患者比双相II型患者有更多的精神发育迟滞、晚期失眠和社交退缩。男性比女性表现出打鼾强迫症/强迫症和自杀倾向，而女性则表现出更多的体重增加和早期失眠。白人比黑人表现出更多的内疚和疲劳，而黑人则表现出更多的自卑和社交退缩。深色眼睛的患者比蓝眼睛的患者更容易抑郁和疲劳。单身、离异或分居的患者比已婚患者有更多的低血糖和昼夜变化。就业患者比失业患者表现出更多的非典型症状，尽管大多数亚组的区别在于汉密尔顿量表。这些结果包括一组生物和社会文化因素，包括种族，性别，婚姻和就业状况，这有助于抑郁症的抑郁症。重要的情绪和社会文化因素，与性别和眼睛颜色的生物因素相比，与非季节性抑郁症的报告相似。特别是浅色的眼睛，可能有助于增强冬季的光输入，减轻弱势群体的抑郁症状。(C)2002 Wiley-Liss，Inc.
Patients with seasonal affective disorder (SAD) may vary in symptoms of their depressed winter snood state, as we showed previously for nondepressed (manic, hypomanic, hyperthymic, euthymic) springtime states [Goel et al., 1999]. Identification of such differences during depression may be useful in predicting differences in treatment efficacy or analyzing the pathogenesis of the disorder. In a cross-sectional analysis, we determined whether 165 patients with, Bipolar Disorder (I, II) or Major Depressive Disorder (MDD), both with seasonal pattern, showed different symptom profiles while depressed. Assessment was by the Structured Interview Guide for the Hamilton Depression Rating Scale-Seasonal Affective Disorder Version (SIGH-SAD), which includes a set of items for atypical symptoms. We identified subgroup differences in SAD based on categories specified for nonseasonal depression, using multivariate analysis of variance and discriminant analysis. Patients with Bipolar Disorder (I and II) were more depressed (had higher SIGH-SAD scores) and showed more psychomotor agitation and social withdrawal than those with MDD. Bipolar I patients had more psychomotor retardation, late insomnia, and social withdrawal than bipolar II patients. Men showed snore obsessions/compulsions and suicidality than women, while women showed more weight gain and early insomnia. Whites showed more guilt and fatigability than blacks, while blacks showed more hypochondriasis and social withdrawal. Darker-eyed patients were significantly more depressed and fatigued than blue-eyed patients. Single and divorced or separated patients showed more hypochondriasis and diurnal variation than married patients. Employed patients showed more atypical symptoms than unemployed patients, although most of the subgroup distinctions lay on the Hamilton Scale. These results comprise a set of biological and sociocultural factors-including race, gender; and marital and employment status-which contribute to depressive symptomatology in SAD. Significant mood and sociocultural factors, in contrast to biological factors of gender and eye color, were similar to those reported for nonseasonal depression. Lightly pigmented eyes, in particular, may serve to enhance photic input during winter and allay depressive symptoms in vulnerable populations. (C) 2002 Wiley-Liss, Inc.