CLINICAL ASPECTS OF WINTER SEASONAL AFFECTIVE DISORDER

冬季季节性情感障碍的临床表现

• 批准号: 2578777
• 负责人: N E ROSENTHAL
• 金额: --
• 依托单位: NATIONAL INSTITUTE OF MENTAL HEALTH
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/2578777
• 关键词: clinical research; human subject; human therapy evaluation; magnetic field; photobiology; phototherapy; seasonal affective disorder; seasons; visible light

The clinical profile of seasonal affective disorder (SAD), a recurring condition of winter depressions & summer remissions which we first described over a decade ago, has been widely corroborated, likewise, light therapy (LTX), which we first found to be an effective treatment for SAD, has become a mainstream psychiatric treatment. We have continued to study the clinical profile of SAD patients (PTS) with studies on: a) the concordance of seasonality & SAD in families; b) response characteristics of LTX: c) repetitive transcranial magnetic stimulation (rTMS); & d) subjects'subjective experiences as research participants & quality control evaluation of the SAD program. PTS report a higher prevalence of SAD & other affective disorders (AD) in their relatives than is found in the general population; hence, both Ad & seasonality (the tendency to be strongly affected by the seasons) are familial. We hypothesize that both seasonality & vulnerability to AD are inherited together. We predicated that the first-degree relatives of PTS with a history of AD will have higher seasonality scores than relatives without AD. WE have contacted 53 former PTS to develop a list of such first-degree relatives & data collection has begun. Formerly, we have adjusted the dose of LTX to achieve maximal clinical response, since our main goal was to compare depressed and non-depressed subjects regarding biological measures. This past year we administered a fixed LTX dose (10,000 lux 45 minutes morning & evening) with 16 PTS for two weeks to: 1)assess the efficacy of LTX as implemented & 2) relate LTX responsiveness to the biological measures under study. The SIGH-SAD, a measure of seasonal depression, was administered to assess LTX responsiveness. Data analysis is underway. rTMS applies a pulsating magnetic field to the brain to alter electrical activity. Study of depressed patients showed that left prefrontal rTMS improved mood but right-sided rTMS did not. In tandem with the LCS/NIMH, we explored whether rTMS may have application in SAD & non-seasonally depressed patients. We compared a single session of left-sided versus right-sided prefrontal rTMS in seven non-SAD depressed patients and two PTS. We will increase our sample of PTS to better understand how they respond to rTMS. We also asked about the subjective experiences of subjects that participated in our studies. Subjects reported that their experiences were primarily positive (e.g., increased understanding of SAD, valuing LTX). A most often reported complaint was discomfort related to procedures (e.g., venipuncture). In regards to informing subjects about studies, the subjects reported that a binder of SAD materials was the most useful source of information & that the official consent form was the least informative. We plan to make such assessments an ongoing component of the SAD program.

季节性情感障碍（SAD）的临床特征， 冬季抑郁症和夏季缓解的条件，我们首先 十多年前所描述的，已经得到了广泛的证实，同样， 光疗法（LTX），我们首先发现这是一种有效的治疗方法， 已经成为一种主流的精神病治疗方法。 我们有 继续研究SAD患者（PTS）的临床特征， 研究：a）家庭中季节性和SAD的一致性; B） LTX的响应特征：c）重复经颅磁共振 刺激（rTMS）;和d）受试者的主观经验作为研究 SAD计划的参与者和质量控制评估。 PTS报告SAD和其他情感障碍（AD）的患病率较高 在他们的亲戚比在一般人群中发现;因此，两者 广告和季节性（受季节强烈影响的趋势） 是家族性的我们假设季节性和对AD的脆弱性 是一起继承的。 我们推断死者的一级亲属 有AD病史的PTS的季节性得分高于 没有AD的亲戚我们已经联系了53名前PTS， 这类一级亲属的数据收集工作已经开始。 以前，我们调整了LTX的剂量，以达到最大的临床效果。 反应，因为我们的主要目标是比较抑郁和非抑郁 关于生物措施。过去的一年里， 固定LTX剂量（10，000 lux，早晚各45分钟），16个PTS 为期两周，以：1）评估实施的LTX的功效; 2）联系 LTX对所研究的生物措施的反应。悲伤的叹息， 一种季节性抑郁的测量方法，用于评估LTX 响应能力。 数据分析正在进行中。 rTMS向大脑施加脉动磁场， 活动对抑郁症患者的研究表明，左前额叶rTMS 改善情绪，但右侧rTMS没有。与LCS/NIMH合作， 我们探讨了rTMS是否可以应用于SAD和非季节性 抑郁症患者我们比较了一个单一的会议左侧与 7名非SAD抑郁症患者和2名 重量份我们将增加PTS的样本，以更好地了解他们如何 回复rTMS 我们还询问了受试者的主观体验， 参与了我们的研究。受试者报告说， 主要是积极的（例如，增加对SAD的了解， LTX）。最常报告的投诉是与以下相关的不适： 程序（例如，静脉穿刺）。关于告知受试者 研究中，受试者报告说，SAD材料的粘合剂是 最有用的信息来源&官方同意书是 最少的信息。我们计划继续进行这种评估， 这是SAD计划的一部分。