CLINICAL ASPECTS OF WINTER SEASONAL AFFECTIVE DISORDER (SAD)

冬季季节性情感障碍 (SAD) 的临床表现

• 批准号: 3759526
• 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/3759526
• 关键词: bipolar depression; child abuse; dissociative hysteria; human subject; mental disorder diagnosis; mental health epidemiology; psychological shock; questionnaires; seasonal affective disorder; sex behavior disorder

We have previously described the syndrome of winter seasonal affective disorder (SAD). SAD is characterized by symptoms of depression that recur regularly during the fall and winter and remit in spring and summer. Although the clinical picture of SAD has been well delineated, little research has been done on its longitudinal course. In this report we complete the description of the follow-up study findings described in last year's report. Although SAD has been described primarily in adults, we and others have reported on a small number of children and adolescents with the syndrome. We expanded our knowledge by studying epidemiological and clinical features of SAD in children and adolescents. SAD has been recognized as a syndrome predominant in females (4 out of 5). However, systematic studies to date have not examined differences in gender with respect to clinical presentations or response to light therapy. We report on the gender difference findings for SAD patients collected over the years. A study of 59 adult patients, discharged from our clinic over 7 years ago indicated that 25 (42%) remained "exclusively seasonal." Those who experienced other, non-seasonal pathology endorsed substantial degrees of seasonality and continue to demonstrate seasonal patterns of symptoms. Twenty-four of the 54 (44%) patients who initially used light treatment continued to use light therapy regularly and successfully each winter to the present. 1,835 Elementary and middle school students of montgomery County were given questionnaires assessing seasonality. Overall, 3% reported clinically significant difficulties. For grades 6 through 9 the prevalence averaged less than 2% for grades 10 through 12 it averaged over 5%. Given previous adult estimates in Montgomery County at approximately 6%, it appears that seasonality problems fulminate around 15 years of age. Females represented 55% of cases and males 45%. In addition, the distribution of prevalence appeared different for females and males such that female prevalence increased with puberty and male prevalence was split between prepubertal and postpubertal groups. A multivariate analysis indicated that a decline in grades and feeling worst and most irritable in the winter months best discriminated between SAD cases and non-cases. In girls eating also contributed to discriminating SAD cases from non-cases. A linear discriminant function analysis revealed that four variables best differentiated women from men. These were carbohydrate craving, winter sleep length, percent seasonal weight change (all greater in women), and severity of seasonal change (greater in men). 93% of women but only 28% of men were correctly classified regarding gender, suggesting that women with SAD are a more homogeneous group than men with SAD. No gender differences with regard to light response were detected.

我们以前曾描述过冬季季节性综合征 情感障碍（SAD）。 SAD的特征是抑郁症状 秋季和冬季定期复发，春季缓解， 夏天 虽然SAD的临床表现已经得到很好的描述， 关于它的纵向过程的研究很少。 本报告中 我们完成了对后续研究结果的描述， 去年的报告。 虽然SAD主要在成人中描述， 我们和其他人报告了少数儿童和青少年的情况， 综合症。 我们通过研究流行病学 儿童和青少年SAD的临床特点。 悲伤一直是 被认为是一种主要见于女性的综合征（4/5）。 然而，在这方面， 迄今为止的系统研究还没有检查性别差异， 关于临床表现或对光疗法的反应。 我们报告 对收集的SAD患者的性别差异结果进行分析， 年 一项对59名成年患者的研究，这些患者7年前从我们的诊所出院 25个（42%）仍然是“完全季节性的”。“那些 经验丰富的其他非季节性病理学证实， 季节性，并继续表现出症状的季节性模式。 54例最初使用光治疗的患者中有24例（44%） 我继续定期使用光疗，并成功地在每个冬天， 现在的 为蒙哥马利县1,835名中小学生发放了 调查问卷评估季节性。 总体而言，3%的患者报告临床 重大困难。 从6年级到9年级， 10至12年级不到2%，平均超过5%。 给定先前 成人估计在蒙哥马利县约为6%，看来， 季节性问题在15岁左右爆发。 女性占 55%的病例和45%的男性。 此外，患病率的分布 女性和男性的患病率不同， 随着青春期的增加而增加，男性患病率在青春期前和青春期后之间分裂。 和青春期后群体。 多变量分析表明， 在等级和感觉最差和最烦躁的冬季最好 区分SAD病例和非病例。 在女孩吃也 导致SAD病例与非病例之间存在差异。 一个线性判别函数分析显示，四个变量最好， 区分女性与男性。 这些是碳水化合物的渴望，冬天 睡眠时间，季节性体重变化百分比（女性更大），以及 季节变化的严重程度（男性更严重）。 93%的女性，但只有28%的 男性被正确地分类为性别，这表明女性与男性相比， SAD是一个比SAD男性更同质的群体。 无性别差异 光响应的检测。