CLINICAL ASPECTS OF WINTER SEASONAL AFFECTIVE DISORDER (SAD)

复发性季节性情感障碍(SAD)的临床特征 冬季萧条和夏季缓解的状况，我们首先 十多年前描述的，到目前为止已经被广泛研究。 同样，光疗法，我们最初发现是一种有效的治疗方法 对于SAD来说，已经成为一种主流的精神治疗方法。我们有 继续探讨SAD患者的临床特征 通过：a)评估认知功能；b)调查自我 报告对环境化学品的敏感性并比较反应 对其他患者组和对照组的研究；c)调查PTS 我们研究的主观体验；以及，d)比较遮光罩和 经光疗后PTS的灯箱效应 心理治疗。 7名接受过光疗(灯箱)的PTS患者 参加另一项冬季研究的人被随机分配到 用灯箱进一步治疗或用遮光罩治疗 每天一次，每次一周。盲人评分者用结构化的方法评估情绪 汉密尔顿抑郁评定量表访谈指南-SAD版 (叹息-SAD)。PTS被维持在光疗的持续时间上 以前被发现是有帮助的，通常两次不到一个小时 一天。在接下来的一周里，抑郁症状没有区别。 与灯箱相比，使用遮光罩进行治疗的可能性更大。 第二项研究评估了PTS对环境暴露的敏感性 化学制品。一份标准化的自填式问卷是 应用于46例PTS，73例慢性疲劳综合征(CFS)患者， 27例强迫症患者，21例强迫症患者 Addison病，19例库欣综合征患者和39例对照。 PTS和Addison病和CFS患者报告的最高 对暴露于各种环境化学品的敏感性，以及对 其程度明显大于其他组。总体而言, 女性报告的化学敏感性比男性更高。 第三项研究包括10个PTS和9个对照(CRT)，实施2个 冬季认知测验和夏季认知测验：模式识别 任务和Stroop任务。PTS与CRTS之间无明显差异 在这两项任务中的任何一项。然而，对于Stroop测试，PTS和CRTS 夏季的表现好于冬季。 在一项针对32名PTS的最终研究中，这些PTS在 季节性研究项目我们进行了半结构化的访谈，询问 关于他们作为研究对象的经历。所有临时秘书处都报告说 研究项目帮助了他们，引用了关于他们病情的教育， 光疗和以员工为首席的良好的个人互动 有益的方面。大多数人报告说，他们的 参与是有问题的，尤其是对时间的要求。大多数PTS声明 他们愿意参与未来的研究。

The clinical profile of seasonal affective disorder (SAD), a recurring condition of winter depressions and summer remissions, which we first described over a decade ago, has by now been widely co rroborated. Likewise, light therapy, which we first found be an effective treatment for SAD, has become a mainstream psychiatric treatment. We have continued to explore aspects of the clinical profile of SAD patients (PTS) by: a) evaluating cognitive functioning; b) surveying self- reported sensitivity to environmental chemicals and comparing responses to those of other patient groups and controls; c) surveying PTS' subjective experience of our research; and, d) comparing light visor and light box effectiveness in PTS previously treated effectively with light therapy. Seven PTS who had been treated with light therapy (light box) following participation in another winter study, were randomly assigned to either further treatment with the light box or treatment with the light visor daily for one week each. Blind raters assessed mood with the Structured Interview Guide for the Hamilton Depression Rating Scale-SAD Version (SIGH-SAD). PTS were maintained on the duration of light therapy that had previously been found to be helpful, usually less than one hour twice a day. There was no difference in depressive symptoms following the week of treatment with the light visor, as compared with the light box. A second study evaluated PTS sensitivity to exposure to environmental chemicals. A standardized, self-administered questionnaire was administered to 46 PTS, 73 patients with chronic fatigue syndrome (CFS), 27 patients with obsessive compulsive disorder, 21 patients with Addison's Disease, 19 patients with Cushing's Syndrome, and 39 controls. PTS and patients with Addison's Disease and CFS, reported highest sensitivities to exposure to various environmental chemicals, and to a significantly greater degree than those in the other groups. In general, women reported greater chemical sensitivity than did men. A third study of 10 PTS and nine controls (CRTS), administered two cognitive tests in winter and again in summer: the pattern recognition task and the Stroop task. There were no differences between PTS and CRTS on either of the tasks. For the Stroop test, however, PTS and CRTS performed better in summer than in the winter. In a final study of 32 PTS who had been through a winter protocol in the Seasonal Studies Program we gave a semi-structured interview, inquiring about their experiences as research subjects. All PTS reported that the research program had helped them, citing education about their condition, light therapy and favorable personal interactions with staff as the chief beneficial aspects. Most reported at least some element of their participation as problematic, especially time demands. Most PTS stated that they would be willing to participate in future studies.