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: 5203777
• 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/5203777
• 关键词: Addison's disease; Cushing's syndrome; chemical hypersensitivity; chronic fatigue syndrome; cognition; human subject; interview; obsessive compulsive disorder; patient care personnel relations; phototherapy; questionnaires; seasonal affective disorder; seasons

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.

季节性情感障碍（SAD）的临床特征， 冬季萧条和夏季缓解的条件，我们首先 十多年前描述的，现在已经被广泛地证实。 同样的，光疗法，我们首先发现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 继续探索SAD患者的临床特征 (PTS)通过：a）评估认知功能; B）调查自我， 报告了对环境化学品的敏感性， 与其他患者组和对照组的情况相比; c）调查PTS' 我们研究的主观经验;以及，d）比较遮光板和 光箱在以前用光有效治疗的PTS中的有效性 疗法 7名PTS接受了以下光疗（灯箱）治疗 参加另一项冬季研究的人，被随机分配到 进一步用灯箱处理或用遮光板处理 每天一次，每次一周。 盲评者用结构化的 汉密尔顿抑郁量表SAD版访谈指南 （叹气-悲伤）。 在光治疗期间维持PTS， 以前被发现是有帮助的，通常不到一个小时的两次 一天 一周后的抑郁症状没有差异 与灯箱相比，使用遮光板的治疗效果更好。 第二项研究评估了PTS对环境暴露的敏感性。 化学品 一个标准化的，自我管理的问卷调查， 对46例PTS，73例慢性疲劳综合征（CFS）患者， 27例强迫症患者，21例 Addison病组、库欣综合征组19例、对照组39例。 PTS和Addison病和CFS患者，报告最高 暴露于各种环境化学品的敏感性，以及 显著高于其他组。 总的来说， 女性比男性对化学物质更敏感。 第三项研究包括10名PTS和9名对照（CRTS）， 在冬季和夏季进行认知测试：模式识别 任务和Stroop任务。 PTS和CRTS之间无差异 任何一项任务。 然而，对于Stroop测试，PTS和CRTS 夏天比冬天表现得更好。 在对32名参加了冬季方案的PTS的最后一项研究中， 我们进行了一次半结构化的采访，询问 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， 光疗法和良好的个人互动与工作人员作为主任 有利的方面。 大多数人至少报告了他们的一些元素， 参与是有问题的，尤其是时间要求。 大多数临时秘书处表示， 他们愿意参与未来的研究。