CLINICAL ASPECTS OF WINTER SEASONAL AFFECTIVE DISORDER

复发性季节性情感障碍(SAD)的临床特征 冬季萧条的状况和我们首先缓解的夏季 十多年前的描述，同样得到了广泛的证实， 光疗法(LTX)，我们最初发现这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 继续研究SAD患者(PTS)的临床特征 研究：a)家庭的季节性和SAD的一致性；b) LTX：C)重复经颅磁的响应特性 刺激(RTMS)；&d)受试者的主观体验为研究 参与人员和SAD项目的质量控制评估。 PTS报告SAD和其他情感障碍(AD)的患病率更高 在他们的亲属中比在普通人群中发现的更多；因此，两者 广告与季节性(受季节影响较大的倾向) 都是家族成员。我们假设AD的季节性和易感性 是一起遗传的。我们推测，一级亲属 有AD病史的PTS患者的季节性得分高于 没有AD的亲属。我们已经联系了53名前PTS成员，以制定一份名单 这种一级亲属的情况&数据收集工作已经开始。 以前，我们已经调整了LTX的剂量，以达到最大的临床疗效 回答，因为我们的主要目标是比较抑郁和非抑郁 与生物测量有关的科目。在过去的一年里，我们实施了 固定剂量的LTX(10,000勒克斯，早晚45分钟)，16次PTS 两周时间：1)评估LTX的实施效果；2)联系 LTX对正在研究的生物措施的反应性。叹息-SAD， 一种季节性抑郁的测量方法用于评估LTX 响应性。数据分析正在进行中。 RTMS向大脑施加脉动磁场，以改变电信号 活动。对抑郁症患者的研究表明，左侧前额叶rTMS 情绪有所改善，但右侧rTMS没有。在LCS/NIMH的配合下， 我们探讨了rTMS是否可以非季节性地应用于SAD 抑郁的病人。我们比较了左侧和左侧的单次测试 7例非SAD抑郁症患者和2例抑郁症患者的右侧前额叶rTMS PTS。我们将增加PTS的样本，以更好地了解他们是如何 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。受试者报告说他们的经历 主要是积极的(例如，增加对SAD的理解，重视 LTX)。最常报告的投诉是与以下各项有关的不适 手术(例如，静脉穿刺术)。关于告知受试者关于 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 信息量最少的。我们计划将这样的评估作为一项持续的 SAD计划的组成部分。

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.