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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although light therapy is a recognized effective treatment for seasonal affective disorder (SAD), there has been little research into the critical wavelengths of light that produce the antidepressant effect. Previous studies found conflicting results for the importance of the ultraviolet (UV) spectrum in the therapeutic effect of light therapy. To assess the clinical effects of UV-A wavelengths (315-400 nm), we studied 33 depressed SAD patients diagnosed with structured interviews by DSM-IIIR criteria. Following a baseline week, patients underwent 2 weeks of 2500 lux light therapy for 2 h daily (06:00-08:00). Light therapy consisted of cool-white fluorescent light with the addition of a special UV-A fluorescent tube. Patients were randomized to wear glasses during light therapy that either blocked (UV-blocked condition) or passed (UV-A condition) wavelengths below 400 nm. Both treatments significantly reduced all depression ratings, but no differences were found between the UV-A and UV-blocked conditions. We conclude that the UV-A spectrum does not increase the antidepressant response of light therapy. Given the potential side effects of chronic UV exposure, clinical application of light therapy should use light sources that have the UV spectrum filtered.
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PMID:The effects of ultraviolet-A wavelengths in light therapy for seasonal depression. 157 79

Seasonal Affective Disorder (SAD) has received formal research attention only within the last eight years. Diagnostic criteria for SAD include many characteristics typical of depression: sadness, low self-esteem, lack of energy, social withdrawal, and suicide ideation, and features of atypical depression: carbohydrate craving, overeating, weight gain, and hypersomnia. Differential diagnosis of the disorder depends on an onset in fall/winter and remission in spring/summer. It was hypothesized that spinal cord injury (SCI) patients would have a higher incidence of the disorder in the northern latitudes because of decreased outdoor activities in winter and because of such light-depriving winter survival tactics as installing opaque plastic for storm windows. SCI patient responded to a postal survey which included Rosenthal's Seasonal Pattern Assessment Questionnaire (SPAQ) and the Beck Depression Inventory (BDI). Results showed a substantially higher rate of SAD among SCI patients than in the normative sample.
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PMID:Seasonal affective disorder in a spinal cord injury population. 158 5

In a longitudinal cohort study of young adults from the Canton of Zurich in Switzerland (Zurich Study), seasonal patterns of several psychiatric and psychosomatic syndromes were investigated in two interviews over a period of three years. At an age of 27-28 years, 23% of the depressives, 15% of the neurasthenic subjects, and 14% of the subjects with backache reported an increased susceptibility in autumn and/or winter. With respect to the course we found that 10.4% of the subjects of the longitudinal sample (n = 417) suffered from seasonal depression (including individuals with subsyndromal seasonal difficulties) over two consecutive years. Specific symptoms, such as hypersomnia, increase of appetite or weight gain, were not found to be consistently associated with seasonal depression. A comparison of actual and retrospective reports on seasonal depression resulted in a very low reliability. In view of these results the seasonal subtype of depression should be diagnosed with caution, except when the diagnosis is based on longitudinal observations and/or external sources of information (e.g. family members, partner).
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PMID:The Zurich Study. XIV. Epidemiology of seasonal depression. 160 94

In a mailed survey conducted at four centers--Nashua, NH; New York, NY; Washington, DC; and Sarasota, FL--1,671 respondents provided information on monthly variations in 10 behavioral categories representing extremes in the areas of mood, socializing, appetite, weight gain/loss, and sleep length. A 10-factor solution revealed the following factors: (1) a winter weight gain factor; (2) a winter depression factor; (3) a winter hypersomnia factor; (4) a summer weight gain factor; (5) a summer hypersomnia factor; (6) a summer depression factor; (7) a winter socializing factor; (8) a winter weight loss factor; (9) a fall depression factor; and (10) a possibly mixed factor. Factors consistent with winter seasonal affective disorder were positively correlated with latitude, while those consistent with summer seasonal affective disorder were negatively correlated with latitude.
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PMID:Seasonal variations in mood and behavior in the general population: a factor-analytic approach. 175 39

Since the first description of seasonal affective disorder (SAD), many international studies have confirmed the existence of this subgroup of depressive patients. Even though the diagnosis of SAD has been incorporated into the DSM-III-R classification system, many psychiatrists maintain a certain skepsis as to the existence of SAD as a separate sub-group of depression. The diagnostic issues are important because of the apparent specificity of treatment of SAD with bright light. Most diagnoses have relied on retrospective descriptions of the patients' depressive and healthy phases with respect to time of year. We present prospectively gathered weekly depression self-ratings in a SAD patient over a period of six years that may provide valid criteria for diagnostic purposes. This is a particularly exemplary case with implications for the relationship between light therapy and the course of depressive phases, the possible interaction of light treatment with lithium, the relationship between weight-changes and mood changes over the year and aspects of family loading of the illness.
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PMID:[Mood follow-up over 6 years in a patient with season-dependent form of depression (SAD)]. 176 Dec 72

Phototherapy was administered to 24 depressed patients with seasonal affective disorder (SAD), of which 62%, 24%, and 14%, respectively, showed improvements of greater than or equal to 50%, 25-50%, and less than 25% based on the Hamilton rating scale for depression for SAD (HAMSAD). No patients showed aggravation or side effects. Although the improvement rate in HAMSAD correlated significantly with the pretreatment severity of atypical symptoms of depression, it did not correlate with that of typical symptoms. This suggests that phototherapy is a useful treatment in SAD and that responsiveness to phototherapy in SAD can possibly be predicted by the atypical depressive symptoms before treatment.
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PMID:Atypical depressive symptoms possibly predict responsiveness to phototherapy in seasonal affective disorder. 179 Dec 63

A multi-center study on seasonal affective disorder (SAD) was conducted from the autumn of 1988 to the spring of 1989 with the cooperation of 16 facilities in Japan. Forty-six SAD patients were identified among 1104 respondents to our advertisements in mass media, or patients seen at the outpatient clinics. Essentially similar findings to other previous reports were obtained in terms of onset age of the first episode, duration of episode, high proportion of depression in first-degree relatives and atypical vegetative symptoms. However, a nearly equal sex ratio, together with a high proportion of unipolar depression, is characteristic of the present study. Increased appetite and carbohydrate craving were predominant only in female patients, whereas hypersomnia was prominent in both sexes. Effective response to light therapy was found in 17 SAD patients. However, a controlled study on a large number of patients is required to allow final conclusions on the efficacy of light therapy in Japanese SAD patients.
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PMID:Multi-center study of seasonal affective disorders in Japan. A preliminary report. 182 77

The standard phototherapy procedure for seasonal affective disorder (SAD) has been to expose patients to 2500 lux light intensity for 2 h. This study investigated whether high-intensity light treatment with a brief exposure time would relieve symptoms of SAD. Ten SAD patients were randomly assigned to 40-min exposure to 10,000 lux white light or to 400 lux red light which served as placebo. Each patient received treatment for 8 days, and after a wash-out period was crossed over to the other treatment condition. Depression was assessed by the 21-item HDRS and SIGH-SAD by a blind rater and the patients completed the BDI for self-assessment. Significantly greater improvement was found with 10,000 lux treatment than with the placebo (P = 0.011, P = 0.017 and P = 0.028 for SIGH-SAD, HDRS and BDI respectively). The 10,000 lux therapy improved the SIGH-SAD score by an average of 16.1 while the average improvement on placebo treatment was 5.0. The patients were rated again the following summer; most of them were the symptomless. Those patients who improved most on phototherapy also tended to improve most during the summer.
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PMID:Treatment of seasonal affective disorder with high-intensity light. A phototherapy study with an Icelandic group of patients. 182 41

By means of a review of genetic, biological and neurophysiological studies, we attempted to validate the DSM III-R depressive disorder categories. Genetic studies support the distinction between bipolar and recurrent major (unipolar) depression although genetic heterogeneity and variable phenotypic expressivity have been suggested in bipolar depression. Biological and neuroendocrine abnormalities in depression seem to relate more to a particular symptomatological profile than to a specific depressive subtype including the bipolar-unipolar dichotomy. For example, catecholamines and serotonin metabolism seem to reflect respectively psychomotor status and aggressiveness in depression. Using genetic and biological criteria, major depression with psychotic features is the best validated category of the four main DSM-R major depressive subclasses or specifications (psychotic, chronic, melancholic, seasonal). Psychotic depression seems to constitute the most coherent subgroup and biological abnormalities such as dexamethasone non suppression and shortened REM latency are very often observed. An important confounding variable in these biological validation studies is the severity of the depressive state. Psychotic depression is considered to be a more severe depressive subtype and also shows marked biological disturbances. Conversely, in seasonal depression, a less severe depressive subtype, CSF monoamine metabolism abnormalities, dexamethasone non suppression and shortened REM latency could not clearly be demonstrated. Genetic studies show that early onset dysthymia and cyclothymia could be part of the affective spectrum and some maintain that these two clinical entities are attenued forms of bipolar or recurrent major depression.
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PMID:[Biological psychiatry and current classifications of depressive disorders]. 186 51

Previous reports have shown that bright light exposure may benefit patients with seasonal depression. In the present study, the possible therapeutic effect of bright light in nonseasonal major depressive disorder was examined. Forty-two depressed patients not receiving additional antidepressant medication were exposed to bright white light of 2500 lux or dim red light of 50 lux over one week for two hr daily in the morning. The change in depressive symptoms was assessed by rating scales (Hamilton Depression Rating Scale, CGI) and by self-rating scales (Depression Scale, Complaint List, Visual Analogue Scale). Consistent for all ratings, the decrease in depressive symptoms after bright white light was only slight and not different from dim red-light exposure. Contrary to the findings in seasonal affective disorder, phototherapy administered over one week for two hr daily is not effective in nonseasonal major depressive disorder.
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PMID:Phototherapy in nonseasonal depression. 191 17


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