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

The objectives of this study were to test the hypothesis that a dopaminergic deficiency plays a role in the pathogenesis of winter seasonal affective disorder (SAD) and to test the efficacy of levodopa plus carbidopa as a treatment for SAD. Two weeks of double-blind placebo washout were followed by random assignment to parallel treatments for 2 weeks with levodopa and carbidopa versus placebo. Observations were made during weekly outpatient visits. All subjects met criteria for SAD. Fifty patients entered the study. Twenty-four were significantly depressed after the washout period and were randomly assigned to medication or placebo. Twenty-three completed the study. Twelve patients received placebo capsules four times a day during the 2-week drug comparison period. On an identical schedule, 11 patients received capsules containing levodopa (up to 7 mg/kg per day by the end of the second week) and carbidopa (100 mg/day). Twenty-one item Hamilton Rating Scale for Depression scores were used to determine antidepressant efficacy. No differences were found in the rates of response. There is no evidence to support the use of levodopa for the treatment of SAD patients in general. A model of systemic dopaminergic deficiency does not readily explain the pathology of SAD.
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PMID:A controlled trial of levodopa plus carbidopa in the treatment of winter seasonal affective disorder: a test of the dopamine hypothesis. 802 16

The role of cognitive sensitivity to light in the development of seasonal affective disorder (SAD, winter type) was studied by comparing 29 SAD patients during remission with 29 non-depressed controls matched by sex and age, and by relating measures for cognitive sensitivity of remitted SAD patients to the onset of a depressive episode during the following autumn/winter. To ensure that only cognitive processes were involved, the subjects were exposed to symbolic light. Three schematic drawings of ambiguous faces expressing different emotions were embedded in light or dark backgrounds for this purpose. The subjects rated the various facial expressions with respect to the degree of elation-sadness, rejection-invitation, and activation-sleepiness. SAD patients saw larger differences in activation between faces embedded in light and dark backgrounds than controls, perceiving less activation in faces with dark backgrounds. Furthermore, the larger the difference that SAD patients saw in invitation between faces with light and dark backgrounds, the earlier they became depressed in the subsequent autumn/winter. Only the SAD patients who became depressed early (before December 21) differed from controls in the perception of invitation. Results are interpreted within the framework of psychological theories on the development of depression and suggest that altered cognitive sensitivity of SAD patients to light plays a role in the development of depressive episodes.
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PMID:Relationship between cognitive sensitivity to (symbolic) light in remitted seasonal affective disorder patients and the onset time of a subsequent depressive episode. 804 59

The relationship of food and eating with affective and other clinical disorders is complex and intriguing. Serotoninergic dysfunction in seasonal affective disorder, atypical depression, premenstrual syndrome, anorexia and bulimia nervosa, and binge eating disorder is reviewed. Patients exhibiting a relationship between food and behaviour are found in various diagnostic categories. This points to a need to shift from nosological to functional thinking in psychiatry. It also means application of psychopharmacological treatments across diagnostic boundaries. The use of phototherapy and psychotropic drugs (MAO inhibitors and selective serotonin reuptake inhibitors like fluoxetine) in these disorders is discussed.
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PMID:Food and mood: relationship between food, serotonin and affective disorders. 805 64

The concept of seasonal affective disorder (SAD) includes any depression whose onset is related to a certain season. Reduced environmental light is hypothesized to be the main precipitating factor of winter depression. Light treatment is used to prevent the onset of depressive episodes and to reduce depressive symptoms in patients with depression during winter months. The mechanisms of action which lead to the well-documented antidepressant response are still unknown. Several hypotheses of the pathogenesis of SAD are discussed, and the clinical practice of light treatment is reviewed.
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PMID:Light treatment for seasonal affective disorder: theoretical considerations and clinical implications. 805 65

The psychobiology of idiopathic fatigue has received renewed interest in the medical literature in recent years. In order to examine the relation between chronic, idiopathic fatigue and specific subtypes of depressive illness, we characterized the pattern and severity of seasonal symptom variation in 73 patients with chronic, idiopathic fatigue, compared to patients with major depression (n = 55), atypical depression (n = 35), and seasonal affective disorder (n = 16) Fifty of the fatigued subjects also met the specific Centers for Disease Control and Prevention case criteria for chronic fatigue syndrome, though this definition was unable to discriminate a distinct subgroup of patients, based on their seasonality scores alone. As a group, the fatigued subjects reported the lowest levels of symptom seasonality of any of the study groups. Further, even in those fatigued subjects with scores in the range of those seen in patients with seasonal affective disorder, seasonality was not reported to be a subjectively distressing problem. These findings lend support to the idea that although chronic fatigue shares some clinical features with certain mood disorders, they are not the same illnesses. These data are also consistent with the emerging view that chronic fatigue represents a heterogeneously determined clinical condition.
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PMID:Seasonal symptom variation in patients with chronic fatigue: comparison with major mood disorders. 806 38

Forty-three subjects with seasonal affective disorder were randomly assigned to receive 2 weeks of treatment with either bright- (mean 4106 lx) or dim-light (mean 96 lx) therapy, using red light-emitting diode light sources, in a head-mounted unit. Defining response as a 50% reduction in the 21-item Hamilton Depression Rating Scale score to a post-treatment score of less than 8, there was no significant difference in response rate between patients receiving bright light (67%) as compared with patients receiving dim light (68%). Possible explanations for the similar response rate to 2 very different illuminances of red light are discussed.
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PMID:Dim versus bright red (light-emitting diode) light in the treatment of seasonal affective disorder. 806 73

A modified depression rating scale was distributed to a sample of the adult Finnish population (n = 1000) in November 1991. No dependence on latitude (60 degrees N-70 degrees N) was seen in the occurrence of depression. The depressed subjects (n = 54) were reevaluated the following May, and four cases with seasonal affective disorder were found. The results suggest that high latitudes with large variations in the daily lightperiod may not be responsible for high prevalence of major depression with a seasonal pattern.
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PMID:Frequencies of seasonal major depressive symptoms at high latitudes. 811 63

Phototherapy was administered to three female outpatients with seasonal affective disorder (winter depression), according to the DSM III-R criteria. The intensity of light was about 2.500 lux in two, and 1.500 lux in one cases at the eyes level. The treatment has shown to be very effective. Antidepressant response was observed after about one week of treatment. A short-lasting switch into hypomania was observed in one case.
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PMID:[Phototherapy for winter depression: report of three cases]. 813

In a study of the quantitative relationship between ambient light and depression in winter seasonal affective disorder, 13 outpatients and 13 normal comparison subjects each wore a light monitor for 1 week. The patients and normal subjects showed similar light exposure profiles; among the patients, severity of depression was inversely related to photoperiod, and there was a trend toward a correlation between greater severity of depression and later time of onset of morning light exposure. These findings suggest that vulnerability to short photoperiods may be related to depression in winter seasonal affective disorder.
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PMID:Exposure to ambient light in patients with winter seasonal affective disorder. 814 59

Bright-light therapy is widely regarded as an effective treatment for winter seasonal affective disorder (SAD). We attempted to identify predictors of light therapy response in 54 depressed, drug-free outpatients diagnosed with SAD by DSM-III-R criteria. After a baseline week, patients were treated for 2 weeks with 2500-lx cool-white fluorescent light exposure from 0600 to 0800 daily. The results showed that light therapy significantly reduced depression scores. Several indices of atypical and typical symptoms correlated with response, but none was clearly superior to the pre-treatment depression score. A multiple regression analysis identified 3 factors (hypersomnia, increased eating and younger age) that predicted light-therapy response. These results suggest that specific symptoms of hypersomnia and hyperphagia are predictors of response to morning bright-light therapy in SAD.
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PMID:Morning light therapy for winter depression: predictors of response. 817 70


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