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

Seasonal affective disorders is a form of recurrent depression that appears to be precipitated by a specific stressor (i.e., winter) and resolves spontaneously in spring or summer. The elements of winter that must contribute to SAD are unknown at this time although light deficiency most likely plays a role. It is similar to late luteal dysphoric disorder because of the circumscribed time course, range of severity and female predominance. Atypical anergic symptoms usually dominate the clinical picture but more typical anxious and agitated symptoms can be present. Onset and offset of symptoms and severity varies greatly. Fall onset is usually gradual while spring remission can be more startling and abrupt producing hypomania in some patients. Full summer remission occurs in most patients when followed prospectively and is associated with improvement in personality and biological measures. Most patients improve with light therapy but it is not known how sustained this effect is or whether it is comparable to treatment with antidepressants in similarly affected patients. BL treatment also implies a single etiological mechanism of SAD, but this is still unproven. Lights, while effective do not appear to be as effective as summer. This could be because most BL clinical trials have been too brief to actually simulate summer or because of the significant heterogeneity in population. It is important to remember that lights alone cannot replicate summer conditions. Summer light is up to ten times stronger than currently available light boxes and the season produces many other environmental and social changes. Most likely SAD will prove similar to other forms of depression in that it is a multidimensional problem which requires a variety of treatments to alleviate various aspects of the syndrome.
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PMID:Seasonal affective disorders. 201 63

Depression is a common condition in the practice of most physicians. Some depressed patients are prone to suicide, many ambivalent about it. The SAD PERSONS scale may be helpful for the physician in assessing risk. Because of the ambivalence, it is important that an authority figure-physician, friend, family member- not fail to recognize the risk and unthinkingly sanction a destructive act.
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PMID:To be or not to be: the suicidal patient. 279 77

It is well-established that human nocturnal melatonin secretion is suppressed by presentation of artificial light greater than 2,000 lux, a level that is also therapeutically effective in alleviating winter depression symptoms of Seasonal Affective Disorder [SAD]. Furthermore, early-morning bright light induces phase advances of the melatonin cycle in SAD patients (Lewy et al., 1987a). The functional significance of melatonin in SAD remains unclear. With plasma melatonin sampled at 20-min intervals in a series of overnight studies, we found marked phase delays of the cycle, relative to that previously reported for normals, in 4/5 depressed SAD patients. 2,500 lux light exposure at 6-8 a.m. resulted in exponentially declining melatonin levels that approached low daytime baselines within two hours (t1/2 = 45.52 min). All five patients showed clinical remissions as well as phase advances of the melatonin cycle of 0.75 to 3.27 hours (mean, 1.94 +/- 0.84 hours) after one week of daily exposure from 6-8 a.m. and p.m. These results suggest that the combination of early morning and early evening light exposures induces circadian phase adjustments similar to those of morning light alone, by impacting a photosensitive interval when, in SAD, melatonin secretion overshoots its normal nocturnal phase.
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PMID:Response of the melatonin cycle to phototherapy for Seasonal Affective Disorder. Short note. 338 26

Five theories advocate the existence of psychogenic factors in the etiology of cardiovascular diseases. The first of these theories involves a behavioral pattern. Pattern A is predictive of cardiovascular diseases and their risk factors. The second of these theories implies three personality patterns: IRA (Impulsiveness, Repression, Aggressiveness), HHD (Hypochondriasis, Hysteria, Depression) and SAD (Stress, Anxiety, Depression). IRA discriminates significantly people with cardiovascular diseases from healthy subjects. IRA-like patterns account for some 60% of the variance. HHD discriminates to some degree people who show thrombopenia as a reaction to stress. Cardiovascular patients stereotype their defenses and seem to cluster in two subamples: 66% of them repress their aggressiveness and 34% use opposite defense mechanisms. SAD is a reliable predictor; stressful events constitute a risk factor, mainly in anxious or depressed and hostile subjects.
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PMID:Psychological etiology in cardiovascular disorders. Basic findings and new trends. 351 51

Because of the methodologic differences and limited data, the sensitivity and specificity of the dexamethasone suppression test in children are in question. In our study we used 0.5 mg of dexamethasone and a 4 p.m. cortisol sample to perform the DST on 32 hospitalized prepubertal children diagnosed by a structured interview (DICA) and DSM-III criteria. Cortisols differed significantly by ANOVA among principal diagnoses, with highest values in children with major depression (MDE) or separation anxiety (SAD) and lowest in those with behavior disorders (BD). Using 5.0 micrograms/dl as a cutoff value for positive DST, MDE and SAD are positively and BD negatively associated with positive DST results. Rating scales for anxiety and depression showed no significant association with cortisol level. We conclude that the DST in this sample shows excellent sensitivity but its specificity is limited to distinguishing depressed or anxious children from those with pure behavior disorder.
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PMID:Depression, anxiety and the dexamethasone suppression test in hospitalized prepubertal children. 365 43

One hundred and nine women were studied during the course of pregnancy in an attempt to predict which of them would later rate themselves as suffering from depressed mood up to twelve months post-natally. The psychometric measures used comprised the Zung Self-Rating Scale to measure depression, the DSSI/SAD sub-scale to measure anxiety and the Hostility and Direction of Hostility Questionnaire. Post-natal depression observed up to twelve months post-partum was positively associated with first trimester ante-natal scores on all three measures. The HDHQ and the DSSI/SAD measures were good predictors of depression at six weeks post-partum and both correlated significantly at six and nine months post-partum, whereas the Zung measure predicted depression at nine and twelve months as well as at six weeks post-partum. Parity was significantly associated with severe depression at six months post-partum.
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PMID:Psychometric ante-natal predictors of post-natal depressed mood. 403 31

Forty-seven women were studied during the course of pregnancy in an attempt to predict which of them would later rate themselves as suffering from depressed mood post-natally. Psychometric and physiology measures were used in the three trimesters of pregnancy and six weeks after birth. The psychometric measures used ante-natally and post-natally comprised the Hostility and Direction of Hostility Questionnaire, and Locus of Control Scale, the DSSI/SAD sub-scale to measure anxiety, and the Zung Self-Rating Scale to measure depression. Psychophysiological measures used water heart-rate and blood pressure. Post-natal ratings of depression were associated with a high ante-natal score on overall hostility. Women with high anxiety and hostility ratings had a more pronounced response to the sound of a baby crying than to noise of similar frequency and intensity. This more pronounced heart response was also related to later post-natal depression ratings. However, by far the most useful predictive measure was the Hostility and Direction of Hostility Questionnaire: its predictive power in the first trimester of pregnancy was almost as good as in the third trimester.
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PMID:Psychophysiological ante-natal predictors of post-natal depressed mood. 714 82

Retrospective analysis of the stringency of diagnosis and therapeutic response was carried out in 80 patients with major recurrent winter depression (SAD) who had participated in controlled light therapy trials in Switzerland from 1984 to 1990. Two groups were formed with respect to anamnestic information: patients whose previous episodes of seasonal depression had been reconstructed graphically, and those who could only globally recollect prior depressive phases. These data were taken to test conformity to DSM-III-R criteria for seasonal pattern, as well as its prognostic usefulness for response to light therapy. The more liberal 'Rosenthal criteria' for SAD of at least two consecutive, seasonally recurring major depressive episodes were sufficient to predict improvement with light: none of the other DSM-III-R criteria differentiated further, and few patients could remember previous depressive episodes in precise detail. Our data support suggestions to revise the restrictive SAD diagnostic criteria for DSM-IV.
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PMID:Seasonal affective disorder: are the DSM-III-R criteria valid? 784 53

In winters 1990-1991 and 1991-1992 women with and without seasonal affective disorder, winter type, were treated by light at 2500 lux either in the morning (0800h-1000h) or afternoon (1600h-1800h). In winter before light treatment, melatonin levels in serum in daytime (1200h and 1600h) were higher in patients compared to controls (p < 0.05). This difference disappeared in the summer or after light treatment in the winter. Also, light treatment and change in season resulted in a phase advance shift of melatonin rhythm in patients. The decline in melatonin levels correlated with the decline in specific SAD symptoms of hyperphagia and carbohydrate craving. In winter, neither patients nor controls showed significant diurnal variations in levels of whole blood serotonin. In both patients and controls, levels of serotonin were higher in summer as compared with winter, especially at 2000h. Our data suggest that elevated daytime melatonin can be a state marker of winter depression, and that seasonal change of photoperiod may also affect the circadian amplitude and daytime levels of blood serotonin.
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PMID:Diurnal and seasonal variations of melatonin and serotonin in women with seasonal affective disorder. 798 18

Winter depression (Seasonal Affective Disorder, SAD) is a depressive illness, which starts in the autumn and disappears in the spring. The depression is, in contrast to the typical endogenous depression, characterized by increased appetite with carbohydrate craving, and increased sleep. There is an increase in the frequency of the illness towards the geographical poles. About 80% of the patients are women. The most remarkable aspect of the depression is however, that it can be effectively treated with bright light, given two hours daily for one to two weeks. A number of biological functions are currently under investigation in relation to winter depressions; among these are the metabolism of melatonin, various diurnal rhythms and the serotonergic system.
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PMID:[Winter depression and light therapy]. 799 36


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