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Seasonal DepressionAka: Seasonal Affective Disorder
- Epidemiology
- Peak Incidence: Fall and winter (October to February)
- Symptoms
- See Major Depression Diagnosis Criteria
- Diagnosis: DSM IV Criteria (all must be present)
- Regular temporal relationship of Major Depression onset
- Occurs at the same time every year
- Usually occurs in fall or winter
- Unrelated to seasonal life stressors
- Full remission occurs at a specific time of year
- Two Seasonal Major Depression episodes in last 2 years
- No Non-seasonal episodes of Major Depression in 2 years
- Seasonal depression episodes outnumber non-seasonal
- Associated conditions
- Generalized Anxiety Disorder
- Panic Disorder
- Bulimia Nervosa
- Premenstrual Syndrome
- Chronic Fatigue Syndrome
- Seasonal Alcohol Abuse
- Attention Deficit Disorder
- Management
- Light Therapy (preferred therapy)
- Light exposure early in day
- Synchronizes with circadian rhythm
- Terman (2001) Arch Gen Psychiatry 58:69
- Dose and Duration
- Exposure to 2500 lux for 2 hours per day or
- Exposure to 10,000 lux for 30 minutes per day
- Cognitive behavior therapy
- No studies to date to definitively support use
- Pharmacotherapy
- Indications
- High Suicide Risk
- Significant functional Impairment
- Recurrent moderate to severe Major Depression
- Patient preference
- Failure to respond to Light Therapy, Psychotherapy
- Agents
- Selective Serotonin Reuptake Inhibitor (SSRI)
- References
- Zal (March 1997) Consultant, 641-9
- APA (1994) DSM IV, APA, p. 317-91
- Lurie (2006) Am Fam Physician 74:1521
- Partonen (1998) Lancet 352:1369
- Saeed (1998) Am Fam Physician 57(6):1340
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