Citation

Cléry-Melin ML, Gorwood P, Friedman S, Even C. J. Affect. Disord. 2018; 227: 353-357.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.jad.2017.11.014

PMID

29145077

Abstract

BACKGROUND: Seasonal affective disorder (SAD) is mainly characterized by a seasonal pattern of depressive recurrences over the years. However, few studies have been conducted on the long-term course of patients with SAD, whose findings raised questions about the diagnosis stability over time. This study aimed to better characterize the diagnosis evolution, and determine prognosis markers.
METHODS: An initial cohort of 225 outpatients diagnosed as having a SAD, was assessed at baseline (T1) for clinical symptoms and response to bright light therapy. One hundred and nineteen patients (53%) were interviewed 2-12 years after (T2).
RESULTS: Of 119 patients reached at follow-up (T2), only 32 patients (27%) still fulfilled the DSM-IV criteria for a stable SAD (S-SAD). A large proportion (59%) of the follow up cohort was in remission and 14% still suffered from a non-seasonal mood disorder. Family history of depression, previous suicide attempt, carbohydrate craving and HAD-depression score at baseline were associated with a stable SAD (S-SAD) diagnosis at T2, the HAD-depression score being the only one still significantly predictive (p=0.025) of a later stable SAD, with a multivariate approach. Carbohydrate craving, a core symptom of SAD, showed a trend (p=0.100) to predict diagnosis stability.
LIMITATIONS: Only 53% patients from the initial cohort were assessed at follow-up.
CONCLUSIONS: Patients with eventual stable SAD show more subjective severity (higher HAD-Depression score) and carbohydrate craving at baseline. A low predictive validity of diagnosis criteria suggests that SAD is a temporary expression of a mood disorder rather than a specific disorder.

Language: en

Keywords

Humans; Adult; Female; Male; Middle Aged; Depression; Prospective Studies; Time Factors; Prognosis; Recurrence; Craving; Seasonality; Predictive validity; Phototherapy; Seasonal Affective Disorder; Diagnosis stability; Prognosis markers