@article{ref1,
title="Stability of the diagnosis of seasonal affective disorder in a long-term prospective study",
journal="Journal of affective disorders",
year="2018",
author="Cléry-Melin, Marie-Laure and Gorwood, Philip and Friedman, Serge and Even, Christian",
volume="227",
number="",
pages="353-357",
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.<p /><p>Language: en</p>",
language="en",
issn="0165-0327",
doi="10.1016/j.jad.2017.11.014",
url="http://dx.doi.org/10.1016/j.jad.2017.11.014"
}