University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh, PA 15213, USA.
Phys Sportsmed. 2009 Dec;37(4):104-15. doi: 10.3810/psm.2009.12.1748.
Seasonal affective disorder (SAD) is defined as a history of major depressive episodes that recur regularly at a particular time of year. Depending on the diagnostic instruments and criteria available, the reported prevalence (1%-10%) varies. Neurotransmitter abnormalities have been implicated in the pathophysiology, but they do not necessarily explain the seasonal pattern or the known chronobiological abnormalities in SAD compared with nonseasonal depression. Circadian rhythm abnormalies have been hypothesized to account for these aspects of SAD, and they provide a rationale for the therapeutic use of light therapy. Family history, twin, and molecular genetics studies suggest that hereditary factors are also involved. Light therapy and antidepressant medication are effective treatment options, with limited evidence for the efficacy of psychotherapy. Some studies demonstrate that narrow-band short wavelength "blue" light, naturalistic dawn simulation, and high-density negative air ionization are effective. Patients should be informed of the benefits of diet and exercise. Light therapy should be clinically monitored in the same manner, as it is done for other antidepressant treatments.
季节性情感障碍（SAD）定义为在一年中的特定时间反复出现的重度抑郁发作史。根据可用的诊断工具和标准，报告的患病率（1%-10%）有所不同。神经递质异常与病理生理学有关，但它们不一定能解释 SAD 的季节性模式或与非季节性抑郁症相比的已知生物钟异常。昼夜节律异常被假设可以解释 SAD 的这些方面，并为光疗的治疗用途提供了依据。家族史、双胞胎和分子遗传学研究表明，遗传因素也与之相关。光疗和抗抑郁药物是有效的治疗选择，心理治疗的疗效证据有限。一些研究表明，窄带短波长“蓝光”、自然拂晓模拟和高密度负空气离子化是有效的。应告知患者饮食和运动的益处。应像对待其他抗抑郁治疗一样，对光疗进行临床监测。
