Department of Psychiatry, University Medical Centre Groningen, University of Groningen, The Netherlands.
BMC Psychiatry. 2011 Dec 19;11:198. doi: 10.1186/1471-244X-11-198.
Little is known about seasonality of specific depressive symptoms and anxiety symptoms in different patient populations. This study aims to assess seasonal variation of depressive and anxiety symptoms in a primary care population and across participants who were classified in diagnostic groups 1) healthy controls 2) patients with a major depressive disorder, 3) patients with any anxiety disorder and 4) patients with a major depression and any anxiety disorder.
Data were used from the Netherlands Study of Depression and Anxiety (NESDA). First, in 5549 patients from the NESDA primary care recruitment population the Kessler-10 screening questionnaire was used and data were analyzed across season in a multilevel linear model. Second, in 1090 subjects classified into four groups according to psychiatric status according to the Composite International Diagnostic Interview, overall depressive symptoms and atypical versus melancholic features were assessed with the Inventory of Depressive Symptoms. Anxiety and fear were assessed with the Beck Anxiety Inventory and the Fear questionnaire. Symptom levels across season were analyzed in a linear regression model.
In the primary care population the severity of depressive and anxiety symptoms did not show a seasonal pattern. In the diagnostic groups healthy controls and patients with any anxiety disorder, but not patients with a major depressive disorder, showed a small rise in depressive symptoms in winter. Atypical and melancholic symptoms were both elevated in winter. No seasonal pattern for anxiety symptoms was found. There was a small gender related seasonal effect for fear symptoms.
Seasonal differences in severity or type of depressive and anxiety symptoms, as measured with a general screening instrument and symptom questionnaires, were absent or small in effect size in a primary care population and in patient populations with a major depressive disorder and anxiety disorders.
对于不同患者群体中特定抑郁症状和焦虑症状的季节性变化知之甚少。本研究旨在评估初级保健人群中抑郁和焦虑症状的季节性变化，并评估根据诊断组别分类的参与者中抑郁和焦虑症状的季节性变化，诊断组别为 1）健康对照者，2）患有重度抑郁症的患者，3）患有任何焦虑障碍的患者，以及 4）患有重度抑郁症和任何焦虑障碍的患者。
本研究使用了荷兰抑郁与焦虑研究（NESDA）的数据。首先，在 NESDA 初级保健招募人群的 5549 例患者中使用 Kessler-10 筛查问卷，并在多层次线性模型中分析季节性数据。其次，根据综合国际诊断访谈，将 1090 例受试者分为四组，根据精神状态分类，使用抑郁症状量表评估总体抑郁症状和非典型与忧郁特征，使用贝克焦虑量表和恐惧问卷评估焦虑和恐惧。使用线性回归模型分析季节性的症状水平。
在初级保健人群中，抑郁和焦虑症状的严重程度没有表现出季节性模式。在诊断组中，健康对照者和患有任何焦虑障碍的患者，但没有患有重度抑郁症的患者，冬季抑郁症状略有升高。非典型和忧郁症状在冬季均升高。未发现焦虑症状的季节性模式。恐惧症状存在与性别相关的季节性差异。
在初级保健人群和患有重度抑郁症和焦虑障碍的患者人群中，使用一般筛查工具和症状问卷测量的抑郁和焦虑症状的严重程度或类型，没有季节性差异，或者季节性差异的影响较小。
