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阳光与悲伤:一例夏季抑郁症病例报告

Sunshine and Sadness: A Case Report on Summer Season Depression.

作者信息

Shidhore Nikita, Mangot Ajish

机构信息

Psychiatry, Krishna Institute of Medical Sciences, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, IND.

出版信息

Cureus. 2024 Dec 5;16(12):e75190. doi: 10.7759/cureus.75190. eCollection 2024 Dec.

Abstract

Seasonal affective disorder (SAD) is typically associated with winter; however, its less common variant, summertime depression, presents with depressive episodes during the summer months. We report a case of a 46-year-old male patient with recurrent summertime depressive episodes characterized by low mood, fatigue, anhedonia, insomnia, and loss of appetite, each resolving with the onset of the winter season. Our patient's history of summertime depression aligned with the atypical SAD symptoms, including irritability and weight loss, commonly associated with non-seasonal depression. A diagnosis of major depressive disorder, moderate severity, with a seasonal pattern was confirmed using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision criteria, and the Seasonal Pattern Assessment Questionnaire. The patient was initiated on desvenlafaxine 50 mg once a day with a dose titrated to 100 mg once a day in two weeks, while his previous mood stabilizer oxcarbazepine 600 mg in two divided doses was continued. He achieved remission within four to six weeks with his Hamilton Rating Scale for Depression score decreasing from 18 to seven. Our case underscores the importance of recognizing seasonal patterns in affective disorders within tropical climates, like India, and highlights potential environmental and physiological mechanisms, such as heat stress and immune responses, contributing to summertime SAD.

摘要

季节性情感障碍(SAD)通常与冬季相关;然而,其较罕见的变体,夏季抑郁症,在夏季出现抑郁发作。我们报告一例46岁男性患者,有复发性夏季抑郁发作,其特征为情绪低落、疲劳、快感缺乏、失眠和食欲不振,每次发作在冬季开始时缓解。我们患者的夏季抑郁症病史与非季节性抑郁症常见的非典型SAD症状相符,包括易怒和体重减轻。根据《精神疾病诊断与统计手册》第五版修订版标准和季节性模式评估问卷,确诊为中度严重程度的重度抑郁症,具有季节性模式。患者开始服用去甲文拉法辛,每日一次,每次50毫克,两周内剂量滴定至每日一次,每次100毫克,同时继续服用之前的情绪稳定剂奥卡西平,每日两次,每次600毫克。他在四到六周内实现缓解,汉密尔顿抑郁量表评分从18分降至7分。我们的病例强调了在印度等热带气候地区识别情感障碍季节性模式的重要性,并突出了潜在的环境和生理机制,如热应激和免疫反应,对夏季SAD的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7ac/11700541/f344594bbbe0/cureus-0016-00000075190-i01.jpg

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