Srivastava S, Sharma M
Department of Psychiatry, New Cross Hospital, Wolverhampton, UK.
J Affect Disord. 1998 May;49(2):145-50. doi: 10.1016/s0165-0327(97)00204-8.
A number of studies have established the entity of seasonal affective disorder (SAD) and delineated the presence of atypical depressive features of carbohydrate craving, hyperphagia and hypersomnia. Most literature has emanated from research carried out in temperate climates, and only few reports are available from tropical countries, especially India.
Consecutive patients with recurrent mood disorder (who had at least 2 episodes of depression in the past) comprised the study sample. The diagnosis of mood disorder was made according to DSM-III-R criteria. The sample was divided into two groups - seasonal and non-seasonal according to the DSM-III-R criteria of seasonal pattern. The depressed patients were rated on SADD and HDRS, and manic patients on BRMRS.
Eighteen of 93 patients fulfilled the criteria of seasonal pattern; 7 of these seasonal patients, and 25 of the non-seasonal patients were currently in depressive phase. Males dominated the sample in both the groups. The seasonal and non-seasonal groups as regards symptomatology, differed only on a few items - decreased libido on SADD, and suicidal ideation and helplessness on HDRS. Atypical vegetative features were not seen in any of the seasonal patients.
SAD is seen at lower latitudes also, although atypical vegetative features are not a prominent part of the symptomatology.
The study sampled was obtained from a very select population, and thus does not indicate the prevalence of SAD in India. Secondly, the small sample size precludes any categorical comments of the symptomatology. Moreover, winter and summer depressives were considered as one group.
Emphasising the presence of SAD in a tropical country where there is relatively less variation in daylight periods, this report forms a base for future studies. It also raises the question of the role of variations in daylight in the aetiology SAD.
多项研究已确立季节性情感障碍（SAD）这一病症，并明确了其具有对碳水化合物的渴望、食欲亢进及嗜睡等非典型抑郁特征。大多数文献源自温带气候地区开展的研究，而热带国家，尤其是印度，仅有少数相关报道。
连续纳入患有复发性情绪障碍（过去至少有2次抑郁发作）的患者作为研究样本。情绪障碍的诊断依据《精神疾病诊断与统计手册》第三版修订本（DSM - III - R）标准进行。根据DSM - III - R的季节性模式标准，将样本分为两组——季节性和非季节性组。对抑郁患者采用季节性情感障碍评定量表（SADD）和汉密尔顿抑郁量表（HDRS）进行评分，对躁狂患者采用倍克-拉范森躁狂量表（BRMRS）进行评分。
93例患者中有18例符合季节性模式标准；这些季节性患者中有7例，非季节性患者中有25例目前处于抑郁阶段。两组样本中男性均占主导。在症状学方面，季节性和非季节性组仅在少数项目上存在差异——SADD量表上的性欲减退、HDRS量表上的自杀观念和无助感。在任何季节性患者中均未观察到非典型植物神经功能特征。
尽管非典型植物神经功能特征并非症状学的突出部分，但在低纬度地区也能发现季节性情感障碍。
本研究样本来自非常特定的人群，因此无法表明印度季节性情感障碍的患病率。其次，样本量较小，无法对症状学进行任何明确的评论。此外，冬季和夏季抑郁症患者被视为一组。
本报告强调了在白昼时长相对变化较小的热带国家存在季节性情感障碍，为未来研究奠定了基础。它还提出了白昼变化在季节性情感障碍病因学中的作用问题。
