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Epidemiology and socioeconomic impact of seasonal affective disorder in Austria

Published online by Cambridge University Press:  23 March 2020

E. Pjrek*
Affiliation:
Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, A-1090Vienna, Austria
*
*Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria. Tel.: +43 1404 0035470; fax: +43 1404 0030990. E-mail address: edda.winkler-pjrek@meduniwien.ac.at (E. Pjrek).
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Abstract

Background

Seasonal affective disorder (SAD) is a subtype of recurrent depressive or bipolar disorder that is characterized by regular onset and remission of affective episodes at the same time of the year. The aim of the present study was to provide epidemiological data and data on the socioeconomic impact of SAD in the general population of Austria.

Methods

We conducted a computer-assisted telephone interview in 910 randomly selected subjects (577 females and 333 males) using the Seasonal Health Questionnaire (SHQ), the Seasonal Pattern Assessment Questionnaire (SPAQ), and the Sheehan Disability Scale (SDS). Telephone numbers were randomly drawn from all Austrian telephone books and transformed using the random last digits method. The last birthday method was employed to choose the target person for the interviews.

Results

Out of our subjects, 2.5% fulfilled criteria for the seasonal pattern specifier according to DSM-5 and 2.4% (95% CI = 1.4–3.5%) were diagnosed with SAD. When applying the ICD-10 criteria 1.9% (95% CI = 0.9–2.8%) fulfilled SAD diagnostic criteria. The prevalence of fall-winter depression according to the Kasper-Rosenthal criteria was determined to be 3.5%. The criteria was fulfilled by 15.1% for subsyndromal SAD (s-SAD). We did not find any statistically significant gender differences in prevalence rates. When using the DSM-5 as a gold standard for the diagnosis of SAD, diagnosis derived from the SPAQ yielded a sensitivity of 31.8% and a specificity of 97.2%. Subjects with SAD had significantly higher scores on the SDS and higher rates of sick leave and days with reduced productivity than healthy subjects.

Conclusions

Prevalence estimates for SAD with the SHQ are lower than with the SPAQ. Our data are indicative of the substantial burden of disease and the socioeconomic impact of SAD. This epidemiological data shows a lack of gender differences in SAD prevalence. The higher rates of females in clinical SAD samples might, at least in part, be explained by lower help seeking behaviour in males.

Type
Original article
Copyright
Copyright © European Psychiatric Association 2016

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References

Kasper, S., Wehr, T.A., Bartko, J.J., Gaist, P.A., Rosenthal, N.E.Epidemiological findings of seasonal changes in mood and behavior. A telephone survey of Montgomery County, Maryland. Arch Gen Psychiatry 1989; 46: 823–33.Google ScholarPubMed
Altamura, C., VanGastel, A., Pioli, R., Mannu, P., Maes, M.Seasonal and circadian rhythms in suicide in Cagliari, Italy. J Affect Disord 1999; 53: 77–85.CrossRefGoogle ScholarPubMed
Vyssoki, B., Kapusta, N.D., Praschak-Rieder, N., Dorffner, G., Willeit, M.Direct effect of sunshine on suicide. JAMA Psychiatry 2014; 71: 1231–7.CrossRefGoogle ScholarPubMed
Rosenthal, N.E., Sack, D.A., Gillin, J.C., Lewy, A.J., Goodwin, F.K., Davenport, Y., et al.Seasonal affective disorder. A description of the syndrome and preliminary findings with light therapy. Arch Gen Psychiatry; 1984; 41: 72–80.CrossRefGoogle ScholarPubMed
Pail, G., Huf, W., Pjrek, E., Winkler, D., Willeit, M., Praschak-Rieder, N., et al.Bright-light therapy in the treatment of mood disorders. Neuropsychobiology; 2011; 64: 152–62.CrossRefGoogle ScholarPubMed
Fischer, R., Kasper, S., Pjrek, E., Winkler, D.On the application of light therapy in German-speaking countries. Eur Arch Psychiatry Clin Neurosci 2012; 262: 501–5.CrossRefGoogle ScholarPubMed
Kasper, S., Ruhrmann, S., Neumann, S., Moeller, H.J.Use of light therapy in German psychiatric hospitals. Eur Psychiatry 1994; 9: 288–92.Google Scholar
Levitan, R.D.The chronobiology and neurobiology of winter seasonal affective disorder. Dialogues Clin Neurosci 2007; 9: 315–24.Google ScholarPubMed
Winkler, D., Pjrek, E., Konstantinidis, A., Kasper, S.Drug therapy of seasonal affective disorderPartonen, T.Pandi-Perumal, S.R.Seasonal affective disorder. Practice and research Second ed.Oxford: Oxford University Press; 2009. 281–95.CrossRefGoogle Scholar
Pjrek, E., Winkler, D., Stastny, J., Konstantinidis, A., Heiden, A., Kasper, S.Bright light therapy in seasonal affective disorder – does it suffice?. Eur Neuropsychopharmacol 2004; 14: 347–51.CrossRefGoogle ScholarPubMed
Dam, H., Jakobsen, K., Mellerup, E.Prevalence of winter depression in Denmark. Acta Psychiatr Scand 1998; 97: 1–4.CrossRefGoogle ScholarPubMed
Kegel, M., Dam, H., Ali, F., Bjerregaard, P.The prevalence of seasonal affective disorder (SAD) in Greenland is related to latitude. Nord J Psychiatry 2009; 63: 331–5.CrossRefGoogle ScholarPubMed
Saarijarvi, S., Lauerma, H., Helenius, H., Saarilehto, S.Seasonal affective disorders among rural Finns and Lapps. Acta Psychiatr Scand 1999; 99: 95–101.CrossRefGoogle ScholarPubMed
Magnusson, A., Stefansson, J.G.Prevalence of seasonal affective disorder in Iceland. Arch Gen Psychiatry 1993; 50: 941–6.CrossRefGoogle ScholarPubMed
Muscettola, G., Barbato, G., Ficca, G., Beatrice, M., Puca, M., Aguglia, E., et al.Seasonality of mood in Italy: role of latitude and sociocultural factors. J Affect Disord; 1995; 33: 135–9.CrossRefGoogle ScholarPubMed
Mersch, P.P., Middendorp, H.M., Bouhuys, A.L., Beersma, D.G., van den Hoofdakker, R.H.The prevalence of seasonal affective disorder in The Netherlands: a prospective and retrospective study of seasonal mood variation in the general population. Biol Psychiatry 1999; 45: 1013–22.CrossRefGoogle ScholarPubMed
Broman, J.E., Hetta, J.Prevalence of seasonal affective disorders and related symptoms at two latitudes in Sweden. Meeting of the Society for Research on Biological Rhythms. 1998; 162 [Abstract]Google Scholar
Rastad, C., Sjoden, P.O., Ulfberg, J.High prevalence of self-reported winter depression in a Swedish county. Psychiatry Clin Neurosci 2005; 59: 666–75.CrossRefGoogle Scholar
Steinhausen, H.C., Gundelfinger, R., Winkler Metzke, C.Prevalence of self-reported seasonal affective disorders and the validity of the seasonal pattern assessment questionnaire in young adults findings from a Swiss community study. J Affect Disord 2009; 115: 347–54.CrossRefGoogle ScholarPubMed
Wicki, W., Angst, J., Merikangas, K.R.The Zurich Study. XIV. Epidemiology of seasonal depression. Eur Arch Psychiatry Clin Neurosci 1992; 241: 301–6.CrossRefGoogle ScholarPubMed
Wirz-Justice, A., Graw, P., Krauchi, K., Wacker, H.R.Seasonality in affective disorders in Switzerland. Acta Psychiatr Scand Suppl 2003; 108: 92–5.CrossRefGoogle Scholar
Michalak, E.E., Wilkinson, C., Dowrick, C., Wilkinson, G.Seasonal affective disorder: prevalence, detection and current treatment in North Wales. Br J Psychiatry 2001; 179: 31–4.CrossRefGoogle ScholarPubMed
Pjrek, E., Willeit, M., Praschak-Rieder, N., Konstantinidis, A., Semlitsch, H.V., Kasper, S., et al.Treatment of seasonal affective disorder with duloxetine: an open-label study. Pharmacopsychiatry; 2008; 41: 100–5.CrossRefGoogle Scholar
Daniel, W.W., Biostatistics:, A foundation for analysis in the health sciences 7th edition.New York: John Wiley & Sons; 1999.Google Scholar
Naing, L., Winn, T., Rusli, B.N.Practical issues in calculating the sample size for prevalence studies. Arch Orofac Sci 2006; 1: 9–14.Google Scholar
Schnell, R., Hill, P.B., Esser, E.Methoden der empirischen Sozialforschung München: Oldenbourg Wissenschaftsverlag; 2008.Google Scholar
O’Rourke, D., Blair, J.Improving random respondent selection in telephone surveys. J Mark Res 1983; 20: 428–32.CrossRefGoogle Scholar
Thompson, C., Cowan, A.The Seasonal Health Questionnaire: a preliminary validation of a new instrument to screen for seasonal affective disorder. J Affect Disord 2001; 64: 89–98.CrossRefGoogle ScholarPubMed
Thompson, C., Thompson, S., Smith, R.Prevalence of seasonal affective disorder in primary care; a comparison of the seasonal health questionnaire and the seasonal pattern assessment questionnaire. J Affect Disord 2004; 78: 219–26.CrossRefGoogle ScholarPubMed
Rosenthal, N.E., Bradt, G.H., Wehr, T.A.Seasonal Pattern Assessment Questionnaire Washington, DC: National Institute of Mental Health; 1987.Google Scholar
Kasper, S., Rogers, S.L., Yancey, A., Schulz, P.M., Skwerer, R.G., Rosenthal, N.E.Phototherapy in individuals with and without subsyndromal seasonal affective disorder. Arch Gen Psychiatry 1989; 46: 837–44.Google ScholarPubMed
Sheehan, D.V.The anxiety disease New York: Charles Scribner's Sons; 1983.Google Scholar
Hodgins, D.C.Reliability and validity of the Sheehan Disability Scale modified for pathological gambling. BMC Psychiatry 2013;13:177.CrossRefGoogle ScholarPubMed
American Psychiatric Association, Diagnostic and statistical manual of mental disorders 5th edition.Washington, DC: American Psychiatric Publishing; 2013.CrossRefGoogle Scholar
World Health, Organization, The ICD-10 Classification of mental and behavioral disorders: clinical descriptions and diagnostic guidelines Geneva: WHO; 1991.Google Scholar
IBM Corporation, IBM SPSS Statistics, Release 19.0.0; NY, USA: Armonk; 1989–2010.Google Scholar
Schneider, F., Dreer, E.Volkswirtschaftliche Analyse eines rechtzeitigen Erkennens von Burnout. Johannes Kepler Universität Linz; 2013.Google Scholar
Statistik Austria, Abgestimmte Erwerbsstatistik. 2014 http://www.statistik.at.Google Scholar
Winkler, D., Willeit, M., Praschak-Rieder, N., Lucht, M.J., Hilger, E., Konstantinidis, A., et al.Changes of clinical pattern in seasonal affective disorder (SAD) over time in a German-speaking sample. Eur Arch Psychiatry Clin Neurosci; 2002; 252: 54–62.CrossRefGoogle Scholar
Kessler, R.C., McGonagle, K.A., Nelson, C.B., Hughes, M., Swartz, M., Blazer, D.G.Sex and depression in the National Comorbidity Survey. II: cohort effects. J Affect Disord 1994; 30: 15–26.CrossRefGoogle ScholarPubMed
Klerman, G.L., Weissman, M.M.Increasing rates of depression. JAMA 1989; 261: 2229–35.CrossRefGoogle ScholarPubMed
Winkler, D., Praschak-Rieder, N., Willeit, M., Lucht, M.J., Hilger, E., Konstantinidis, A., et al.Seasonal affective depression in 2 German speaking university centers: Bonn, Vienna. Clinical and demographic characteristics. Nervenarzt; 2002; 73: 637–43.CrossRefGoogle ScholarPubMed
Winkler, D., Pjrek, E., Kasper, S.Gender-specific symptoms of depression and anger attacks. J Men Health Gender 2006; 3: 19–24.CrossRefGoogle Scholar
Moller-Leimkuhler, A.M.The gender gap in suicide and premature death or: why are men so vulnerable?. Eur Arch Psychiatry Clin Neurosci 2003; 253: 1–8.CrossRefGoogle ScholarPubMed
Rutz, W., Walinder, J., Von Knorring, L., Rihmer, Z., Pihlgren, H.Prevention of depression and suicide by education and medication: impact on male suicidality. An update from the Gotland study. Int J Psychiatry Clin Pract 1997; 1: 39–46.CrossRefGoogle ScholarPubMed
Statistik Austria, Vorhandensein von Konsumgütern im Haushalt nach soziodemographischen Merkmalen. 2014 http://www.statistik.at.Google Scholar
Statistik Austria, Bevölkerung 2013 nach detailliertem Geburtsland, Geschlecht und Staatsangehörigkeit. 2013 http://www.statistik.at.Google Scholar
Hemp, P.Presenteeism: at work – but out of it. Harv Bus Rev 2004; 82. 49–58, 155.Google ScholarPubMed
Gartlehner, G., Nussbaumer, B., Gaynes, B.N., Forneris, C.A., Morgan, L.C., Kaminski-Hartenthaler, A., et al.Second-generation antidepressants for preventing seasonal affective disorder in adults. Cochrane Database Syst Rev 2015;11:CD011268.Google Scholar
Forneris, C.A., Nussbaumer, B., Kaminski-Hartenthaler, A., Morgan, L.C., Gaynes, B.N., Sonis, J.H., et al.Psychological therapies for preventing seasonal affective disorder. Cochrane Database Syst Rev 2015;11:CD011270.Google Scholar
Kaminski-Hartenthaler, A., Nussbaumer, B., Forneris, C.A., Morgan, L.C., Gaynes, B.N., Sonis, J.H., et al.Melatonin and agomelatine for preventing seasonal affective disorder. Cochrane Database Syst Rev 2015;11:CD011271.Google Scholar
Nussbaumer, B., Kaminski-Hartenthaler, A., Forneris, C.A., Morgan, L.C., Sonis, J.H., Gaynes, B.N., et al.Light therapy for preventing seasonal affective disorder. Cochrane Database Syst Rev 2015;11:CD011269.Google Scholar
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