Skip to main content
SpringerLink
Log in

Prevalence of seasonal depression in a prospective cohort study

  • Original Paper
  • Published:
European Archives of Psychiatry and Clinical Neuroscience Aims and scope Submit manuscript

Abstract

The prevalence of autumn/winter seasonality in depression has been documented in the longitudinal Zurich cohort study by five comprehensive diagnostic interviews at intervals over more than 20 years (N = 499). Repeated winter major depressive episodes (MDE—unipolar + bipolar) showed a prevalence of 3.44% (5× more women than men), whereas MDE with a single winter episode was much higher (9.96%). A total of 7.52% suffered from autumn/winter seasonality in major and minor depressive mood states. The clinical interviews revealed novel findings: high comorbidity of Social Anxiety Disorder and Agoraphobia within the repeated seasonal MDE group, high incidence of classic diurnal variation of mood (with evening improvement), as well as a high rate of oversensitivity to light, noise, or smell. Nearly twice as many of these individuals as in the other MDE groups manifested the syndrome of atypical depression (DSM-V), which supports the prior description of seasonal affective disorder (SAD) as presenting primarily atypical symptoms (which include hypersomnia and increase in appetite and weight). This long-term database of regular structured interviews provides important confirmation of SAD as a valid diagnosis, predominantly found in women, and with atypical vegetative symptoms.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Wehr TA (2001) Photoperiodism in humans and other primates: evidence and implications. J Biol Rhythms 16:348–364

    Article  CAS  PubMed  Google Scholar 

  2. Wirz-Justice A (2018) Seasonality in affective disorders. Gen Comp Endocrinol 258:244–249

    Article  CAS  PubMed  Google Scholar 

  3. Rosenthal NE, Sack DA, Gillin JC, Lewy AJ, Goodwin FK, Davenport Y, Mueller PS, Newsome DA, Wehr TA (1984) Seasonal affective disorder. A description of the syndrome and preliminary findings with light therapy. Arch Gen Psychiatry 41:72–80

    Article  CAS  PubMed  Google Scholar 

  4. Diagnostic and Statistical Manual of Mental Disorders Revised (DSM-III-R) (1987) American Psychiatric Association, Washington, DC

  5. Traffanstedt MK, Mehta S, LoBello SG (2016) Major depression with seasonal variation. Is it a valid construct? Clin Psychol Sci 5:825–834

    Article  Google Scholar 

  6. Young MA (2016) Does seasonal affective disorder exist? A commentary on Traffanstedt, Mehta, and LoBello. Clin Psychol Sci 5:750–754

    Article  Google Scholar 

  7. Winkler D, Pjrek E, Spies M, Willeit M, Dorffner G, Lanzenberger R, Kasper S (2017) Has the existence of seasonal affective disorder been disproven? J Affect Disord 208:54–55

    Article  PubMed  Google Scholar 

  8. Kegel M, Dam H, Ali F, Bjerregaard P (2009) The prevalence of seasonal affective disorder (SAD) in Greenland is related to latitude. Nord J Psychiatry 63:331–335

    Article  PubMed  Google Scholar 

  9. Murray G (2004) How common is seasonal affective disorder in temperate Australia? A comparison of BDI and SPAQ estimates. J Affect Disorder 81:23–28

    Article  Google Scholar 

  10. Magnusson A (2000) An overview of epidemiological studies on seasonal affective disorder. Acta Psychiatr Scand 101:176–184

    Article  CAS  PubMed  Google Scholar 

  11. Saarijärvi S, Lauerma H, Helenius H, Saarilehto S (1999) Seasonal affective disorders among rural Finns and Lapps. Act Psychiatr Scand 99:95–101

    Article  Google Scholar 

  12. Magnússon A, Axelsson J (1993) The prevalence of seasonal affective disorder is low among descendants of Icelandic emigrants in Canada. Arch Gen Psychiatry 50:947–951

    Article  PubMed  Google Scholar 

  13. Booker JM, Hellekson CJ, Putilov AA, Danilenko KV (1990) Seasonal depression and sleep disturbances in Alaska and Siberia: a pilot study. Arct Med Res 50(Suppl. 5):281–284

    Google Scholar 

  14. Raheja UK, Stephens SH, Mitchell BD, Rohan KJ, Vaswani D, Balis TG, Nijjar GV, Sleemi A, Pollin TI, Ryan K, Reeves GM, Weitzel N, Morrissey M, Yousufi H, Langenberg P, Shuldiner AR, Postolache TT (2013) Seasonality of mood and behavior in the Old Order Amish. J Affect Disord 147:112–117

    Article  PubMed  Google Scholar 

  15. Kasper S, Wehr TA, Bartko JJ, Gaist PA, Rosenthal NE (1989) Epidemiological findings of seasonal changes in mood and behavior. A telephone survey of Montgomery County, Maryland. Arch Gen Psychiatry 46:823–833

    Article  CAS  PubMed  Google Scholar 

  16. Wirz-Justice A, Graw P, Kräuchi K, Wacker HR (2003) Seasonality in affective disorders in Switzerland. Acta Psychiatr Scand Suppl 418:92–95

    Article  Google Scholar 

  17. Steinhausen HC, Gundelfinger R, Winkler Metzke C (2009) 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 115:347–354

    Article  PubMed  Google Scholar 

  18. Wicki W, Angst J, Merikangas KR (1992) The Zurich Study. XIV. Epidemiology of seasonal depression. Eur Arch Psychiatry Clin Neurosci 241:301–306

    Article  CAS  PubMed  Google Scholar 

  19. Derogatis LR (1977) SCL-90. Administration, Scoring and Procedures Manual-I for the R (revised) version and other instruments of the Psychopathology Rating Scale Series. Johns Hopkins University School of Medicine, Chicago

    Google Scholar 

  20. Pjrek E, Baldinger-Melich P, Spies M, Papageorgiou K, Kasper S, Winkler D (2016) Epidemiology and socioeconomic impact of seasonal affective disorder in Austria. Eur Psychiatry 32:28–33

    Article  CAS  PubMed  Google Scholar 

  21. Wirz-Justice A (2008) Diurnal variation of depressive symptoms. Dialogues Clin Neurosci 10:337–343

    PubMed  PubMed Central  Google Scholar 

  22. Postolache TT, Wehr TA, Doty RL, Sher L, Turner EH, Bartko JJ, Rosenthal NE (2002) Patients with seasonal affective disorder have lower odor detection thresholds than control subjects. Arch Gen Psychiatry 59:1119–1122

    Article  PubMed  Google Scholar 

  23. Parker GB (2007) Atypical depression: a valid subtype? J Clin Psychiatry 68(Suppl 3):18–22

    PubMed  Google Scholar 

  24. Haggarty JM, Cernovsky Z, Husni M, Minor K, Kermeen P, Merskey H (2002) Seasonal affective disorder in an Arctic community. Acta Psychiatr Scand 105:378–384

    Article  CAS  PubMed  Google Scholar 

  25. Booker JM, Hellekson CJ (1992) Prevalence of seasonal affective disorder in Alaska. Am J Psychiatry 149:1176–1182

    Article  CAS  PubMed  Google Scholar 

  26. Magnússon A, Stefánsson JG. Prevalence of seasonal affective disorder in Iceland (1993) Arch Gen Psychiatry 50:941–946

  27. Chotai J, Smedh K, Johansson C, Nilsson LG, Adolfsson R (2004) An epidemiological study on gender differences in self-reported seasonal changes in mood and behaviour in a general population of northern Sweden. Nord J Psychiatry 58:429–437

    Article  PubMed  Google Scholar 

  28. Okawa M, Shirakawa S, Uchiyama M, Oguri M, Kohsaka M, Mishima K, Sakamoto K, Inoue H, Kamei K, Takahashi K (1996) Seasonal variation of mood and behaviour in a healthy middle-aged population in Japan. Acta Psychiatr Scand 94:211–216

    Article  CAS  PubMed  Google Scholar 

  29. Rosen LN, Targum SD, Terman M, Bryant MJ, Hoffman H, Kasper SF, Hamovit JR, Docherty JP, Welch B, Rosenthal NE (1990) Prevalence of seasonal affective disorder at four latitudes. Psychiatry Res 31:131–144

    Article  CAS  PubMed  Google Scholar 

  30. Mersch PP, Middendorp HM, Bouhuys AL, Beersma DG, van den Hoofdakker RH (1999) The prevalence of seasonal affective disorder in The Netherlands: a prospective and retrospective study of seasonal mood variation in the general population. Biol Psychiatry 45:1013–1022

    Article  CAS  PubMed  Google Scholar 

  31. Mersch PP, Middendorp HM, Bouhuys AL, Beersma DG, van den Hoofdakker RH (1999) Seasonal affective disorder and latitude: a review of the literature. J Affect Disord 53:35–48

    Article  CAS  PubMed  Google Scholar 

  32. Thompson C, Thompson S, Smith R (2004) Prevalence of seasonal affective disorder in primary care; a comparison of the seasonal health questionnaire and the seasonal pattern assessment questionnaire. J Affect Disord 78:219–226

    Article  PubMed  Google Scholar 

  33. Shand AJ, Scott NW, Anderson SM, Eagles JM (2011) The seasonality of bipolar affective disorder: comparison with a primary care sample using the Seasonal Pattern Assessment Questionnaire. J Affect Disord 132:289–292

    Article  PubMed  Google Scholar 

  34. Sakamoto K, Kamo T, Nakadaira S, Tamura A, Takahashi K (1993) A nationwide survey of seasonal affective disorder at 53 outpatient university clinics in Japan. Acta Psychiatr Scand 87:258–265

    Article  CAS  PubMed  Google Scholar 

  35. Blazer DG, Kessler RC, Swartz MS (1998) Epidemiology of recurrent major and minor depression with a seasonal pattern. The National Comorbidity Survey. Br J Psychiatry 172:164–167

    Article  CAS  PubMed  Google Scholar 

  36. Eagles JM, Wileman SM, Cameron IM, Howie FL, Lawton K, Gray DA, Andrew JE, Naji SA (1999) Seasonal affective disorder among primary care attenders and a community sample in Aberdeen. Br J Psychiatry 175:472–475

    Article  CAS  PubMed  Google Scholar 

  37. Michalak EE, Wilkinson C, Dowrick C, Wilkinson G (2001) Seasonal affective disorder: prevalence, detection and current treatment in North Wales. Br J Psychiatry 179:31–34

    Article  CAS  PubMed  Google Scholar 

  38. Levitt AJ, Boyle MH, Joffe RT, Baumal Z (2000) Estimated prevalence of the seasonal subtype of major depression in a Canadian community sample. Can J Psychiatry 45:650–654

    Article  CAS  PubMed  Google Scholar 

  39. Elbi H, Noyan A, Korukoğlu S, Unal S, Bekaroğlu M, Oğuzhanoğlu N, Türköz N, Abay E, Kumbasar H, Yurdakul S (2002) Seasonal affective disorder in eight groups in Turkey: a cross-national perspective. J Affect Disord 70:77–84

    Article  PubMed  Google Scholar 

  40. Baek JH, Kim JS, Huh I, Lee K, Park JH, Park T, Ha K, Hong KS (2015) Prevalence, behavioral manifestations and associated individual and climatic factors of seasonality in the Korean general population. Compr Psychiatry 57:148–154

    Article  PubMed  Google Scholar 

  41. Leonhardt G, Wirz-Justice A, Kräuchi K, Graw P, Wunder D, Haug HJ (1994) Long-term follow-up of depression in seasonal affective disorder. Compr Psychiatry 35:457–464

    Article  CAS  PubMed  Google Scholar 

  42. Graw P, Gisin B, Wirz-Justice A (1997) Follow-up study of seasonal affective disorder in Switzerland. Psychopathol 30:208–214

    Article  CAS  Google Scholar 

  43. Sakamoto K, Nakadaira S, Kamo K, Kamo T, Takahashi K (1995) A longitudinal follow-up study of seasonal affective disorder. Am J Psychiatry 152:862–868

    Article  CAS  PubMed  Google Scholar 

  44. Cléry-Melin ML, Gorwood P, Friedman S, Even C (2018) Stability of the diagnosis of seasonal affective disorder in a long-term perspective. J Affect Disord 227:353–357

    Article  PubMed  Google Scholar 

Download references

Funding

This work was supported by Grant numbers 3200-050881.97/1 and 32-50881.97 of the Swiss National Science Foundation.

Author information

Authors and Affiliations

  1. Centre for Chronobiology, Psychiatric Clinics, University of Basel, Basel, Switzerland

    Anna Wirz-Justice

  2. Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland

    Vladeta Ajdacic, Wulf Rössler & Jules Angst

  3. Department of Psychiatry and Psychotherapy, Charité University Medicine Berlin, Berlin, Germany

    Wulf Rössler

  4. Department of Child and Adolescent Psychiatry, University of Zurich, Zurich, Switzerland

    Hans-Christoph Steinhausen

  5. Clinical Psychology and Epidemiology, Institute of Psychology, University of Basel, Basel, Switzerland

    Hans-Christoph Steinhausen

  6. Child and Adolescent Mental Health Centre, Capital Region Psychiatry, Copenhagen, Denmark

    Hans-Christoph Steinhausen

  7. Department of Child and Adolescent Psychiatry, University of Southern Denmark, Odense, Denmark

    Hans-Christoph Steinhausen

Authors
  1. Anna Wirz-Justice
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vladeta Ajdacic
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Wulf Rössler
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hans-Christoph Steinhausen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jules Angst
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jules Angst.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest with the present study.

Ethical approval

The study was approved (1978) by the Ethical Committee of the Zurich University Psychiatric Hospital and has, therefore, been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

All persons gave their informed consent prior to their inclusion in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wirz-Justice, A., Ajdacic, V., Rössler, W. et al. Prevalence of seasonal depression in a prospective cohort study. Eur Arch Psychiatry Clin Neurosci 269, 833–839 (2019). https://doi.org/10.1007/s00406-018-0921-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00406-018-0921-3

Keywords

Search

Navigation