Estimating the Disease Burden of Seasonal Affective Disorder

  • M. C. Freed
  • R. L. Osborn
  • K. J. Rohan
Reference work entry


 Seasonal Affective Disorder (SAD) is defined as a recurrent pattern of Major Depressive Episodes with a temporal relationship between the episodes and time of year (e.g., onset during fall/winter with remission during spring/summer) that affects 10–20% of major depression cases. Because SAD is a subtype of recurrent major depression and shares many symptoms, it also presumably shares the same disability during symptomatic months. In an alarming trend, the WHO predicts that by 2020, unipolar depression will rank second only to ischemic heart disease in disease burden. Although no SAD disease burden estimates exist to date, extant SAD literature is sufficient in scope and content to provide the information needed to estimate the disease burden, using the major depression literature as a proxy if necessary. We summarize and present literature that addresses key components to estimating disease burden:  prevalence; treatment efficacy, existing  preference weights, and course of illness.

Current SAD prevalence estimates vary between 0.4 and 16% in the general adult population, depending on latitude, age, gender, and measurement method. Longitudinal data suggest that SAD remits in up to 27% of patients, becomes more complicated in presentation in up to 44% of patients, and remains in 42% of patients. Efficacy data suggests that treatment can lead to remission in up to 83% of patients, depending on treatment type. We present preference weights from the major depression literature, because they do not exist for SAD.  Disability weights range from 0.09 (minor depression) to 0.83 (severe depression). Similarly, health utilities range from 0.83 (mild depression) to 0.15 (severe depression).

SAD is a chronic, disabling, but treatable condition. Disease burden estimates of SAD could be used to better determine the need for and utility of therapeutic interventions designed to alleviate symptoms of SAD and associated impairment.


Health Utility Light Therapy Preference Weight Disability Weight Seasonal Affective Disorder 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of Abbreviations:


American Psychiatric Association


 cognitive behavioral therapy


confidence interval


disability adjusted life year


diagnostic and statistical manual of mental disorders IV – text revision


global burden of disease


international classification of disease-10


 light therapy


no data available


 quality adjusted life year


seasonal affective disorder


Seasonal Health Questionnaire


structured interview guide for the Hamilton depression rating scale-seasonal affective disorder version


seasonal pattern assessment questionnaire


selective serotonin reuptake inhibitors


World Health Organization


years of life with disability


years of life lost


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© Springer Science+Business Media LLC 2010

Authors and Affiliations

  • M. C. Freed
  • R. L. Osborn
  • K. J. Rohan

There are no affiliations available

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