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Seasonal Influences on Human
Physical and Mental Performance
Glenn Booker
BMES 531
June 7, 2007
SAD Definition
Seasonal Affective Disorder (SAD) is
a recurrent major depression which
generally results in lethargy and
depression symptoms during the
Fall and Winter seasons
– Measure with Global Seasonality Score (GSS)
from the Seasonal Pattern Assessment
Questionnaire (SPAQ). (Rosenthal, 1987)
– Diagnostic and Statistical Manual of Mental
Disorders, 4th edition (DSM-IV) (APA, 2000)
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SAD Definition
– Structured Interview Guide for the Hamilton
Depression Rating Scale: Seasonal Affective
Disorder Version (SIGH-SAD) (Williams, 1988)
– WHO “ICD-10 Classification of Mental and
Behavioral Disorders” (WHO, 1992)
SAD epidemiology favors age (young),
gender (female), and latitude (far from
equator), but not race or ethnicity (Sher,
2001; Boehnert, 2003; Magnusson, 2000; Eagles, 2003 )
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SAD Mechanisms
Phase Shift Hypothesis (Lewy, 1989)
– Phase delay in body
Melatonin Dysregulation (Malhotra, 2004; Arnedt, 2003;
Lam, 2000; Wehr, 2001)
– Secretion is longer than normal in winter
Serotonin Deficiency (Sher, 2001)
– L-tryptophan is a precursor of serotonin
Genetic Abnormalities (Sher, 2004; Ebisawa, 2007)
– Based on epidemiology studies; serotonin transporter
or clock gene defects
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Comorbidity
SAD also frequently found with
– Bulimia nervosa (Levitan, 2004; Eagles, 2003)
– Premenstrual dysphoric disorder (Portella, 2006)
– Alcoholism (Sher, 2004)
– Increased odor sensitivity (Postolache, 2002)
No diurnal preference (morningness vs
eveningness) (Natale, 2005; Bernert, 2005)
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SAD Treatment
Light therapy (Wirz-Justice, 2005; Golden, 2005)
– 2500 to 10,000 lux white light for 15-30 min
– Wake therapy? Controlled sleep deprivation
SSRIs (Prozac, Zoloft) do as well as light
(Blumberger, 2005)
Dawn Simulators or Negative Ions
(Terman,
2006)
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Reduce SAD Symptoms
Vitamin D improves mood (Vieth, 2004)
Self-esteem and social support reduce
symptoms’ severity (McCarthy, 2002)
Good weather and being outside (Keller, 2004)
– Measured time spent outdoors, outside
temperature, and barometric pressure
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Distill Information
Take all the previous information, and
turn it into two checklists
– One for background information which isn’t
likely to change often; call it the Personal
History Form
– One for information which may change
frequently (location, weather, etc.) and
call it the Recent Habits Survey
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Personal History Form
What is your gender?
What is your birthday?
– Calculate age
Have you reached
puberty yet? If you
don’t know, say no.
Have you completed
menopause?
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Have you ever been
diagnosed with
Seasonal Affective
Disorder (SAD)?
Have you ever been
diagnosed with
bulimia?
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Personal History Form
Have you ever been
diagnosed with
premenstrual
dysphoric disorder
(severe PMS)?
Have you ever been
diagnosed as an
alcoholic?
Are you more
sensitive to odors
than others?
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Do you have a twin?
If yes, do they have
SAD?
Does anyone in your
immediate family
(other than your twin,
if you have one) have
seasonal affective
disorder?
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Recent Habits Survey
What is your location?
– Use to get latitude,
altitude, and weather
What is today’s date?
– Or get automatically
What vitamin
supplements are you
taking?
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Do you feel good
about yourself today?
Do you have friends
you can talk to easily?
How much time per
day have you spent
outdoors during the
daytime?
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Analysis
From the Personal History Form and
Recent Habits Survey, calculate risk
values from each answer
– Typically, “yes” means a risk value of 1,
and “no” means a risk value of 0
– Add up the risk values for each form
– Possible range for the Personal History Form
is -1 to +8 ½, whereas for the Recent Habits
Survey the possible range is -2 to +4
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Conclusion
The total risk value for the Personal
History Form and Recent Habits Survey
help quantify the risk of having SAD, and
the likely severity of symptoms if it occurs
Can also help identify client actions to
reduce symptoms, and point to effective
treatments
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References
(APA, 2000) American Psychiatric Association. (2000) Diagnostic
and Statistical Manual of Mental Disorders, 4th edition, text revision
(DSM-IVTR). Washington, DC: American Psychiatric Press.
(Arendt, 2003) J. Arendt (2003) Importance and Relevance of
Melatonin to Human Biological Rhythms. Journal of
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(Barinaga, 2002) Marcia Barinaga (8 Feb 2002) Circadian Clock:
How the Brain's Clock Gets Daily Enlightenment. Science Vol. 295.
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(Bernert, 2005) Rebecca A. Bernert (2005) A Circadian Vulnerability
For Depression: Eveningness And Sleep Variability. Master’s thesis
for Florida State University.
(Bhatia, 2007) Subhash C. Bhatia, Shashi K. Bhatia. Diagnosis and
Treatment of Premenstrual Dysphoric Disorder. Downloaded on
6/5/2007 from http://www.aafp.org/afp/20021001/1239.html.
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References
(Bierman, 2005) Andrew Bierman, Terence R Klein and Mark S Rea
(2005) The Daysimeter: a device for measuring optical radiation as a
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Levitt (Oct 2005) The Light-er Side of Treating Seasonal Affective
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CNS and Peripheral Clock Disorders: Human Sleep Disorders and
Clock Genes. J Pharmacol Sci 103, 150 – 154.
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References
(Golden, 2005) Robert N. Golden, Bradley N. Gaynes, R. David
Ekstrom, Robert M. Hamer, Frederick M. Jacobsen, Trisha Suppes,
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References
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Raymond W. Lam, Allan S. Kaplan, Caroline Davis, Pierandrea Muglia,
Bronwyn Mackenzie, Subi Tharmalingam, Sidney H. Kennedy, Fabio
Macciardi, James L. Kennedy (2004) The Dopamine-4 Receptor Gene
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therapeutic effects: history theory and experimental evidence. In: Rosenthal,
N.E., Blehar, M.C. (Eds.), Seasonal Affective Disorders and phototherapy.
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studies on seasonal affective disorder. Acta Psychiatr Scand 101: 176-184.
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References
(Malhotra, 2004) Samir Malhotra, Girish Sawhney, Promila Pandhi
(2004) The Therapeutic Potential of Melatonin: A Review of the
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References
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References
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