Seasonal Affective Disorders and Phototherapy

Overview

While theories linking seasonality and affective episodes date back to the time of Hippocrates, it is only recently that the idea has gained widespread acceptance. The recognition that melatonin could be suppressed by bright light, the delineation of seasonal affective disorder (SAD) as a syndrome with distinct clinical and therapeutic implications, and the efficacy of bright light in the treatment of this condition, were all important steps in this regard. The therapeutic value of bright light in SAD closely ...
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Overview

While theories linking seasonality and affective episodes date back to the time of Hippocrates, it is only recently that the idea has gained widespread acceptance. The recognition that melatonin could be suppressed by bright light, the delineation of seasonal affective disorder (SAD) as a syndrome with distinct clinical and therapeutic implications, and the efficacy of bright light in the treatment of this condition, were all important steps in this regard. The therapeutic value of bright light in SAD closely aligns the biology of the disorder with its treatment and introduces into psychiatry an exciting new therapeutic modality.

Seasonal Affective Disorders And Phototherapy brings together the latest research in four key areas:
* Diagnostic profile of SAD, epidemiological issues, and specific clinical applications of light
* Animal models of seasonality
* Normal human seasonality and its relationship to psychiatric disorders
* Biological mechanisms subserving light treatment

Introductory chapters consider the different profiles of SAD and detail outcome studies across the Northern Hemisphere. Important questions are addressed about summer depression, with and without winter depression, as well as seasonality and SAD in children and adolescents. Also included are current prevalence data on SAD--several reports in this volume suggest it may occur in approximately 5% of the population with subclinical disturbances present in even more individuals.

Reports on seasonal changes in the normal population consider whether the mood and personality changes observed in SAD are extremes of normal human seasonality and whether the disorder's pathophysiology is actually on a continuum with a range of biological seasonal changes found in the general population. A neurological theory is presented that maps the basic systems involved in mobilizing behavior and engaging the organism with its environment. The theory is then applied to seasonal changes both in normal motivated behavior and in SAD.

Points of consensus as well as points of contention are given balanced consideration in the book's chapters, which address several unresolved questions concerning phototherapy's mechanism of action. Among these controversial areas are the assessment of placebo effect, choice of placebo control, and the importance of the timing of light treatment to its antidepressant effect. Also discussed are the circadian phase shift theory of SAD, the melatonin hypothesis, and other current theories.

There is substantial agreement among clinical researchers that SAD is a common condition, and that, in a large percentage of cases, symptoms of winter depression can be ameliorated by treatment with environmental light. Beyond these fundamental points of agreement, however, many aspects of SAD remain controversial. This timely, authoritative compilation provides all clinicians and researchers with a comprehensive update on important, new investigations on this intriguing disorder.
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Editorial Reviews

Booknews
A review of seasonal affective disorders (SAD) research in animals and humans. Covers: clinical, diagnostic, and epidemiolgical issues; animal models of seasonality and their applicability to humans; normal human seasonality and its relationship to seasonal disorders; light treatment and its neurobiology. Annotation c. Book News, Inc., Portland, OR (booknews.com)
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Product Details

  • ISBN-13: 9780898627411
  • Publisher: Guilford Publications, Inc.
  • Publication date: 4/21/1989
  • Edition number: 1
  • Pages: 386
  • Product dimensions: 6.35 (w) x 9.45 (h) x 1.21 (d)

Meet the Author

Norman E. Rosenthal, MD, is a pioneer in the field of seasonal studies who is internationally recognized for his outstanding contribution to the understanding and treatment of depression. He is a Senior Researcher at the National Institute of Mental Health and Clinical Professor of Psychiatry at Georgetown University. Widely published, he is the author of St. John's Wort: The Herbal Way to Feeling Good.

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Table of Contents


1. Introduction and Overview, Rosenthal & Blehar.
I. CLINICAL ASPECTS OF SEASONAL AFFECTIVE DISORDERS.
2. Seasonal Affective Disorders: A Historical Overview, Wehr.
3. Phenomenology of Seasonal Affective Disorder: An Alaskan Perspective, Hellekson.
4. Seasonal Affective Disorder of Childhood and Adolescence: A Review, Sonis.
5. Summer Depression: Description of the Syndrome and Comparison with Winter Depression, Wehr, Giesen, Schultz, Joseph-Vanderpool, Kasper, Kelly, & Rosenthal.
6. Comparison between Seasonal Affective Disorder and Other Forms of Recurrent Depression, Thase.
7. The Validity of Seasonal Affective Disorder, Spitzer & Williams.
II. A SEARCH FOR ANIMAL MODELS OF SEASONAL AFFECTIVE DISORDERS.
8. The Photoperiodic Phenomena: Seasonal Modulation of "The Day Within,' Pittendrigh.
9. Seasonal Variations in Body Weight and Metabolism in Hamsters, Wade. 10. Seasonal Affective Disorder, Hibernation, and Annual Cycles in Animals: Chipmunks in the Sky, Mrosovsky.
11. Seasonal Affective Disorders: Animal Models, Non Fingo, Zucker.
III. SEASONAL CHANGES IN THE NORMAL POPULATION. 12. Seasonal Variation in Normal Subjects: An Update of Variables Current in Depression Research, Lacoste & Wirz-Justice.
13. Dopamine Functioning in the Behavioral Facilitation System and Seasonal Variation in Behavior: Normal Population and Clinical Studies, Depue, Arbisi, Spoont, Leon, & Ainsworth.
14. Psychological Effects of Light Therapy in Normals, Kasper, Rogers, Yancey, Skwerer, Schulz, & Rosenthal.
IV. PHOTOTHERAPY FOR WINTER SEASONAL AFFECTIVE DISORDER AND NONSEASONAL DEPRESSION: CLINICAL AND THEORETICAL CONSIDERATIONS.
15. Phototherapy for Seasonal Affective Disorder, Rosenthal, Sack, Skwerer, Jacobsen, & Wehr.
16. Winter Depression and the Phase-Shift Hypothesis for Bright Light's Therapeutic Effects: History, Theory, and Experiemtnal Evidence, Lewy, Sack, Singer, White, & Hoban.
17. Neurobiology of Seasonal Affective Disorder and Biological Effects of Light, Skwerer, Jacobsen, Duncan, Kelly, Sack, Tamarkin, Gaist, Kasper, & Rosenthal.
18. The Role of Serotonin in Seasonal Affective Disorder and the Antidepressant Response to Phototherapy, Jacobsen, Murphy, & Rosenthal.
19. Phototherapy for Nonseasonal Major Depressive Disorder, Kripke, Mullaney, Savides, & Gillin.
20. On the Question of Mechanism in Phototherapy: Considerations of Clinical Efficacy and Epidemiology, Terman.
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