Korean Journal of Biological Psychiatry (생물정신의학)

The Korean Society of Biological Psychiatry (대한생물정신의학회)
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Seasonal Changes in Mood and Behavior and Associated Factors of Seasonality in Korean Bipolar Disorder Patients and Normal Controls

양극성 장애 환자와 정상인에서 계절성의 양상과 관련 요인 탐색

  • Choi, Jungmi (Department of Psychiatry, Sungkyunkwan University School of Medicine) ;
  • Baek, Ji Hyun (Department of Psychiatry, Sungkyunkwan University School of Medicine) ;
  • Kim, Ji Sun (Department of Psychiatry, Sungkyunkwan University School of Medicine) ;
  • Choi, Ji Sun (Samsung Biomedical Research Institute, Center for Clinical Medicine) ;
  • Noh, Jihae (Samsung Biomedical Research Institute, Center for Clinical Medicine) ;
  • Nam, Hee Jung (Department of Psychiatry, Eunpyeong Hospital) ;
  • Lee, Dongsoo (Department of Psychiatry, Sungkyunkwan University School of Medicine) ;
  • Hong, Kyung Sue (Department of Psychiatry, Sungkyunkwan University School of Medicine)
  • 최정미 (성균관대학교 의과대학 삼성서울병원 정신과학교실) ;
  • 백지현 (성균관대학교 의과대학 삼성서울병원 정신과학교실) ;
  • 김지선 (성균관대학교 의과대학 삼성서울병원 정신과학교실) ;
  • 최지선 (삼성생명과학연구소 임상의학연구센터) ;
  • 노지혜 (삼성생명과학연구소 임상의학연구센터) ;
  • 남희정 (서울특별시 은평병원 정신과) ;
  • 이동수 (성균관대학교 의과대학 삼성서울병원 정신과학교실) ;
  • 홍경수 (성균관대학교 의과대학 삼성서울병원 정신과학교실)
  • Received : 2010.07.12
  • Accepted : 2010.08.03
  • Published : 2010.08.31
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Abstract

Objectives : Recurrence of mood episodes associated with a specific season has been described in various mood disorders. Seasonal change in mood and behavior as a lifetime trait is also observed in healthy individuals. This study aimed at comparing the lifetime trait of seasonal variations of mood and behavior between bipolar disorder patients and controls as well as investigating associated factors of seasonality. Methods : Subjects were ninety-four clinically stable patients with bipolar disorder and 188 age- and sex-matched healthy controls. Seasonality of mood and behavior was assessed retrospectively on lifetime basis using Seasonal Pattern Assessment Questionnaire(SPAQ). Results : The patient group showed a higher median global seasonality score(GSS) of SPAQ and a higher rate of seasonal affective disorder(SAD) compared to the control group(p < 0.0001). For subjects showing prominent seasonality, the seasonal symptom profile and seasonal pattern was similar in both patient and control groups. In addition to the diagnosis, female gender was shown to be a predictor of seasonality in the multiple linear regression analysis(p = 0.045). Conclusion : This study suggests that lifetime trait of seasonality may be related to the susceptibility of bipolar disorder.

Keywords

References

  1. Kasper S, Wehr TA, Bartko JJ, Gaist PA, Rosenthal NE. Epidemiological findings of seasonal changes in mood and behavior. A telephone survey of Montgomery County, Maryland. Arch Gen Psychiatry 1989;46:823-833. https://doi.org/10.1001/archpsyc.1989.01810090065010
  2. Kasper S, Kamo T. Seasonality in major depressed inpatients. J Affect Disord 1990;19:243-248. https://doi.org/10.1016/0165-0327(90)90101-D
  3. Rosenthal NE, Sack DA, Gillin JC, Lewy AJ, Goodwin FK, 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. https://doi.org/10.1001/archpsyc.1984.01790120076010
  4. APA. Diagnostic and Statistical Manual of Mental Disorders, 4th edition American Psychiatric Association. Washington, DC;1994.
  5. Wehr TA, Sack D, Rosenthal N, Duncan W, Gillin JC. Circadian rhythm disturbances in manic-depressive illness. Fed Proc 1983;42:2809-2814.
  6. Hendrick V, Altshuler LL, Burt VK. Course of psychiatric disorders across the menstrual cycle. Harv Rev Psychiatry 1996;4:200-207. https://doi.org/10.3109/10673229609030544
  7. Hardin TA, Wehr TA, Brewerton T, Kasper S, Berrettini W, Rabkin J, et al. Evaluation of seasonality in six clinical populations and two normal populations. J Psychiatr Res 1991;25:75-87. https://doi.org/10.1016/0022-3956(91)90001-Q
  8. Portella AT, Haaga DA, Rohan KJ. The association between seasonal and premenstrual symptoms is continuous and is not fully accounted for by depressive symptoms. J Nerv Ment Dis 2006;194:833-837. https://doi.org/10.1097/01.nmd.0000244488.17025.0e
  9. Young MA, Blodgett C, Reardon A. Measuring seasonality: psychometric properties of the Seasonal Pattern Assessment Questionnaire and the Inventory for Seasonal Variation. Psychiatry Res 2003;117:75-83. https://doi.org/10.1016/S0165-1781(02)00299-8
  10. Blehar MC, Lewy AJ. Seasonal mood disorders: consensus and controversy. Psychopharmacol Bull 1990;26:465-494.
  11. Murray G. The Seasonal Pattern Assessment Questionnaire as a measure of mood seasonality: a prospective validation study. Psychiatry Res 2003;120:53-59. https://doi.org/10.1016/S0165-1781(03)00147-1
  12. Thompson C, Stinson D, Fernandez M, Fine J, Isaacs G. A comparison of normal, bipolar and seasonal affective disorder subjects using the Seasonal Pattern Assessment Questionnaire. J Affect Disord 1988;14:257-264. https://doi.org/10.1016/0165-0327(88)90043-2
  13. Bauer M, Glenn T, Grof P, Rasgon NL, Marsh W, Sagduyu K, et al. Relationship among latitude, climate, season and self-reported mood in bipolar disorder. J Affect Disord 2009;116:152-157. https://doi.org/10.1016/j.jad.2008.11.013
  14. Lee HJ, Kim L, Joe SH, Suh KY. Effects of season and climate on the first manic episode of bipolar affective disorder in Korea. Psychiatry Res 2002;113:151-159. https://doi.org/10.1016/S0165-1781(02)00237-8
  15. Jang KL, Lam RW, Livesley WJ, Vernon PA. Gender differences in the heritability of seasonal mood change. Psychiatry Res 1997;70:145-154. https://doi.org/10.1016/S0165-1781(97)00030-9
  16. Madden PA, Heath AC, Rosenthal NE, Martin NG. Seasonal changes in mood and behavior. The role of genetic factors. Arch Gen Psychiatry 1996;53:47-55. https://doi.org/10.1001/archpsyc.1996.01830010049008
  17. Rosenthal NE, Mazzanti CM, Barnett RL, Hardin TA, Turner EH, Lam GK, et al. Role of serotonin transporter promoter repeat length polymorphism(5-HTTLPR) in seasonality and seasonal affective disorder. Mol Psychiatry 1998;3:175-177. https://doi.org/10.1038/sj.mp.4000360
  18. Praschak-Rieder N, Willeit M, Wilson AA, Houle S, Meyer JH. Seasonal variation in human brain serotonin transporter binding. Arch Gen Psychiatry 2008;65:1072-1078. https://doi.org/10.1001/archpsyc.65.9.1072
  19. Thompson C, Stinson D, Smith A. Seasonal affective disorder and season-dependent abnormalities of melatonin suppression by light. Lancet 1990;336:703-706. https://doi.org/10.1016/0140-6736(90)92202-S
  20. Karadag F, Akdeniz F, Erten E, Pirildar S, Yucel B, Polat A, et al. Menstrually related symptom changes in women with treatment-responsive bipolar disorder. Bipolar Disord 2004;6:253-259. https://doi.org/10.1111/j.1399-5618.2004.00112.x
  21. Kaplan Z, Schild K, Levine J. Violence in hospitalized psychiatric patients: diurnal and seasonal patterns. Psychiatry Res 1996;60:199-204. https://doi.org/10.1016/0165-1781(96)02803-X
  22. Jain S, Kaliaperumal VG, Chatterji S, Rao S, Murthy RS. Climate and admissions for mania in the tropics. J Affect Disord 1992;26:247-250. https://doi.org/10.1016/0165-0327(92)90102-C
  23. Sayer HK, Marshall S, Mellsop GW. Mania and seasonality in the southern hemisphere. J Affect Disord 1991; 23:151-156. https://doi.org/10.1016/0165-0327(91)90027-P
  24. Schaffer A, Levitt AJ, Boyle M. Influence of season and latitude in a community sample of subjects with bipolar disorder. Can J Psychiatry 2003;48:277-280. https://doi.org/10.1177/070674370304800413
  25. Shin K, Schaffer A, Levitt AJ, Boyle MH. Seasonality in a community sample of bipolar, unipolar and control subjects. J Affect Disord 2005;86:19-25. https://doi.org/10.1016/j.jad.2004.11.010
  26. Correll CU, Penzner JB, Lencz T, Auther A, Smith CW, Malhotra AK, et al. Early identification and high-risk strategies for bipolar disorder. Bipolar Disord 2007;9:324-338. https://doi.org/10.1111/j.1399-5618.2007.00487.x
  27. Fava GA. Subclinical symptoms in mood disorders: pathophysiological and therapeutic implications. Psychol Med 1999;29:47-61. https://doi.org/10.1017/S0033291798007429
  28. Benazzi F. Prevalence and clinical correlates of residual depressive symptoms in bipolar II disorder. Psychother Psychosom 2001;70:232-238. https://doi.org/10.1159/000056260
  29. Marangell LB, Dennehy EB, Miyahara S, Wisniewski SR, Bauer MS, Rapaport MH, et al. The functional impact of subsyndromal depressive symptoms in bipolar disorder: data from STEP-BD. J Affect Disord 2009;114: 58-67. https://doi.org/10.1016/j.jad.2008.07.006
  30. Lee MS, Joung YS, Hong SD, Ko YH, Kim SH, Joe SH, et al. Seasonal Variations in Mood and Behavior in Korean High School Students. Sleep Med Psychophysiol 2005;12:111-116.
  31. Baek JH, Park DY, Park HJ, Choi JM, Choi JS, Noh JH, et al. Differences in Clinical Manifestations between Bipolar I and Bipolar II Disorders in Korean Population. J Korean Neuropsychiatr Assoc 2009;48:232-239.
  32. Rosenthal NE, Bradt GH, Wehr TA. Seasonal Pattern Assessment Questionnaire. National Institute of Mental Health, Washington, DC;1987.
  33. Guy W. Clinical global impressions. In: W. Guy, Editor, ECDEU assessment manual for psychopharmacology (Revised). National Institute of Mental Health, Rockville (Md);1976. p.217-221.
  34. Kim SJ, Lee HJ, Choi HS, Jung HG, Kim BJ, Kim JY, et al. Seasonal Variations of Mood and Behavior in Korean Medical Students. Sleep Med Psychophysiol 2004; 11:95-99.
  35. Hakkarainen R, Johansson C, Kieseppa T, Partonen T, Koskenvuo M, Kaprio J, et al. Seasonal changes, sleep length and circadian preference among twins with bipolar disorder. BMC Psychiatry 2003;3:6. https://doi.org/10.1186/1471-244X-3-6
  36. Steinhausen HC, 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;115:347-354. https://doi.org/10.1016/j.jad.2008.09.016
  37. Han L, Wang K, Cheng Y, Du Z, Rosenthal NE, Primeau F. Summer and winter patterns of seasonality in Chinese college students: a replication. Compr Psychiatry 2000;41:57-62. https://doi.org/10.1016/S0010-440X(00)90132-9
  38. Ozaki N, Ono Y, Ito A, Rosenthal NE. Prevalence of seasonal difficulties in mood and behavior among Japanese civil servants. Am J Psychiatry 1995;152:1225-1227. https://doi.org/10.1176/ajp.152.8.1225
  39. Magnusson A, Partonen T. The diagnosis, symptomatology, and epidemiology of seasonal affective disorder. CNS Spectr 2005;10:625-634. https://doi.org/10.1017/S1092852900019593