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What is this thing called “SAD”? A critique of the concept of seasonal affective disorder

Published online by Cambridge University Press:  18 May 2011

Vidje Hansen ,
Ingunn Skre  and
Eiliv Lund
Vidje Hansen*
Affiliation:
Institute of Clinical Medicine, University of Tromsø(Norway)
Ingunn Skre
Affiliation:
institute of Psychology, University of Tromsø(Norway)
Eiliv Lund
Affiliation:
Institute of Community Medicine, University of Tromsø(Norway)
*
Address for correspondence: Professor V. Hansen, Department of Clinical Psychiatry, Psychiatric Department UNN, p.o. 6124, N-9291 Tromsø, (Norway). E-mail: vidje.hansen@unn.no
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Summary

Background – Seasonal Affective Disorder (SAD) is supposed to be caused by lack of daylight in winter. Yet the population of Northern Norway, living without sun for two winter months, does not spontaneously complain about depression during the dark period. Aims – To summarize research bearing upon the validity of the concept of SAD. Method – Review of relevant literature concerning the epidemiology of SAD and the questionnaire developed to measure it in general populations, the Seasonal Pattern Assessment Questionnaire (SPAQ). Results – Large population studies from northern Norway do not point to a higher prevalence of depression in winter than expected in any other general population. The psychometric properties of SPAQ are rather poor, and the diagnosis of SAD based on SPAQ bears little relationship to a meaningful concept of depression. Conclusions – Seasonal Affective Disorder is not a valid medical construct. Instead, “Recurrent depression with seasonal pattern” as defined in the DSM-IV and the ICD-10 should be used as terms. However, more research is needed to establish whether it is at all fruitful to single out such a subtype of recurrent depression.

Declaration of Interest: None.

Keywords

seasonal affective disordervalidityseasonal pattern assessmentquestionnaireepidemiology
Type
Special Articles
Information
Epidemiology and Psychiatric Sciences , Volume 17 , Issue 2 , June 2008 , pp. 120 - 127
Copyright
Copyright © Cambridge University Press 2008

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