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Seasonal influences on first-episode admission in affective and non-affective psychosis

Published online by Cambridge University Press:  24 June 2014

Karen T Hallam*
Mania Research Group, ORYGEN Youth Health Department of Psychiatry, The University of Melbourne, Parkville, Australia
Michael Berk
Mania Research Group, ORYGEN Youth Health Department of Clinical and Biomedical Sciences, Barwon Health
Linda F. Kader
Mania Research Group, ORYGEN Youth Health
Phillipe Conus
Mania Research Group, ORYGEN Youth Health Department of Psychiatry, University of Lausanne, Lausanne, Switzerland
Nellie C. Lucas
Mania Research Group, ORYGEN Youth Health Department of Psychiatry, The University of Melbourne, Parkville, Australia
Melissa Hasty
Mania Research Group, ORYGEN Youth Health
Craig M. Macneil
Mania Research Group, ORYGEN Youth Health
Patrick D. McGorry
Mania Research Group, ORYGEN Youth Health
Karen T. Hallam, Mania Research Group, ORYGEN Youth Health, and Department of Psychiatry, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052, Australia. Tel: +03 9342-2939; Fax: +03 9387 3003; E-mail:



Since bipolar affective disorder has been recorded, clinicians treating patients with this disorder have noted the cyclic nature of episodes, particularly an increase in mania in the spring and summer months and depression during winter.


The aim of this study was to investigate seasonality in symptom onset and service admissions over a period of 10 years in a group of patients (n= 359) with first-episode (FE) mania (n= 133), FE schizoaffective disorder (n= 49) and FE schizophrenia (n= 177).


Patients were recruited if they were between 15 and 28 years of age and if they resided in the geographical mental health service catchment area. The number of patients experiencing symptom onset and service admission over each month and season was recorded.


In terms of seasonality of time of service admission, the results indicate a high overall seasonality (particularly in men), which was observed in both the schizoaffective and the bipolar groups. In terms of seasonality of symptom onset, the results indicate that seasonality remains in the male bipolar group, but other groups have no seasonal trend.


This provides further evidence that systems mediating the entrainment of biological rhythms to the environment may be more pronounced in BPAD than in schizoaffective disorder and schizophrenia. These results may help facilitate the preparedness of mental heath services for patients at different times of the year.

Research Article
Copyright © 2006 Blackwell Munksgaard

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