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계절성 정동장애: 정신생리학적 측면을 중심으로

Seasonal Affective Disorder: Focusing on Psychophysiological Aspects

  • 김선혜 (한양대학교 의과대학 한양대학교병원 정신의학교실) ;
  • 이건석 (한양대학교 의과대학 한양대학교병원 정신의학교실)
  • Sunhae Kim (Department of Psychiatry, College of Medicine, Hanyang University) ;
  • Kounseok Lee (Department of Psychiatry, College of Medicine, Hanyang University)
  • 투고 : 2023.06.01
  • 심사 : 2023.06.29
  • 발행 : 2023.06.30

초록

The Seasonal Affective Disorder (SAD) is a disorder characterized by prolonged periods of depression and various physical and psychological symptoms experienced during specific seasons, typically winter. In this review aims to provide a comprehensive overview of SAD with a specific focus on psychophysiological aspects. Through the review from ancient times to the present, this paper explores the characteristics, causes, and underlying mechanisms of SAD. Particularly, it comprehensively reviews the research findings on the relationship between external factors such as light, sunlight, climate, and their association with SAD. Furthermore, the paper discusses the interplay between SAD and psychophysiological changes, along with the latest research trends in treatment and prevention strategies. By combining theoretical and practical perspectives on SAD, this article aims to provide a holistic understanding and offer suggestions for future research directions and clinical interventions.

키워드

과제정보

이 연구는 산업통상자원부의 재원으로 한국산업기술진흥원(P0018663) 및 산업기술평가관리원(20012931)의 연구비를 지원 받아 수행된 연구임.

참고문헌

  1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5, 2014 American psychiatric association Washington, D.C.
  2. Anderson JL, Glod CA, Dai J, Cao Y, Lockley SW. Lux vs. wavelength in light treatment of Seasonal Affective Disorder. Acta Psychiatrica Scandinavica 2009;120:203-212. https://doi.org/10.1111/j.1600-0447.2009.01345.x
  3. Anderson JL, St Hilaire MA, Auger RR, Glod CA, Crow SJ, Rivera AN, et al. Are short (blue) wavelengths necessary for light treatment of seasonal affective disorder? Chronobiology International 2016;33:1267-1279. https://doi.org/10.1080/07420528.2016.1207660
  4. Asghari V, Sanyal S, Buchwaldt S, Paterson A, Jovanovic V, Van Tol HH. Modulation of intracellular cyclic AMP levels by different human dopamine D4 receptor variants. Journal of Neurochemistry 1995;65:1157-1165. https://doi.org/10.1046/j.1471-4159.1995.65031157.x
  5. Avery D, Bolte M, Millet M. Bright dawn simulation compared with bright morning light in the treatment of winter depression. Acta Psychiatrica Scandinavica 1992;85:430-434. https://doi.org/10.1111/j.1600-0447.1992.tb03206.x
  6. Avery DH, Dahl K, Savage MV, Brengelmann GL, Larsen LH, Kenny MA, et al. Circadian temperature and cortisol rhythms during a constant routine are phase-delayed in hypersomnic winter depression. Biological Psychiatry 1997;41:1109-1123. https://doi.org/10.1016/S0006-3223(96)00210-7
  7. Blazer DG, Kessler RC, Swartz MS. Epidemiology of recurrent major and minor depression with a seasonal pattern: the national comorbidity survey. The British Journal of Psychiatry 1998;172:164-167. https://doi.org/10.1192/bjp.172.2.164
  8. Boivin D. Circadian clock. Seasonal Affective Disorder, Practice and Research, T Partonen, A Magnusson Oxford University Press, Oxford 2001:247-258.
  9. Brewerton TD. Seasonal variation of serotonin function in humans research and clinical implications. Annals of Clinical Psychiatry 1989;1:153-164. https://doi.org/10.3109/10401238909149974
  10. Carlsson A, Svennerholm L, Winblad B. Seasonal and circadian monoamine variations in human brains examined post mortem. Acta Psychiatrica Scandinavica 1980;61:75-85. https://doi.org/10.1111/acps.1980.61.s280.75
  11. Charry JM. Biological effects of air ions; a comprehensive review of laboratory and clinical data. Air Ions 2018:101-160.
  12. Cheung A, Dewa C, Michalak EE, Browne G, Levitt A, Levitan RD, et al. Direct health care costs of treating seasonal affective disorder: a comparison of light therapy and fluoxetine. Depression Research and Treatment 2012:1-5.
  13. Choi J, Baek JH, Kim, JS, Choi JS, Noh J, Nam HJ, et al. Seasonal changes in mood and behavior and associated factors of seasonality in Korean bipolar disorder patients and normal controls. Journal of the Korean Society of Biological Psychiatry 2010;17:153-160.
  14. Clinic M. "Seasonal affective disorder," [Fact sheet], Rochester, Minn, USA, Mayo Clinic.
  15. Dahl K, Avery D, Savage M, Brengelmann G, Kenny M, Lewy A, et al. Temperature, melatonin and TSH in seasonal affective disorder during a constant routine. In Soc Light Treat Biol Rhythms Abstr 1990;20:20.
  16. Dahl K, Avery DH, Lewy AJ, Savage MV, Brengelmann GL, Larsen LH, et al. Dim light melatonin onset and circadian temperature during a constant routine in hypersomnic winter depression. Acta Psychiatrica Scandinavica 1993;88:60-66. https://doi.org/10.1111/j.1600-0447.1993.tb03414.x
  17. Danilenko KV, Ivanova IA. Dawn simulation vs. bright light in seasonal affective disorder: treatment effects and subjective preference. Journal of Affective Disorders 2015;180:87-89. https://doi.org/10.1016/j.jad.2015.03.055
  18. Desan PH, Weinstein AJ, Michalak EE, Tam EM, Meesters Y, Ruiter MJ, et al. A controlled trial of the Litebook light-emitting diode (LED) light therapy device for treatment of Seasonal Affective Disorder (SAD). Bmc Psychiatry 2007;7:1-8. https://doi.org/10.1186/1471-244X-7-38
  19. Dilsaver S, Qamar A, Del Medico V. The efficacy of bupropion in winter depression: results of an open trial. The Journal of Clinical Psychiatry 1992;53:252-255.
  20. Dowdall M, de Montigny C. Effect of atmospheric ions on hippocampal pyramidal neuron responsiveness to serotonin. Brain Research 1985;342:103-109. https://doi.org/10.1016/0006-8993(85)91357-5
  21. Eagles JM. Light therapy and seasonal affective disorder. Psychiatry 2009;8:125-129. https://doi.org/10.1016/j.mppsy.2009.01.005
  22. Gimenez MC, Hessels M, van de Werken M, de Vries B, Beersma DG, et al. Effects of artificial dawn on subjective ratings of sleep inertia and dim light melatonin onset. Chronobiology International 2010;27:1219-1241. https://doi.org/10.3109/07420528.2010.496912
  23. Glickman G, Byrne B, Pineda C, Hauck WW, Brainard GC. Light therapy for seasonal affective disorder with blue narrow-band light-emitting diodes (LEDs). Biological Psychiatry 2006;59:502-507. https://doi.org/10.1016/j.biopsych.2005.07.006
  24. Griesinger W. Mental pathology and therapeutics, 1882 W. Wood & Company.
  25. Hare E, Walter S. Seasonal variation in admissions of psychiatric patients and its relation to seasonal variation in their births. Journal of Epidemiology & Community Health 1978;32:47-52. https://doi.org/10.1136/jech.32.1.47
  26. Hebert M, Beattie CW, Tam EM, Yatham LN, Lam RW. Electroretinography in patients with winter seasonal affective disorder. Psychiatry Research 2004;127:27-34. https://doi.org/10.1016/j.psychres.2004.03.006
  27. Hebert M, Dumont M, Lachapelle P. Electrophysiological evidence suggesting a seasonal modulation of retinal sensitivity in subsyndromal winter depression. Journal of Affective Disorders 2002;68:191-202. https://doi.org/10.1016/S0165-0327(00)00192-0
  28. Joseph-Vanderpool JR, Jacobsen FM, Murphy DL, Hill JL, Rosenthal NE. Seasonal variation in behavioral responses to m-CPP in patients with seasonal affective disorder and controls. Biological Psychiatry 1993;33:496-504. https://doi.org/10.1016/0006-3223(93)90003-V
  29. 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. Archives of General Psychiatry 1989.
  30. Labbate LA, Lafer B, Thibault A, Rosenbaum JF, Sachs GS. Influence of phototherapy treatment duration for seasonal affective disorder: outcome at one vs. two weeks. Biological Psychiatry 1995;38:747-750. https://doi.org/10.1016/0006-3223(95)00069-0
  31. Lacoste V. Seasonal variation in normal subjects: an update of variables current in depression research. Seasonal Affective Disorders and Phototherapy 1989:167-229.
  32. Lam RW, Bowering T, Tam E, Grewal A, Yatham L, Shiah I, et al. Effects of rapid tryptophan depletion in patients with seasonal affective disorder in natural summer remission. Psychological Medicine 2000;30:79-87. https://doi.org/10.1017/S003329179900152X
  33. Lam RW, Gorman CP, Michalon M, Steiner M, Levitt AJ, Corral MR, et al. Multicenter, placebo-controlled study of fluoxetine in seasonal affective disorder. The American Journal of Psychiatry 1995;152:1765-1770. https://doi.org/10.1176/ajp.152.12.1765
  34. Lam RW, Tam EM. A clinician's guide to using light therapy, 2009 Cambridge university press New York, NY.
  35. Lam RW, Zis AP, Grewal A, Delgado PL, Charney DS, Krystal JH. Effects of rapid tryptophan depletion in patients with seasonal affective disorder in remission after light therapy. Archives of General Psychiatry 1996;53:41-44. https://doi.org/10.1001/archpsyc.1996.01830010043007
  36. Leppamaki S, Meesters Y, Haukka J, Lonnqvist J, Partonen T. Effect of simulated dawn on quality of sleep-a community-based trial. BMC Psychiatry 2003;3:1-5. https://doi.org/10.1186/1471-244X-3-14
  37. Levitan RD, Kaplan AS, Brown GM, Vaccarino FJ, Kennedy SH, Levitt AJ, et al. Hormonal and subjective responses to intravenous m-chlorophenylpiperazine in women with seasonal affective disorder. Archives of General Psychiatry 1998;55:244-249. https://doi.org/10.1001/archpsyc.55.3.244
  38. Levitan RD, Kaplan AS, Levitt AJ, Joffe RT. Seasonal fluctuations in mood and eating behavior in bulimia nervosa. International Journal of Eating Disorders 1994;16:295-299. https://doi.org/10.1002/1098-108X(199411)16:3<295::AID-EAT2260160311>3.0.CO;2-7
  39. Levitan RD, Masellis M, Lam RW, Muglia P, Basile VS, Jain U, et al. Childhood inattention and dysphoria and adult obesity associated with the dopamine D4 receptor gene in overeating women with seasonal affective disorder. Neuropsychopharmacology 2004;29:179-186. https://doi.org/10.1038/sj.npp.1300314
  40. Levitt A, Levitan R. Length of light treatment trial: does it influence outcome. Chronobiol Int 2003;20:1213-1214.
  41. Lewy AJ, Emens JS, Songer JB, Sims N, Laurie AL, Fiala SC, et al. Winter depression: integrating mood, circadian rhythms, and the sleep/wake and light/dark cycles into a bio-psycho-social-environmental model. Sleep Medicine Clinics 2009;4:285-299. https://doi.org/10.1016/j.jsmc.2009.02.003
  42. Lewy AJ, Kern HA, Rosenthal NE, Wehr TA. Bright artificial light treatment of a manic-depressive patient with a seasonal mood cycle. The American Journal of Psychiatry 1982;139:1496-1498. https://doi.org/10.1176/ajp.139.11.1496
  43. Lewy AJ, Sack RL, Miller LS, Hoban TM. Antidepressant and circadian phase-shifting effects of light. Science 1987;235:352-354. https://doi.org/10.1126/science.3798117
  44. Lewy AJ, Sack RL, Singer CM. Immediate and delayed effects of bright light on human melatonin production: Shifting "Dawn" and "Dusk" Shifts the Dim Light Melatonin Onset (DLMO) a. Annals of the New York Academy of Sciences 1985;453:253-259. https://doi.org/10.1111/j.1749-6632.1985.tb11815.x
  45. Lingjaerde O, Foreland A, Dankertsen J. Dawn simulation vs. lightbox treatment in winter depression: a comparative study. Acta Psychiatrica Scandinavica 1998;98:73-80. https://doi.org/10.1111/j.1600-0447.1998.tb10045.x
  46. Lurie SJ, Rosseau S, Pierce D, Gawinski B. Seasonal affective disorder. American Family Physician 2006;74:1521-1524.
  47. Magnusson A, Axelsson J. The Prevalence of Seasonal Affective Disorder Is Low Among Descendants of Icelandic Emigrants in Canada: Andres Magnusson, MD, Johann Axelsson, DPhil. Archives of General Psychiatry 1993;50:947-951. https://doi.org/10.1001/archpsyc.1993.01820240031004
  48. Meador-Woodruff JH, Damask SP, Wang J, Haroutunian V, Davis KL, Watson SJ. Dopamine receptor mRNA expression in human striatum and neocortex. Neuropsychopharmacology 1996;15:17-29. https://doi.org/10.1016/0893-133X(95)00150-C
  49. Meesters Y, Dekker V, Schlangen LJ, Bos EH, Ruiter MJ. Low-intensity blue-enriched white light (750 lux) and standard bright light (10000 lux) are equally effective in treating SAD. A randomized controlled study. BMC Psychiatry 2011;11:1-8. https://doi.org/10.1186/1471-244X-11-1
  50. Meesters Y, Lambers P. Light therapy in patient with seasonal fatigue. The Lancet 1990;336:745.
  51. Meesters Y, Letsch M. The dark side of light treatment for seasonal affective disorder. International Journal of Risk & Safety in Medicine 1998;11:115-120.
  52. Mersch PPA, Middendorp HM, Bouhuys AL, Beersma DG, van den Hoofdakker RH. Seasonal affective disorder and latitude: a review of the literature. Journal of Affective Disorders 1999;53:35-48. https://doi.org/10.1016/S0165-0327(98)00097-4
  53. Mersch PPA, Vastenburg NC, Meesters Y, Bouhuys AL, Beersma DG, van den Hoofdakker RH, et al. The reliability and validity of the Seasonal Pattern Assessment Questionnaire: a comparison between patient groups. Journal of Affective Disorders 2004;80:209-219. https://doi.org/10.1016/S0165-0327(03)00114-9
  54. Miller AL. Epidemiology, etiology, and natural treatment of seasonal affective disorder. Alternative Medicine Review 2005;10:5-13.
  55. Modell JG, Rosenthal NE, Harriett AE, Krishen A, Asgharian A, Foster VJ, et al. Seasonal affective disorder and its prevention by anticipatory treatment with bupropion XL. Biological Psychiatry 2005;58:658-667. https://doi.org/10.1016/j.biopsych.2005.07.021
  56. Moscovici L, Kotler M. A multistage chronobiologic intervention for the treatment of depression: a pilot study. Journal of Affective Disorders 2009;116:201-207. https://doi.org/10.1016/j.jad.2009.01.015
  57. Myers D, Davies P. The seasonal incidence of mania and its relationship to climatic variables. Psychological Medicine 1978;8:433-440. https://doi.org/10.1017/S003329170001610X
  58. Neumeister A, Konstantinidis A, Praschak-Rieder N, Willeit M, Hilger E, Stastny J, et al. Monoaminergic function in the pathogenesis of seasonal affective disorder. International Journal of Neuropsychopharmacology 2001;4:409-420. https://doi.org/10.1017/S1461145701002644
  59. Neumeister A, Praschak-Rieder N, Heβelmann B, Rao ML, Gluck J, Kasper S. Effects of tryptophan depletion on drug-free patients with seasonal affective disorder during a stable response to bright light therapy. Archives of General Psychiatry 1997;54:133-138. https://doi.org/10.1001/archpsyc.1997.01830140043008
  60. Neumeister A, Turner EH, Matthews JR, Postolache TT, Barnett RL, Rauh M, et al. Effects of tryptophan depletion vs catecholamine depletion in patients with seasonal affective disorder in remission with light therapy. Archives of General Psychiatry 1998;55:524-530. https://doi.org/10.1001/archpsyc.55.6.524
  61. Neumeister A, Willeit M, Praschak-Rieder N, Asenbaum S, Stastny J, Hilger E, et al. Dopamine transporter availability in symptomatic depressed patients with seasonal affective disorder and healthy controls. Psychological Medicine 2001;31:1467-1473. https://doi.org/10.1017/S003329170105434z
  62. Niemegeers P, Dumont GJ, Patteet L, Neels H, Sabbe BG. Bupropion for the treatment of seasonal affective disorder. Expert Opinion on Drug Metabolism & Toxicology 2013;9:1229-1240. https://doi.org/10.1517/17425255.2013.804062
  63. Nir I, Harrison JM, Haque R, Low MJ, Grandy DK, Rubinstein M, et al. Dysfunctional light-evoked regulation of cAMP in photoreceptors and abnormal retinal adaptation in mice lacking dopamine D4 receptors. Journal of Neuroscience 2002;22:2063-2073. https://doi.org/10.1523/JNEUROSCI.22-06-02063.2002
  64. Overy C, Tansey E. The Recent History of Seasonal Affective Disorder (SAD), 2014.
  65. Partonen T, Lonnqvist J. Seasonal affective disorder. The Lancet 1998;352:1369-1374. https://doi.org/10.1016/S0140-6736(98)01015-0
  66. Partonen T, Pandi-Perumal S. Seasonal affective disorder: practice and research, 2010 Oxford University Press.
  67. Praschak-Rieder N, Willeit M, Neumeister A, Hilger E, Stastny J, Thierry N, et al. Prevalence of premenstrual dysphoric disorder in female patients with seasonal affective disorder. Journal of Affective Disorders 2001;63:239-242. https://doi.org/10.1016/S0165-0327(00)00176-2
  68. Rastad C, Ulfberg J, Lindberg P. Improvement in fatigue, sleepiness, and health-related quality of life with bright light treatment in persons with seasonal affective disorder and subsyndromal SAD. Depression Research and Treatment 2011;2011:543906.
  69. Reme C, Terman M, Wirz-Justice A. Are deficient retinal photoreceptor renewal mechanisms involved in the pathogenesis of winter depression? Archives of General Psychiatry 1990;47:878-879. https://doi.org/10.1001/archpsyc.1990.01810210086016
  70. Rice J, Mayor J, Tucker HA, Bielski RJ. Effect of light therapy on salivary melatonin in seasonal affective disorder. Psychiatry Research 1995;56:221-228. https://doi.org/10.1016/0165-1781(95)02610-9
  71. Rosen LN, Targum SD, Terman M, Bryant MJ, Hoffman H, Kasper SF, et al. Prevalence of seasonal affective disorder at four latitudes. Psychiatry Research 1990;31:131-144. https://doi.org/10.1016/0165-1781(90)90116-M
  72. Rosenthal NE. Seasonal pattern assessment questionnaire. Journal of Affective Disorders 1984.
  73. Rosenthal NE, Sack DA, Jacobsen FM, James SP, Parry BL, Arendt J, et al. Melatonin in seasonal affective disorder and phototherapy. J Neural Transm Suppl 1986;21:257-267.
  74. Rosenthal NE. Diagnosis and treatment of seasonal affective disorder. JAMA 1993;270:2717-2720. https://doi.org/10.1001/jama.1993.03510220073037
  75. Rosenthal NE, Sack DA, James SP, Parry BL, Mendelson WB, Tamarkin L, et al. Seasonal affective disorder and phototherapy. Annals of the New York Academy of Sciences 1985.
  76. Rosenthal NE, Wehr TA. Seasonal affective disorders. Psychiatric Annals 1987;17:670-674.
  77. Ruhrmann S, Kasper S, Hawellek B, Martinez B, Hoflich G, Nickelsen T, et al. Effects of fluoxetine versus bright light in the treatment of seasonal affective disorder. Psychological Medicine 1998;28:923-933. https://doi.org/10.1017/S0033291798006813
  78. Scarinci E, Tropea A, Notaristefano G, Arena V, Alesiani O, Fabozzi SM, et al. "Hormone of darkness" and human reproductive process: direct regulatory role of melatonin in human corpus luteum. Journal of Endocrinological Investigation 2019;42:1191-1197. https://doi.org/10.1007/s40618-019-01036-3
  79. Sonis W, Yellin A, Garfinkel B, Hoberman H. The antidepressant effect of light in seasonal affective disorder of childhood and adolescence. Psychopharmacology Bulletin 1987;23:360-363.
  80. Strong RE, Marchant BK, Reimherr FW, Williams E, Soni P, Mestas R. Narrow-band blue-light treatment of seasonal affective disorder in adults and the influence of additional nonseasonal symptoms. Depression and Anxiety 2009;26:273-278. https://doi.org/10.1002/da.20538
  81. Swedo SE, Allen AJ, Glod CA, Clark CH, Teicher MH, Richter D, et al. A controlled trial of light therapy for the treatment of pediatric seasonal affective disorder. Journal of the American Academy of Child & Adolescent Psychiatry 1997;36:816-821. https://doi.org/10.1097/00004583-199706000-00019
  82. Swedo SE, Pleeter JD, Richter DM, Hoffman CL, Allen A, Hamburger SD, et al, Rosenthal NE. Rates of seasonal affective disorder in children and adolescents. The American Journal of Psychiatry 1995;152:1016-1019. https://doi.org/10.1176/ajp.152.7.1016
  83. Symonds RL, Williams P. Seasonal variation in the incidence of mania. The British Journal of Psychiatry 1976;129:45-48. https://doi.org/10.1192/bjp.129.1.45
  84. Terman M, Schlager D, Fairhurst S, Perlman B. Dawn and dusk simulation as a therapeutic intervention. Biological Psychiatry 1989;25:966-970. https://doi.org/10.1016/0006-3223(89)90276-X
  85. Terman M, Terman JS. Treatment of seasonal affective disorder with a high-output negative ionizer. The Journal of Alternative and Complementary Medicine 1995;1:87-92. https://doi.org/10.1089/acm.1995.1.87
  86. Terman M, Terman JS. Light therapy for seasonal and nonseasonal depression: efficacy, protocol, safety, and side effects. CNS Spectrums 2005;10:647-663. https://doi.org/10.1017/S1092852900019611
  87. Terman M, Terman JS. Controlled trial of naturalistic dawn simulation and negative air ionization for seasonal affective disorder. American Journal of Psychiatry 2006;163:2126-2133. https://doi.org/10.1176/ajp.2006.163.12.2126
  88. Thalen BE, Kjellman B, Wetterberg L. Phototherapy and melatonin in relation to seasonal affective disorder and depression. Melatonin 2020. CRC Press.
  89. Thompson C, Cowan A. The Seasonal Health Questionnaire: a preliminary validation of a new instrument to screen for seasonal affective disorder. Journal of Affective Disorders 2001;64:89-98. https://doi.org/10.1016/S0165-0327(00)00208-1
  90. Virk G, Reeves G, Rosenthal NE, Sher L, Postolache TT. Short exposure to light treatment improves depression scores in patients with seasonal affective disorder: a brief report. International Journal on Disability and Human Development 2009;8:283-286. https://doi.org/10.1515/IJDHD.2009.8.3.283
  91. Walter S. Seasonality of mania: a reappraisal. The British Journal of Psychiatry 1977;131:345-350. https://doi.org/10.1192/bjp.131.4.345
  92. Wehr TA, Duncan WC, Sher L, Aeschbach D, Schwartz PJ, Turner EH, et al. A circadian signal of change of season in patients with seasonal affective disorder. Archives of General Psychiatry 2001;58:1108-1114. https://doi.org/10.1001/archpsyc.58.12.1108
  93. Wehr TA, Rosenthal NE. Seasonality and affective illness. The American Journal of Psychiatry 1989;14:829-839.
  94. White DM, Lewy AJ, Sack RL, Blood ML, Wesche DL. Is winter depression a bipolar disorder? Comprehensive Psychiatry 1990;31:196-204. https://doi.org/10.1016/0010-440X(90)90002-A
  95. Wirz-Justice A, Benedetti F, Terman M. Chronotherapeutics for Affective Disorders: A Clinician's Manual for Light and Wake Therapy, 2nd, 2013 Karger Medical and Scientific Publishers.