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Seasonal Affective Disorder

Christopher White, MD, JD, MHA Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Seasonal affective disorder (SAD) is a heterogeneous mood disorder with depressive episodes usually occurring in winter months, with full remissions in the spring and summer.

  • Ranges f...

DIAGNOSIS

  • Carefully document the presence or absence of prior manic episodes.

  • Screen for the existence of any suicidal ideation and safety risk factors.

  • Remission of symptoms during spring and summer

  • Sym...

TREATMENT

MEDICATION

Lack of evidence to determine whether light therapy or medication should be the first-line agent. Both supported by the literature and in some studies have equal efficacy. Medicati...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Regular monitoring by PCP or psychiatrist for response to treatment; patients may become manic when treated with SSRIs or light therapy. 

Patient Monitoring

Patient...

REFERENCES

1
Lam RW, Levitt AJ, Levitan RD, et al. The Can-SAD study: a randomized controlled trial of the effectiveness of light therapy and fluoxetine in patients with winter seasonal affective disor...

ADDITIONAL READING

  • Mårtensson B, Petterson A, Berglund L, et al. Bright white light therapy in depression: a critical review of the evidence. J Affective Disorders.  2015;182:1–7. [View Abstract...

SEE ALSO

  • Bipolar I Disorder; Bipolar II Disorder; Depression

  • Algorithm: Depressive Episode, Major

CODES

ICD10

  • F33.9 Major depressive disorder, recurrent, unspecified

  • F33.0 Major depressive disorder, recurrent, mild

  • F33.1 Major depressive disorder, recurrent, moderate

  • F33.2 Major depressv disorder, rec...

CLINICAL PEARLS

  • SAD is a subtype of major depressive disorder. Once the patient has a diagnosed mood disorder, such as depression or bipolar, ask whether the symptoms vary in a seasonal pattern to qua...

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