Abstract
BackgroundSeasonal affective disorder (SAD) is a seasonally recurrent type of major depression. This predictable aspect makes it promising for preventive treatment. However, evidence for the efficacy and harm of preventive treatment of SAD is scarce, as are recommendations from clinical practice guidelines. The aim of this study was to assess the current use of preventive treatment of SAD in clinical practice in German-speaking countries for the first time.MethodsWe conducted a postal and web-based survey sent to the heads of all psychiatric institutions listed in the inventory “Deutsches Krankenhaus Adressbuch, 2015” that contains all psychiatric hospitals in Germany, Austria, and Switzerland.ResultsOne hundred institutions (out of 533 institutions, 19%), which treated in total more than 3100 SAD patients in the years 2014/2015, responded. Of those, 81 reported recommending preventive treatment to patients with a history of SAD. There was no consensus on the optimal starting point for preventive treatment. Most of the institutions that implemented prevention of SAD, recommended lifestyle changes (85%), antidepressants (84%), psychotherapy (73%), and light therapy (72%) to their patients. The situation was similar in northern and southern regions.ConclusionsMost hospitals recommended the use of preventive treatment to SAD patients, although evidence on efficacy and harm is limited. A wide variety of interventions were recommended, although guidelines only include recommendations for acute treatment. To assist psychiatrists and patients in future decision making, controlled studies on preventive treatment for SAD that compare different interventions with one another are needed.
Highlights
Seasonal affective disorder (SAD) is a seasonally recurrent type of major depression
18 were from Austria, 71 from Germany, and 11 from Switzerland. This is reflective of a 19% (100/533) response-rate. These questionnaires summed up experience in 3.119 SAD patients over a two-year period (2014/2015)
Proportion of hospitals recommending preventive treatment and timing The majority (84%) of the 96 psychiatric hospitals and departments that answered this question recommend the use of preventive interventions in order to reduce the risk of the onset of a new depressive episode in the upcoming fall/winter season in patients with a history of SAD
Summary
Seasonal affective disorder (SAD) is a seasonally recurrent type of major depression. This predictable aspect makes it promising for preventive treatment. Seasonal affective disorder (SAD), winter-type, is a subtype of major depression, characterized by a recurrent pattern in which depressive episodes start in fall/winter and remit in spring [1, 2]. It affects 2–8% of the total population in Europe, depending on latitude [3,4,5,6,7]. Treatment options other than light therapy and antidepressants include agomelatine [16], melatonin [17], psychological interventions [18,19,20,21], as well as lifestyle and diet changes [22]
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