To examine estimates of lifetime prevalence of seasonal affective disorder (SAD) in Toronto, Ontario.
Method
Random telephone numbers were generated for the city of Toronto, and 781 respondents completed a telephone interview. Trained nonphysician interviewers conducted all interviews, which involved structured questions for diagnosing major depression. Patterns of symptom change across seasons were evaluated to establish a diagnosis of SAD according to DSM-III-R criteria.
Results
Correcting for sex and age, the prevalence of SAD defined by DSM-III-R criteria was 2.9% (95%CI, 1.7% to 4.0%), and the overall lifetime prevalence of major depression in the sample was 26.4% (95%CI, 23.3% to 29.4%). Some subjects were contacted for a follow-up interview conducted in person; the positive predictive value for the diagnosis of major depression for the telephone interview was 100%, and the negative predictive value was 93%.
Conclusions
The seasonal subtype of depression represents 11% of all subjects with major depression, suggesting that SAD is a significant public health concern. The telephone interview demonstrated adequate reliability, indicating that it is appropriate for epidemiological surveys of this nature.
Rosenthal NE, Sack DA, Gillin JC, Lewy AJ, Goodwin FK, Davenport Y, and others Seasonal affective disorder. A description of the syndrome and preliminary findings with light therapy. Arch Gen Psychiatry1984;41:72–80.
2.
BlazerDGKesslerRCSwartzMS. Epidemiology of recurrent major and minor depression with a seasonal pattern. The National Comorbidity Survey. Br J Psychiatry1998;172:164–7.
3.
BookerJMHelleksonCJ. Prevalence of seasonal affective disorder in Alaska. Am J Psychiatry1992;149:1176–82.
4.
DamHJakobsenKMellerupE. Prevalence of winter depression in Denmark. Acta Psychiatrica Scandinavica1998;97:1–4.
5.
EaglesJMMercerGBoshierAJJamiesonF. Seasonal affective disorder among psychiatric nurses in Aberdeen. J Affect Disord1996;37:129–35.
6.
HegdeALWoodsonH. Prevalence of seasonal changes in mood and behavior during the winter months in central Texas. Psychiatry Res1996;62:265–71.
7.
ItoAIchiharaMHisanagaNOnoYKayukawaY, Ohta T, and others. Prevalence of seasonal mood changes in a low latitude: Seasonal Pattern Assessment Questionnaire score of Quezon City workers. Japanese Journal of Psychiatry & Neurology1992;46(1):249.
8.
KasperSWehrTABartkoJJGaistPARosenthalNE. Epidemiological findings of seasonal changes in mood and behavior. A telephone survey of Montgomery County, Maryland. Arch Gen Psychiatry1989;46:823–33.
9.
LingjaerdeOReichbom-KjennerudT. Characteristics of winter depression in the Oslo area (60 degrees N). Acta Psychiatr Scand1993;88:111–20.
10.
MagnussonAAxelssonJ. The prevalence of seasonal affective disorder is low among descendants of Icelandic emigrants in Canada. Arch Gen Psychiatry1993;50:947–51.
11.
MerschPPAMiddendorpHBouhysALBeersmaDGMVan Den HoofdakkerRH. The prevalence of seasonal affective disorder (SAD) in The Netherlands. Acta Neuropsychiatrica1995;7:47–9.
12.
OzakiNOnoYItoARosenthalNE. Prevalence of seasonal difficulties in mood and behavior among Japanese civil servants. Am J Psychiatry1995;152:1225–7.
13.
PalinkasLAHousealMRosenthalNE. Subsyndromal seasonal affective disorder in Antarctica. J Nerv Ment Dis1996;184:530–4.
14.
PartonenTPartinenMLonnqvistJ. Frequencies of seasonal major depressive symptoms at high latitudes. Eur Arch Psychiatry Clin Neurosci1993;243:189–92.
15.
RosenLNTargumSDTermanMBryantMJHoffmanH, Kasper SF, and others. Prevalence of seasonal affective disorder at four latitudes. Psychiatry Res1990;31:131–44.
16.
SakamotoKKamoTNakadairaSTamuraATakahashiK. A nationwide survey of seasonal affective disorder at 53 outpatient university clinics in Japan. Acta Psychiatr Scand1993;87:258–65.
17.
SchlagerDFroomJJaffeA. Winter depression and functional impairment among ambulatory primary care patients. Compr Psychiatry1995;36:18–24.
18.
SrivastavaSSharmaM. Seasonal affective disorder: Report from India (latitude 26 degrees 45′N). J Affect Disord1998;49:145–50.
19.
WickiWAngstJMerikangasKR. The Zurich Study. XIV. Epidemiology of seasonal depression. Eur Arch Psychiatry Clin Neurosci1992;241:301–6.
20.
WilliamsRJSchmidtGG. Frequency of seasonal affective disorder among individuals seeking treatment at a northern Canadian mental health center. Psychiatry Res1993;46:41–5.
21.
RahejaSKKingEAThompsonC. The Seasonal Pattern Assessment Questionnaire for identifying seasonal affective disorders. J Affect Disord1996;41:193–9.
22.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. Revised. 3rd ed.Washington (DC): American Psychiatric Association; 1987.
23.
PattenSB. Performance of the Composite International Diagnostic Interview Short Form for major depression in community and clinical samples. Chronic Diseases in Canada1997;18(3):109–12.
24.
KesslerRCNelsonCBMcGonagleKALiuJSwartzMBlazerDG. Comorbidity of DSM-III-R major depressive disorder in the general population: Results from the US National Comorbidity Survey. Br J Psychiatry Suppl1996;(30):17–30.
25.
BoyleMHOffordDRCampbellDCatlinGGoeringP, Lin E, and others. Mental health supplement to the Ontario Health Survey: Methodology. Can J Psychiatry1996;41:549–58.
26.
LevyPSLemeshowS. Sampling of populations: Methods and applications. New York: John Wiley & Sons; 1991. p 136–40.
27.
EndicottJSpitzerRL. A diagnostic interview: The schedule for affective disorders and schizophrenia. Arch Gen Psychiatry1978;35:837–44.
28.
FournierLLesageADToupinJCyrM. Telephone surveys as an alternative for estimating prevalence of mental disorders and service utilization: A Montreal catchment area study. Can J Psychiatry1997;42:737–43.
29.
OffordDRBoyleMHCampbellDGoeringPLinE, Wong M, and others. One-year prevalence of psychiatric disorder in Ontarians 15 to 64 years of age. Can J Psychiatry1996;41:559–63.
30.
EaglesJMNajiSAGrayDAChristieJBeattieJA. Seasonal affective disorder among primary care consulters in January: Prevalence and month by month consultation patterns. J Affect Disord1998;49:1–8.
31.
MagnussonAStefanssonJG. Prevalence of seasonal affective disorder in Iceland. Arch Gen Psychiatry1993;50:941–6.
32.
RohdePLewinsohnPMSeeleyJR. Comparability of telephone and face-to-face interviews in assessing axis I and II disorders. Am J Psychiatry1997;154:1593–8.
33.
AndrewsGPetersL. The psychometric properties of the Composite International Diagnostic Interview. Soc Psychiatry Psychiatr Epidemiol1998;33:80–8.
