The actuality of seasonal variation in mood has been documented thoroughly by both retrospective and prospective studies. In the general population, depressive symptoms peak in winter, and the most extreme form of this disposition, SAD, appears to be a relatively common disorder.
These results indicate that a rapid lowering of tryptophan increases impulsiveness and decreases discriminating ability in normal individuals. The effect of 5-HT depletion on discriminating ability in this study was similar to that previously reported in depressed patients.
An unexpectedly high level of unrecognized depressive symptoms was found in the general rural population of Bangladesh. These are among the first data to suggest that depressive symptoms in this culture are common, especially in women. Depression is particularly common in those with diabetes. Psychiatric intervention may be necessary in addition to lifestyle changes to prevent the exponential increase in the occurrence of Type 2 diabetes. In addition, a common approach including psychiatric treatment in diabetes care may be necessary to achieve improved glycaemic control in this population.
The operational criteria for seasonal affective disorder (SAD) have undergone several changes since first proposed in 1984. SAD is currently included as a specifier of either bipolar or recurrent major depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The International Classification of Diseases, Tenth Edition has provisional diagnostic criteria for SAD. The most characteristic quality of SAD is that the symptoms usually present during winter and remit in the spring. Furthermore, the symptoms tend to remit when the patients are exposed to daylight or bright light therapy. The cognitive and emotional symptoms are as in other types of depression but the vegetative symptoms are the reverse of classic depressive vegetative symptoms, namely increased sleep and increased appetite. SAD is a common condition, but the exact prevalence rates vary between different studies and countries and is consistently found to be more common in women and in youth. SAD probably possibly occurs in children although not as commonly as in young adults. Some studies have found that certain ethnic groups who live at high northern latitudes may have adapted to the long arctic winter.
The aim of the present study was to examine the relationship between reported environmental tobacco smoke (ETS) exposure and respiratory symptoms.In 1996, a postal questionnaire was randomly distributed in three areas of Estonia to a population-based sample, of which 4,995 females and 1,822 males had never smoked. The main outcome measures were current respiratory symptoms and the amount of reported ETS exposure outside the home.ETS exposure at home was more common in females (31% versus 19%), while exposure outside of the home was more common in males (53% versus 7%). Females reported more symptoms from tobacco smoke than males (37.7% versus 21.6%). If ETS exposure outside of the home exceeded 5 h daily, the risk for wheeze (odds ratio (OR) 2.67, 95% confidence interval (CI) 1.98-3.61) and physician-diagnosed asthma (OR 1.79, 1.02-3.16) were increased. ETS exposure outside of the home was shown to be strongly related to almost all respiratory symptoms in a dose/response manner. ETS exposure at home did not show significantly elevated ORs for any respiratory symptoms.This study shows that females seem to be more troubled by environmental smoke exposure than males and provides further evidence of the serious health hazards associated with environmental smoke exposure. Indeed, the findings of this study support a ban on smoking in the workplace and public areas. Eur Respir J 2003; 21: 672-676.
Seasonal affective disorder and S-SAD are more common in younger individuals and among women. The weight gained by patients during the winter does not seem to result in chronic obesity. The prevalence of SAD and S-SAD was lower in Iceland than on the East Coast of the United States, in spite of Iceland's more northern latitude. These results are unexpected since the prevalence of these disorders has been found to increase in more northern latitudes. The Icelandic population has remained remarkably isolated during the past 1000 years. It is conceivable that persons with a predisposition to SAD have been at a disadvantage and that there may have been a population selection toward increased tolerance of winter darkness.
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