Seasonal influences on first-episode admission in affective and non-affective psychosis

Abstract

Background: Since bipolar affective disorder has been recorded, clinicians treating patients with this disorder have noted the cyclic nature of episodes, particularly an increase in mania in the spring and summer months and depression during winter. Objective: The aim of this study was to investigate seasonality in symptom onset and service admissions over a period of 10 years in a group of patients (n ¼ 359) with first-episode (FE) mania (n ¼ 133), FE schizoaffective disorder (n ¼ 49) and FE schizophrenia (n ¼ 177). Method: Patients were recruited if they were between 15 and 28 years of age and if they resided in the geographical mental health service catchment area. The number of patients experiencing symptom onset and service admission over each month and season was recorded. Results: In terms of seasonality of time of service admission, the results indicate a high overall seasonality (particularly in men), which was observed in both the schizoaffective and the bipolar groups. In terms of seasonality of symptom onset, the results indicate that seasonality remains in the male bipolar group, but other groups have no seasonal trend. Conclusions: This provides further evidence that systems mediating the entrainment of biological rhythms to the environment may be more pronounced in BPAD than in schizoaffective disorder and schizophrenia. These results may help facilitate the preparedness of mental heath services for patients at different times of the year.

Psychiatric hospitalizations for affective disorders in Warsaw, Poland: Effect of season and intensity of sunlight

“…However, the results point to a peak of such admissions during the summer months (Whitney et al, 1999;Cassidy and Carroll, 2002), as well as in early spring (Lee et al, 2007). Also, different patterns of seasonality of admissions depending on the sex of bipolar patients have been reported (Kerr-Correa et al, 1998;Hallam et al, 2006). For example, Kerr-Correa et al, (1998) found in their study that the seasons influenced only manic episodes and only among women and mostly in the spring and summer.…”

“…For example, Kerr-Correa et al, (1998) found in their study that the seasons influenced only manic episodes and only among women and mostly in the spring and summer. On the other hand, Hallam et al (2006) pointed out that seasonal changes can flare up affective disorders (mainly bipolar disorder), especially among male patients. One can also find studies where no link has been found between the seasons and the frequency of admission of affective disorder patients to hospitals (Daniels et al, 2000).…”

“…However, the methodology in these studies varies so much that it is often hard to quantify the published reports. In the measurement of frequency of affective episodes, various factors have been taken into account, such as the number of antidepressant prescriptions (Skegg et al, 1986), the number of people who visit outpatient clinics complaining about specific symptoms (Posternak and Zimmerman, 2002), phone survey results (Shin et al, 2005), the number of first-time hospital admissions resulting from affective disorders (Hallam et al, 2006) and finally-the total number of hospital admissions caused by affective disorders (Suhail and Cochrane, 1998). Additionally, authors have considered different variables such as patients' sex (Suhail and Cochrane, 1997), smoking habits (D'Mello and Flanagan, 1996) or polarity of affective disorders (Shin et al, 2005) which could have modified the results.…”

Do symptoms of bipolar disorder exhibit seasonal variation? A multisite prospective investigation

“…The long‐standing hypothesis that symptoms of bipolar disorder (BD) vary systematically with the seasons has significant implications. Evidence for seasonal variation would support a role for light and biological rhythms in BD (1) and predictable seasonality could facilitate relapse prevention and service planning (2). However, existing research is equivocal about seasonality in BD, and the overarching aim of this study was to move towards a more definitive conclusion.…”

Effects of Weather and Season on Human Brain Volume

“…A similar relationship exists between MS relapse rates and latitude, with rates increasing further from the equator [4]. An association has been observed between season and first-break schizophrenia and psychosis, with a stronger effect in males [5,6]. Seasonal rhythms in gene expression have been found to be interrupted by Alzheimer's disease [7].…”