Seasonality in depressive and anxiety symptoms among primary care patients and in patients with depressive and anxiety disorders; results from the Netherlands Study of Depression and Anxiety

Abstract

BackgroundLittle is known about seasonality of specific depressive symptoms and anxiety symptoms in different patient populations. This study aims to assess seasonal variation of depressive and anxiety symptoms in a primary care population and across participants who were classified in diagnostic groups 1) healthy controls 2) patients with a major depressive disorder, 3) patients with any anxiety disorder and 4) patients with a major depression and any anxiety disorder.MethodsData were used from the Netherlands Study of Depression and Anxiety (NESDA). First, in 5549 patients from the NESDA primary care recruitment population the Kessler-10 screening questionnaire was used and data were analyzed across season in a multilevel linear model. Second, in 1090 subjects classified into four groups according to psychiatric status according to the Composite International Diagnostic Interview, overall depressive symptoms and atypical versus melancholic features were assessed with the Inventory of Depressive Symptoms. Anxiety and fear were assessed with the Beck Anxiety Inventory and the Fear questionnaire. Symptom levels across season were analyzed in a linear regression model.ResultsIn the primary care population the severity of depressive and anxiety symptoms did not show a seasonal pattern. In the diagnostic groups healthy controls and patients with any anxiety disorder, but not patients with a major depressive disorder, showed a small rise in depressive symptoms in winter. Atypical and melancholic symptoms were both elevated in winter. No seasonal pattern for anxiety symptoms was found. There was a small gender related seasonal effect for fear symptoms.ConclusionsSeasonal differences in severity or type of depressive and anxiety symptoms, as measured with a general screening instrument and symptom questionnaires, were absent or small in effect size in a primary care population and in patient populations with a major depressive disorder and anxiety disorders.

Data-driven discovery of seasonally linked diseases from an Electronic Health Records system

“…Recent reports have found seasonal changes in occurrence of anxiety and depression [6] and seasonality of key neurotransmitters involved in mood has been documented [21,22]. Our analysis showed a strong winter and early spring increase in obsessive-compulsive disorder (300.3), dysthymic disorder (300.4), shown in Figure 3A, and other depressive disorders (311).…”

“…These breakthrough findings have suggested that the thus far unidentified causative pathogen may be a windborne microbe. Other groups have sought to confirm anecdotal findings of seasonal or climate related changes in disease rates, including heart failure [5], depression and anxiety [6], varicose vein ulcers [7], urinary tract infection [8,9], and even cancer [10]. While some of these works searched for seasonality using purpose-driven surveys, Upshur [11] used coded administrative data derived from a large EHR system to investigate whether seasonal peaks in incidence were a common feature in a limited set of the most frequent diagnoses.…”

Seasonal and meteorological associations with depressive symptoms in older adults: A geo-epidemiological study

“…Thus irrespective of the definition there is evidence of seasonal variation in CES-D scores suggesting that those interviewed in the colder, darker months had greater levels of depressive symptoms. However, in common with the earlier report from the Netherlands Study of Depression and Anxiety group investigating seasonality in objective depressive symptoms (Winthorst et al, 2011), although we saw statistical trends towards seasonal variation using either definition the absolute effect on depressive symptoms is small ( o1 on the CES-D). In addition, we note that our collection period covers two winters and one of each of the other seasons -however similar numbers of participants were interviewed in winter months and summer months.…”

Seasonal affective disorder, winter type: current insights and treatment options

“…Unfortunately, this study does not assess SAD itself, but the higher and lower prevalence of complaints of depression in a cross-sectional approach. In a cross-sectional cohort study, using the Kessler Psychological Distress Scale (K10), Winthorst et al142 did not find a clear seasonal pattern in predefined depressive subgroups. Using the SPAQ in the same population, some seasonal variation was found in subgroups with depression and anxiety 143.…”