Has the sun set for seasonal affective disorder and HPA axis studies? A systematic review and future prospects

JOURNAL OF AFFECTIVE DISORDERS

卷:256

Review

Agustini, Bruno¹  Bocharova, Mariia^2,3  Walker, Adam J.¹  Berk, Michael¹  Young, Allan H.^2,3  Juruena, Mario F.^2,3 

[1] Deakin Univ, Sch Med, IMPACT Strateg Res Ctr, Barwon Hlth, Geelong, Vic, Australia

[2] South London & Maudsley NHS Fdn Trust SLaM, Ctr Affect Disorders, Dept Psychol Med, Inst Psychiat Psychol & Neurosci,Biomed Res Ctr B, London, England

[3] Kings Coll London, London, England

关键词: Seasonal affective disorder;    Winter depression;    HPA axis;    Cortisol;    Depression;    Mood disorder;   

DOI  :  10.1016/j.jad.2019.06.060

来源: Elsevier

【 摘 要 】

Objective: Seasonal Affective Disorder (SAD) is a form of cyclic mood disorder that tends to manifest as winter depression. SAD has anecdotally been described as a hypocortisolemic condition. However, there are no systematic reviews on SAD and Hypothalamic-Pituitary-Adrenal (HPA) axis function. This review intends to summarize these findings. Methods: Using the PRISMA (2009) guideline recommendations we searched for relevant articles indexed in databases including MEDLINE, EMBASE, PsycINFO, and PsychArticles. The following keywords were used: Seasonal affective disorder, OR Winter Depression, OR Seasonal depression associated with: HPA Axis OR cortisol OR CRH OR ACTH. Results: Thirteen papers were included for qualitative analysis. Studies used both heterogeneous methods and populations. The best evidence comes from a recent study showing that SAD patients tend to demonstrate an attenuated Cortisol Awakening Response (CAR) in winter, but not in summer, compared to controls. Dexamethasone Suppression Test (DST) studies suggest SAD patients have normal suppression of the HPA axis. Conclusion: There is still insufficient evidence to classify SAD as a hypocortisolemic condition when compared to controls. Heterogeneous methods and samples did not allow replication of results. We discuss the limitations of these studies and provide new methods and targets to probe HPA axis function in this population. SAD can provide a unique window of opportunity to study HPA axis in affective disorders, since it is highly predictable and can be followed before, during and after episodes subsides.

【 授权许可】

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