SEASONAL AFFECTIVE-DISORDER AMONG PRIMARY-CARE CONSULTERS IN JANUARY - PREVALENCE AND MONTH BY MONTH CONSULTATION PATTERNS

Background: Little is known about the prevalence or the consultation p atterns of patients with seasonal affective disorder (SAD) in primary care settings. Methods: Patients aged 16-64 years consulting a general practitioner (G.P.) during a three week period in January were screen ed with the Seasonal Pattern Assessment Questionnaire (SPAQ). Intervie w-confirmed cases of SAD (N = 33) were matched by age and sex to contr ols without seasonal morbidity and primary care consultation patterns were compared over a 5 year period. Results: Of 692 patients screened, 64 (9.3%) satisfied SPAQ criteria for winter SAD. Patients with SAD s howed no winter excess of consultations but were high year round consu lters, averaging 1.8 times more consultations than controls. Conclusio ns: High levels of SAD caseness on the SPAQ were found among patients consulting in primary care during January. Possible explanations for t he high non-seasonal consultation patterns among SAD patients include somatisation and diagnostic inaccuracies. Limitations: Diagnostic crit eria for SAD, and the SPAQ in particular, may be over-inclusive. The S PAQ completion rate (about 39% of eligible patients consulting a G.P.) was relatively low. Clinical relevance: Patients with SAD (using SPAQ criteria) commonly consult their G.P.s in winter but frequency, rathe r than seasonality, of consultation may be a better guide to diagnosin g SAD in primary care. (C) 1998 Elsevier Science B.V.