Symptomatology, life events, and coping strategies in seasonal affective disorder

This study examined changes in depressive symptoms, major life stressors, daily minor stressors, cognitive appraisal of stressful events, and coping strategies used in stressful episodes across seasons in depressed subjects and non-depressed controls. Thirty-seven subjects diagnosed with winter seasonal affective disorder (SAD) and 29 nondepressed normal controls were evaluated at two time periods, during the fall/winter months and during the spring/summer months. All subjects with SAD met criteria for a current major depressive episode according to DSM III-R criteria at the time of the study. The majority of SAD subjects showed complete symptom remission on follow-up evaluation; four of the 37 subjects remained depressed on follow-up. Contrary to prediction, SAD subjects did not differ from non-depressed controls in the number of major life stressors experienced in the months prior to their depressive episode, nor did the number of stressors show a significant decrease across seasons. SAD subjects reported more minor stressors on initial evaluation than controls, but showed a significant decrease on follow-up. A similar pattern was observed across seasons in SAD subjects' rating of the severity of these stressors. SAD subjects reported a significant decrease in severity of stressors from winter to summer. However, when compared with controls, they rated stressors as significantly more severe at both time periods. SAD subjects did not differ from controls in how they evaluated the significance of a stressful encounter (primary appraisal) or in their assessment of available resources or coping options (secondary appraisal). However, there was a trend for SAD subjects to be more concerned about threats to self esteem than controls when coping with stressful situations, regardless their level of depression. In addition, both SAD subjects and controls showed an increase in their concern about losing respect for others on follow-up evaluation. However, only SAD subjects showed a significant increase from Time 1 to Time 2. When coping with stressful situations SAD subjects used significantly more escape-avoidance coping when depressed than when symptoms had remitted. They differed from controls when depressed but not on follow-up. There was a trend for SAD subjects to use less Positive Reappraisal when depressed than on remission.