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Lithium has long been used as a cornerstone mood stabilizer in the treatment of bipolar disorder (BD). However, reliable biomarkers that can predict which patients will respond better to lithium are still lacking. This study aims to evaluate the potential of NR1D1 gene SNP; rs2071427 and actigraphic measurements in predicting lithium response. Thirty-one patients diagnosed with BD at Selçuk University Faculty of Medicine and who were euthymic for at least 8 weeks were included in the study. Sleep-wake cycles and circadian rhythms of the participants were monitored by actigraph for approximately 1 week. For genetic analyses, the SNP rs2071427 variant of the NR1D1 gene was evaluated. A significant proportion of patients with homozygous (AA/GG) genotypes responded well to lithium, whereas some patients with heterozygous (AG) genotypes did not respond to lithium. Actigraphic data showed that there were marked variations in the sleep patterns of BD patients. The Morningness-Eveningness Questionnaire scale did not adequately discriminate the morning chronotype. Seasonal Pattern Assessment Questionnaire results showed that most patients had a seasonal pattern, but this was insufficient to predict response to lithium. This study once again demonstrates the need for new biomarkers to predict lithium response. The findings are an important step in the personalization of BD treatment and may improve treatment efficacy and minimize side effects by tailoring the treatment process to the individual characteristics of patients. Future studies should support these findings with larger sample groups and studies on different genetic markers. [ABSTRACT FROM AUTHOR]

Background The World Health Organization (WHO) recommends seasonal malaria chemoprevention (SMC) with sulfadoxine-pyrimethamine and amodiaquine (SPAQ) for children aged 3 to 59 months, living in areas where malaria transmission is highly seasonal. However, due to widespread prevalence of resistance markers, SMC has not been implemented at scale in East and Southern Africa. An initial study in Uganda showed that SMC with SPAQ was feasible, acceptable, and protective against malaria in eligible children in Karamoja region. Nonetheless, exploration of alternative regimens is warranted since parasite resistance threats persist. Objective The study aims to test the effectiveness of SMC with Dihydroartemisinin-piperaquine (DP) or SPAQ (DP-SMC & SPAQ-SMC), chemoprevention efficacy as well as the safety and tolerability of DP compared to that of SPAQ among 3-59 months old children in Karamoja region, an area of Uganda where malaria transmission is highly seasonal. Methods A Type II hybrid effectiveness-implementation study design consisting of four components: 1) a cluster randomized controlled trial (cRCT) using passive surveillance to establish confirmed malaria cases in children using both SPAQ and DP; 2a) a prospective cohort study to determine the chemoprevention efficacy of SPAQ and DP (if SPAQ or DP clears sub-patent infection and provides 28 days of protection from new infection) and whether drug concentrations and/or resistance influence the ability to clear and prevent infection; 2b) a sub study examining pharmacokinetics of DP in children between 3 to

Seasonal affective disorder (SAD) is typically associated with winter; however, its less common variant, summertime depression, presents with depressive episodes during the summer months. We report a case of a 46-year-old male patient with recurrent summertime depressive episodes characterized by low mood, fatigue, anhedonia, insomnia, and loss of appetite, each resolving with the onset of the winter season. Our patient's history of summertime depression aligned with the atypical SAD symptoms, including irritability and weight loss, commonly associated with non-seasonal depression. A diagnosis of major depressive disorder, moderate severity, with a seasonal pattern was confirmed using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision criteria, and the Seasonal Pattern Assessment Questionnaire. The patient was initiated on desvenlafaxine 50 mg once a day with a dose titrated to 100 mg once a day in two weeks, while his previous mood stabilizer oxcarbazepine 600 mg in two divided doses was continued. He achieved remission within four to six weeks with his Hamilton Rating Scale for Depression score decreasing from 18 to seven. Our case underscores the importance of recognizing seasonal patterns in affective disorders within tropical climates, like India, and highlights potential environmental and physiological mechanisms, such as heat stress and immune responses, contributing to summertime SAD., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Shidhore et al.)

Background: Seasonal malaria chemoprevention (SMC) is an effective strategy for reducing malaria morbidity and mortality in children aged 3-59 months in areas with seasonal malaria transmission. Sulphadoxine-pyrimethamine plus amodiaquine is given to an eligible child at monthly intervals during the peak malaria transmission season. The aim of this study was to determine the level of compliance with SMC guidelines by community drug distributors during SMC implementation in Kwara State., Method: Caregivers of eligible children from six Local Government Areas were interviewed using a structured questionnaire on the KoboCollect app downloaded on hand-held android devices. The questionnaire was composed of questions on caregiver's demographics, SMC drug administration, and adherence to SMC protocol., Results: A total of 1,314 caregivers were interviewed, most of them were female 1076 (81.9%), married 1200 (91.3%) and literate 795 (60.5%). The mean SMC coverage for the 4 cycles was 1183(88.5%). SMC information was received by 1166 (88.7%) of caregivers. Most of the caregivers 1166 (88.7%) heard about SMC. Overall, SPAQ administration was directly observed in most cases 1169 (91.5%), second dose was given 1226 (96.0%) and drugs were fully ingested 1140(89.3%). Poor compliance was observed in home visits by lead mothers 988 (77.4%). The report of adverse drug reactions was low 132 (10.3% [95% CI: 8.8-12.3%]), the commonest being severe vomiting 50 (37.9%). There were significant (P<0.05) variations in SMC implementation across the 6 LGAs in virtually all the performance indicators. SPAQ administration to over-age children was low 128 (10.0%)., Conclusion: Overall, the compliance with SMC implementation guidelines in Kwara state was good though significant differences in performance were observed across the six LGAs. Home visits by lead mothers were generally poor. The self-reported coverage of SMC by caregivers was commendable., Competing Interests: The Authors declare that no competing interest exists., (Copyright © 2024 by West African Journal of Medicine.)

Highlights • Of respondents 50% sunbathed frequently. • One third of the sunbathers appeared either tanning dependent/abuser. • Tanning dependent/abusers sunbathed significantly more frequently. • 42.2% of sunbathers showed subsyndromal/definite seasonal affective disorder. • Sunbathing related tanning dependence/abuse and SAD symptoms were not associated. Abstract Ultraviolet radiation (UVR) is a known risk factor for skin cancers. Those who are tanning dependent seek out UVR exposure. Many tanners have expressed symptoms of seasonal affective disorder (SAD), but conclusive evidence of a connection with tanning dependence is lacking. We evaluated the frequency of tanning dependence or abuse and symptoms of SAD among Finnish sunbathers and analysed whether phenomena are associated which could indicate a common biological mechanism. Sunbathing related tanning dependence/abuse among Finnish sunbathers were assessed using the Structured Interview for Tanning Abuse and Dependence measure (SITAD), and symptoms of SAD were assessed with the Seasonal Pattern Assessment Questionnaire (SPAQ). Of 229 sunbathers, 8% (n = 18) were classified as tanning-dependent, and 26% (n = 59) were classified as tanning abusers. Additionally, 16% (n = 37) met the criteria for SAD, and 26% (n = 60) met the criteria for subsyndromal seasonal affective disorder (S-SAD), but there was no significant association between tanning dependence or abuse and SAD or S-SAD. Sunbathing dependence or abuse and SAD/S-SAD were frequent among sunbathers, and they may promote sun-seeking risk behaviour. However, within this sample, tanning dependence and SAD/S-SAD were not associated. [ABSTRACT FROM AUTHOR]

Background and Aim: Seasonal patterns of food intake are found in healthy individuals and particularly in patients with seasonal affective disorder (SAD). One nutritional choice is a vegetarian diet. Methods: In a Finnish population study, FINRISK 2012, information about diet and SAD was collected. In a Dutch outpatient clinic, SAD patients were asked if they were vegetarian. Results: The percentage of SAD patients among Finnish vegetarians was 4 times higher than in the normal population. The percentage of vegetarians among the SAD patients in a Dutch outpatient clinic was 3 times higher than in the normal population. In the Dutch population, the seasonal loss of energy, in particular, is related to vegetarianism. Conclusion: These findings suggest a possible link between vegetarianism and SAD. [ABSTRACT FROM AUTHOR]

Introduction: Seasonal affective disorder (SAD) is a proposed mental disorder still controversial. This condition is prevalent in northern latitudes, but few studies have been conducted at locations in the southern hemisphere. It is usually assessed by the Seasonal Pattern Assessment Questionnaire (SPAQ). This study aimed to evaluate, through on-line questionnaire, the hypothesis that, in the Brazilian population, latitude and longitude influence SPAQ scores. Methods: An advertisement was posted on a sleep medicine website inviting visitors to investigate seasonal patterns of behavior and mood, using a Brazilian Portuguese version of the SPAQ. The geographic coordinates of the place of residence of each respondent were analyzed as a continuous variable or distributed in quartiles of latitude and longitude. The psychometric properties of the SPAQ were assessed by reliability and factor analyses. Results: Answers from 1001 respondents out of 1045 were considered eligible. High SPAQ scores were observed in 287 respondents, equally distributed among all latitude and longitude quartiles. Data collected in different seasons and during daylight saving time did not differ significantly in any of the scores for SPAQ dimensions. No correlations between SPAQ scores and latitude or longitude were observed. Psychometric properties of the SPAQ were preserved in all geographic locations. Conclusion: The finding of similar SPAQ scores at a wide latitude range defies the concept of SAD symptoms as latitude or longitude-dependent phenomena.

Circannual rhythms and seasonality have long been in the interest of research. In humans, seasonal changes in mood have been extensively investigated since a substantial part of the population experiences worsening of mood during winter. Questions remain regarding accompanying physiological phenomena. We report seasonal effects on the acoustic startle response in a cross-sectional ( n = 124) and a longitudinal sample ( n = 23). Startle magnitudes were larger in winter (sample 1: p = 0.026; sample 2: p = 0.010) compared to summer months. Although the findings need to be replicated they may have implications regarding the timing of startle experiments. [ABSTRACT FROM AUTHOR]

Introduction: Seasonal affective disorder (SAD) is a proposed mental disorder still controversial. This condition is prevalent in northern latitudes, but few studies have been conducted at locations in the southern hemisphere. It is usually assessed by the Seasonal Pattern Assessment Questionnaire (SPAQ). This study aimed to evaluate, through on-line questionnaire, the hypothesis that, in the Brazilian population, latitude and longitude influence SPAQ scores. Methods: An advertisement was posted on a sleep medicine website inviting visitors to investigate seasonal patterns of behavior and mood, using a Brazilian Portuguese version of the SPAQ. The geographic coordinates of the place of residence of each respondent were analyzed as a continuous variable or distributed in quartiles of latitude and longitude. The psychometric properties of the SPAQ were assessed by reliability and factor analyses. Results: Answers from 1001 respondents out of 1045 were considered eligible. High SPAQ scores were observed in 287 respondents, equally distributed among all latitude and longitude quartiles. Data collected in different seasons and during daylight saving time did not differ significantly in any of the scores for SPAQ dimensions. No correlations between SPAQ scores and latitude or longitude were observed. Psychometric properties of the SPAQ were preserved in all geographic locations. Conclusion: The finding of similar SPAQ scores at a wide latitude range defies the concept of SAD symptoms as latitude or longitude-dependent phenomena. [ABSTRACT FROM AUTHOR]

Abstract: Background: Research studies on seasonal affective disorder (SAD) among immigrant populations are scarce. The objective of this article was to explore the associated risk and protective factors on prevalence of winter SAD (W-SAD), sub syndromal SAD (S-SAD) and Summer-SAD among five immigrant groups living in Oslo, Norway. Methods: The Oslo Immigrants Health study (innvandrer HUBRO, 2002), is a large cross sectional epidemiological survey conducted among five of the largest immigrant groups living in Oslo. 1047 subjects were included in the analysis out of 3019 who participated in the survey. Mailed questionnaire which included selected items of the seasonal pattern assessment questionnaire (SPAQ), Hopkins symptom check list (HSCL) and other variables were used in the analysis. Results: The lowest levels of W-SAD were found among Sri Lankan men and women and the highest among Iranians. W-SAD was significantly associated with country of birth, younger age, smoking, presence of mental distress, frequent visits to general practitioner or psychiatrist, self reported poor health and presence of chronic disorders. S-SAD was significantly associated with country of birth, smoking and higher levels of alcohol consumption. Limitations: SPAQ was not culturally validated. Poor response rate (39.7%) can also be considered as a limitation. Conclusions: Ethnic differences in W-SAD and S-SAD were observed. Sri Lankans had the lowest levels of W-SAD. However, there is a need for culturally validated instruments and further research must focus on exploring protective factors for SAD. [Copyright &y& Elsevier]

Abstract: Background: This study examined seasonality in a community sample of five diagnostic groups: normal subjects, those with non-seasonal depression (NSD), seasonal depression (SD), non-seasonal bipolar disorder (NSBD) and seasonal bipolar disorder (SBD). Methods: Telephone interviews were conducted across the Province of Ontario. Seasonal changes in mood and behaviour were determined using the Seasonal Pattern Assessment Questionnaire (SPAQ). Five additional seasonality items consisting of depressive symptoms were included in the interview. The mean global severity of seasonality (GSS) scores were obtained and the entire inventory of 11 seasonality items were compared across the identified groups. Results: The mean GSS score for the controls was 5.2 (S.D.=4.0), 8.0 (S.D.=4.9) for NSD, 10.5 (S.D.=3.9) for SD, 10.5 (S.D.=5.4) for NSBD and 13.4 (S.D.=5.4) for SBD. These scores differed significantly (F=61.68, df=4, p<0.001). For the majority of the individual items, the SBD group rated the highest degree of seasonal fluctuation, while the NSBD and SD groups had nearly identical item scores. Limitations: Limitations in this study include the relatively small number of subjects in the NSBD and SBD groups, and the inherent limitations in a telephone interview. Conclusions: Individuals with bipolar disorder experience greater seasonality than those with depression or healthy controls. Even the non-seasonal bipolar group had as much seasonal fluctuation as the seasonal depression group, which has important implications for the management of bipolar illness. [Copyright &y& Elsevier]

Background: The Seasonal Pattern Assessment Questionnaire (SPAQ) is a frequently used screening instrument in the research on Seasonal Affective Disorder (SAD). Nevertheless, studies on its reliability and validity are relatively scarce. In the present study the reliability and the contrast validity of the SPAQ are investigated. Methods: SAD patients, selected by means of a clinical interview, non-seasonal depressed out-patients, non-depressed out-patients, and a control group, are contrasted to estimate the discriminating power of the SPAQ. Also, the reliability and factor structure of the seasonality and the climate subscales are investigated. To study food intake the Seasonal Food Preference Questionnaire (SFPQ) was developed. Results: The SAD criterion of the SPAQ shows good specificity (94%), but a low sensitivity (44%). Discriminant analysis shows sufficient ability to classify subjects (81% correctly classified). The Global Seasonality Scale has a good internal consistency. It consists of two factors, a psychological factor and a food factor. The SFPQ is sensitive for carbohydrate intake by SAD patients. Limitations: Most SAD patients had received treatment and completed the SPAQ while they were not depressed, which may have influenced the sensitivity. Conclusions: The SPAQ is not sensitive enough to be considered a diagnostic instrument for SAD. Nevertheless, it is accurate enough to be used as a screenings instrument. The only false positives were found in the depressive group. The accuracy of prevalence Figs. can be improved by completion of the SPAQ in the summer months, combined with the completion of a depression scale. [Copyright &y& Elsevier]

Background: In 1984, Rosenthal et al. described a group of patients characterised by repeated winter depression with atypical symptoms eventually followed by summer mania or hypomania (seasonal affective disorder, SAD). The relationship between SAD and the classical manic-depressive disorder is uncertain. The aim of this study was to validate the Seasonal Pattern Assessment Questionnaire (SPAQ) classification in relation to the DSM-III-R criteria of seasonal patterns in a group of patients with bipolar affective disorder and to evaluate the stability of the SPAQ score index over time. Methods: A group of bipolar patients were followed for 3 years with examinations every third month and at hospitalisation. At inclusion and at each following examination the patients were rated with the Hamilton Depression Rating Scale, the Newcastle Depression Rating Scale, and the Bech-Rafaelsen Mania Rating Scale. At inclusion and once a year the patients completed the SPAQ. Results: Fifty-six patients agreed to participate and 46 patients completed 1 year or more. Eight patients, all women, had at least one SPAQ score index (SSI) of 11 or more. Women scored significantly higher than men on SPAQ. The test/re-test reliability of SSI between two consecutive years was good, but decreased as the time difference between tests increased. Moreover, we found no relation between seasonal variations of affective episodes according to SSI and DSM-III-R. Limitations: The group of patients with seasonality according to DSM-III-R or SSI was small. Conclusion: The validity of SSI between two consecutive years is good, but decreases as the time difference between tests increases. There is no relationship between seasonality defined by DSM-III-R and SSI. Female bipolar patients show, as the general population, seasonal variations in mood, energy, sociality, appetite, and sleep independently of their affective episodes. SSI cannot be used for the prediction of seasonal variation in a group of bipolar patients. [Copyright &y& Elsevier]

Bright light is used to treat winter depression and may also have positive effects on mood in some healthy individuals. However, there is little information on how bright light treatment influences social behavior. We performed a cross-over study in winter comparing the effects of morning bright light administration with placebo (exposure to negative ions) on mood and social behavior in 38 healthy people with mild to moderate seasonality. Each treatment was given for 21days with a washout period of 14days between treatments. An event-contingent recording assessment was used to measure mood, and social behavior along two axes, agreeable-quarrelsome and dominant-submissive, during each 21-day treatment period. During treatments, participants wore a combined light-sensor and accelerometer to test this method for adherence to light treatment self-administered at home. Data were analyzed using multilevel modeling. Bright light improved mood but increased quarrelsome behavior and decreased submissiveness. Data from the light monitor and accelerometer suggested that 21% of the participants did not adhere to bright light treatment; when this group was analyzed separately, there was no change in quarrelsomeness or mood. However, results for individuals who followed the procedure were similar to those reported for the whole sample., (© 2013.)