根据美国、加拿大和英国社区研究,季节性抑郁和双相型障碍的终生发生率估计值平均在 0.4%-2.9% 之间。[1]Blazer DG, Kessler RC, Swartz MS. Epidemiology of recurrent major and minor depression with a seasonal pattern: the National Comorbidity Survey. Br J Psychiatry. 1998 Feb;172:164-7.http://www.ncbi.nlm.nih.gov/pubmed/9519070?tool=bestpractice.com[2]Levitt AJ, Boyle MH, Joffe RT, et al. Estimated prevalence of the seasonal subtype of major depression in a Canadian community sample. Can J Psychiatry. 2000 Sep;45(7):650-4.http://www.ncbi.nlm.nih.gov/pubmed/11056828?tool=bestpractice.com[3]Levitt AJ, Boyle MH. The impact of latitude on the prevalence of seasonal depression. Can J Psychiatry. 2002 May;47(4):361-7.http://www.ncbi.nlm.nih.gov/pubmed/12025435?tool=bestpractice.com[4]Michalak EE, Lam RW. Seasonal affective disorder: the latitude hypothesis revisited. Can J Psychiatry. 2002 Oct;47(8):787-8.http://www.ncbi.nlm.nih.gov/pubmed/12420660?tool=bestpractice.com 有些研究估计这个数值可能高达9.7%。[5]Magnusson A, Axelsson J, Karlsson MM, et al. Lack of seasonal mood change in the Icelandic population: results of a cross-sectional study. Am J Psychiatry. 2000 Feb;157(2):234-8.http://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.157.2.234http://www.ncbi.nlm.nih.gov/pubmed/10671392?tool=bestpractice.com 然而,这可能归因于采样和所用诊断标准差异。 SAD 发生率在居住于北纬度更高的人群中略高。[6]Mersch PP, Middendorp HM, Bouhuys AL, et al. Seasonal affective disorder and latitude: a review of the literature. J Affect Disord. 1999 Apr;53(1):35-48.http://www.ncbi.nlm.nih.gov/pubmed/10363665?tool=bestpractice.com 虽然北美样本中已证明了纬度和 SAD 的相关性,但在欧洲队列研究中并未确凿地证实这种相关性。 这表明还存在其他因素的影响,例如遗传变异性、文化差异和气候。[6]Mersch PP, Middendorp HM, Bouhuys AL, et al. Seasonal affective disorder and latitude: a review of the literature. J Affect Disord. 1999 Apr;53(1):35-48.http://www.ncbi.nlm.nih.gov/pubmed/10363665?tool=bestpractice.com[7]Radua J, Pertusa A, Cardoner N. Climatic relationships with specific clinical subtypes of depression. Psychiatry Res. 2010 Feb 28;175(3):217-20.http://www.ncbi.nlm.nih.gov/pubmed/20045197?tool=bestpractice.com 与其他季节性情感波动相比,在秋冬季发作的重度抑郁常见得多。[8]Wehr TA, Sack DA, Rosenthal NE. Seasonal affective disorder with summer depression and winter hypomania. Am J Psychiatry. 1987 Dec;144(12):1602-3.http://www.ncbi.nlm.nih.gov/pubmed/3688288?tool=bestpractice.com[9]Winkler D, Pjrek E, Iwaki R, et al. Treatment of seasonal affective disorder. Expert Rev Neurother. 2006 Jul;6(7):1039-48.http://www.ncbi.nlm.nih.gov/pubmed/16831117?tool=bestpractice.com 约 20% 的 SAD 人群患有双相 I 型障碍或双相 II 型障碍,而 SAD 更可能出现在双相 II 型障碍患者中。[10]White DM, Lewy AJ, Sack RL, et al. Is winter depression a bipolar disorder? Compr Psychiatry. 1990 May-Jun;31(3):196-204.http://www.ncbi.nlm.nih.gov/pubmed/2340714?tool=bestpractice.com 在患有焦虑、注意力缺陷多动症 (ADHD) 和经前期情绪障碍的人群中,SAD 发病率可能更高。[11]Levitt AJ, Joffe RT, Brecher D, et al. Anxiety disorders and anxiety symptoms in a clinic sample of seasonal and non-seasonal depressives. J Affect Disord. 1993 May;28(1):51-6.http://www.ncbi.nlm.nih.gov/pubmed/8326080?tool=bestpractice.com[12]Amons PJ, Kooij JJ, Haffmans PM, et al. Seasonality of mood disorders in adults with lifetime attention-deficit/hyperactivity disorder (ADHD). J Affect Disord. 2006 Apr;91(2-3):251-5.http://www.ncbi.nlm.nih.gov/pubmed/16458365?tool=bestpractice.com[13]Praschak-Rieder N, Willeit M, Neumeister A, et al. Prevalence of premenstrual dysphoric disorder in female patients with seasonal affective disorder. J Affect Disord. 2001 Mar;63(1-3):239-42.http://www.ncbi.nlm.nih.gov/pubmed/11246102?tool=bestpractice.com 一些人也可能通过增加饮酒自行治疗 SAD 症状。[14]Sher L. Alcoholism and seasonal affective disorder. Compr Psychiatry. 2004 Jan-Feb;45(1):51-6.http://www.ncbi.nlm.nih.gov/pubmed/14671737?tool=bestpractice.com 平均发病年龄为 20-30 岁,老年人群中的发生率下降。[15]Magnusson A, Partonen T. The diagnosis, symptomatology, and epidemiology of seasonal affective disorder. CNS Spectr. 2005 Aug;10(8):625-34.http://www.ncbi.nlm.nih.gov/pubmed/16041294?tool=bestpractice.com SAD 在女性中的发病率约是男性的 3-5 倍,这一性别差异比在非季节性抑郁症中所观察到的差异更大。[16]Winkler D, Willeit M, Praschak-Rieder N, et al. Changes of clinical pattern in seasonal affective disorder (SAD) over time in a German-speaking sample. Eur Arch Psychiatry Clin Neurosci. 2002 Apr;252(2):54-62.http://www.ncbi.nlm.nih.gov/pubmed/12111337?tool=bestpractice.com 儿童和青少年的患病率在 3.3%-4.2% 之间,青春期女孩的发病率增加。[17]Swedo SE, Pleeter JD, Richter DM, et al. Rates of seasonal affective disorder in children and adolescents. Am J Psychiatry. 1995 Jul;152(7):1016-9.http://www.ncbi.nlm.nih.gov/pubmed/7793436?tool=bestpractice.com[18]Carskadon MA, Acebo C. Parental reports of seasonal mood and behavior changes in children. J Am Acad Child Adolesc Psychiatry. 1993 Mar;32(2):264-9.http://www.ncbi.nlm.nih.gov/pubmed/8444753?tool=bestpractice.com 其他研究发现,在秋冬季评估时,与 6-15 岁人群相比,抑郁症的父母评级在 16-18 岁人群中更严重。[19]Nillni YI, Rohan KJ, Rettew D, et al. Seasonal trends in depressive problems among United States children and adolescents: a representative population survey. Psychiatry Res. 2009 Dec 30;170(2-3):224-8.http://www.ncbi.nlm.nih.gov/pubmed/19896720?tool=bestpractice.com