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Sunshine on My Shoulders: Weather, Pollution, and Emotional Distress
Abstract
Background:
Researchers have examined the relationship between mental health and weather/pollution with mixed results. The current study aimed to examine a range of weather and atmospheric phenomena and their association with time-bound mental health data.
Methods:
Nineteen different weather/pollution variables were examined in connection with an archive of self-reported mental health data for university students participating in mental health treatment (n=16,452) using the Outcome Questionnaire 45.2 (OQ-45). Statistical approach involved randomly selecting 500 subjects from the sample 1000 different times and testing each variable of interest using mixed models analyses.
Results:
Seasonal changes in sun time were found to best account for relationships between weather variables and variability in mental health distress. Increased mental health distress was found during periods of reduced sun time hours. A separate analysis examining subjects' endorsement of a suicidality item, though not statistically significant, demonstrated a similar pattern. Initial results showed a relationship between pollution and changes in mental health distress; however, this was mediated by sun time.
Limitations:
This study examined a relatively homogenous, predominantly European American, and religious sample of college counseling clients from an area that is subject to inversions and is at a high altitude and a latitude where sun time vacillates significantly more than locations closer to the equator.
Conclusions:
Seasonal increases in sun time were associated with decreased mental health distress. This suggests the need for institutions and public health entities to plan for intervention and prevention resources and strategies during periods of reduced sun time.
... Our sample was situated in a subtropical area (24.5 • -25.5 • N). Daylength (duration from sunrise to sunset) was used as the parameter of natural daylight [30,31], and the mean daylength was 12h: 9m (SD 1:04, range 10:35-13:42) from June 2019 to May 2020, and there were less seasonal variations than in areas of higher latitudes. The climate data were obtained from the Central Weather Bureau official website (https://www.cwb.gov.tw/). ...
... Meanwhile, 18.6, 14.0, 90.7, and 23.3% of patients were receiving aripiprazole, quetiapine, benzodiazepines, and Z-drugs. The prescribed dose ranges were as follows (mg per day): escitalopram (5-20), fluoxetine , venlafaxine (75-300), duloxetine (60-90), mirtazapine (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30), bupropion (150-300), agomelatine , aripiprazole (2.5-5), and quetiapine (100-400). One patient took only 5 mg of escitalopram without adjunctive antidepressive agents. ...
... Compared to prior studies, our study was conducted at a low latitude with little daylength variability and higher levels of sunshine. Previous studies reported that less daylength variability, greater sunshine experience, and higher ambient temperature are associated with less mental distress and hyperthymic temperament [30,31,[44][45][46]. In the present study, the daylength was ≥10 h: 35 m in autumn and winter, and the average ambient temperatures were 22.1 • C from October to December and 19.1 • C from January to March. ...
This double-blind, randomized controlled trial assessed bright light therapy (BLT) augmentation efficacy compared with placebo light in treating non-seasonal major depressive disorder. The study participants belonged to a subtropical area (24.5°–25.5°N) with extensive daylight and included outpatients who had received stable dosages and various regimens of antidepressive agents for 4 weeks before enrollment. The outcomes were the 17-item Hamilton Depression Rating Scale, Montgomery–Asberg Depression Rating Scale, and Patient Health Questionnaire-9, which were assessed at weeks 1, 2, and 4. A total of 43 participants (mean age 45 years, ranging from 22–81) were randomized into the BLT [n = 22] and placebo light groups [n = 21]. After a 4-week administration of morning light therapy (30 min/day), depressive symptoms did not reduce significantly, which might be due to the small sample size. Nonetheless, this study had some strengths because it was conducted in warmer climates, unlike other studies, and examined diverse Asians with depression. Our findings suggest that several factors, such as poor drug response, different antidepressive regimens, duration of BLT, and daylength variability (i.e., natural daylight in the environment) may influence the utility of add-on BLT. Researchers may consider these important factors for future non-seasonal depression studies in subtropical environments.
... In this paper, we introduce weather as a novel qualitative data representation for stress tracking data. Weather can influence perceived happiness [17,32], stress [6], and certain weather types are associated with mental health characteristics [39,63]. Furthermore, albeit not scientifically proven, people associate similar weather scenarios with emotions and states of being relaxed (sunshine) vs danger (hail, thunderstorm). ...
... Although the relationship between weather and emotions, mood and (mental) health is not as strong as generally assumed [19,23,25,34], health and well-being can be influenced by weather. For example, less sunshine can increase stress [6], and amplify or trigger seasonal affective disorders [39,63], while intensity and direction of wind can influence the level of energy and fear [11]. Along similar lines, cognitive performance decreases with rising temperature [71]. ...
... The included studies analysed the effect of PM 10, PM 2.5 , BC, NO 2 , NO x , SO 2 , CO, and O 3 on psychological stress and/or anxiety disorder. Fifty-seven percent of the included studies analysed the effect of PM 10 and PM 2.5 whereas the effects of SO 2 and ozone were assessed in five [43,46,48,58,60] and four [16,43,61,62] studies respectively. 11 studies investigated the exposure to ambient NO 2 [15,16,18,23,24,43,44,46,48,50,60] while three studies [43,46,60] dealt with CO exposure. ...
... Psychological stress was found to be associated with exposure to BC [16], SO 2 [48,60], CO [46] and O 3 [61]. Per 0.5 μg/m 3 increase in 1-week average exposure to BC resulted in 0.5 point [95% CI: (0.1, 0.9), (p<0.05)] ...
Objectives
Ambient air pollution (AAP) is an important risk factor for increased mental health morbidity. Studies have highlighted the effect of AAP on psychological stress and anxiety disorder. However, existing evidence regarding this is largely equivocal. This systematic review with meta-analysis aims to synthesize published evidence to calculate the pooled estimate of the effect of AAP on psychological stress and anxiety disorder.
Content
A systematic bibliographic search was undertaken using PubMed, JGateplus, Google Scholar, and Cochrane Library for observational human studies published in English till 31st March 2020 reporting the effect of AAP on psychological stress and anxiety disorder. Study quality was assessed using the Joanna Briggs Institute critical appraisal tools. Meta-analysis was performed adopting a random-effects model using Meta-XL. Of 412 articles retrieved, a total of 30 articles [AAP and anxiety disorders, (n=17, 57%); AAP and psychological stress, (n=9, 30%) and AAP and both psychological stress and anxiety disorders, (n=4, 13%)] fulfilled the inclusion criteria covering a total population of 973,725 individuals. The pooled estimate (OR) of the effects of PM 10 on psychological stress was 1.03 [(95% CI: 1.00, 1.05) (p=0.17, I ² =41%)]. The pooled estimate of the effects of NO 2 and PM 10 on anxiety disorder was 0.93 [(95% CI: 0.89, 0.97) (p=0.91, I ² =0%)] and 0.88 [(95% CI: 0.78, 0.98) (p=0.01, I ² =59%)] respectively. The pooled estimate of the effects of PM 2.5 on anxiety Disorder was 0.88 [(95% CI: 0.72, 1.06) (p=0.00, I ² =80%)].
Summary and Outlook
The present study provides the most updated pooled estimate of the effect of AAP on psychological stress and anxiety disorder. Future studies should focus on longitudinal studies conducted in LIC and LMIC countries using uniform and standardized criteria for exposure and outcome assessment as well as robust adjustment for confounders to minimize methodological heterogeneity resulting in reliable and comparable estimation of environmental mental health burden.
... Previous investigations have often focused on a nomothetic approach, pooling data to identify influential features across individuals. [1,2] However, this approach typically has the drawback that insight into any particular individual is limited due to heterogeneous effects of factors on individual-level stress, and may not generalize due to biological variability or overfitting. [3] For example, for some participants, hot weather may reduce stress, whereas it may increase stress in others. ...
... Some have taken an exclusively nomothetic approach; Wang et al. [1] used both EMA data and automatically sensed activity and sociability data to explore correlates of stress, depression, and loneliness, but did not use a personalized machine learning approach or investigate individual predictors. Beecher et al. [2] used a large set of meteorological data paired with responses to a selfreport questionnaire, and a mixed modeling approach, finding that increased sun exposure decreased reported distress. ...
Background:
Investigations into person-specific predictors of stress have typically taken either a population-level nomothetic approach or an individualized ideographic approach. Nomothetic approaches can quickly identify predictors but can be hindered by the heterogeneity of these predictors across individuals and time. Ideographic approaches may result in more predictive models at the individual level but require a longer period of data collection to identify robust predictors.
Objective:
Our objectives were to compare predictors of stress identified through nomothetic and ideographic models and to assess whether sequentially combining nomothetic and ideographic models could yield more accurate and actionable predictions of stress than relying on either model. At the same time, we sought to maintain the interpretability necessary to retrieve individual predictors of stress despite using nomothetic models.
Methods:
Data collected in a 1-year observational study of 79 participants performing low levels of exercise were used. Physical activity was continuously and objectively monitored by actigraphy. Perceived stress was recorded by participants via daily ecological momentary assessments on a mobile app. Environmental variables including daylight time, temperature, and precipitation were retrieved from the public archives. Using these environmental, actigraphy, and mobile assessment data, we built machine learning models to predict individual stress ratings using linear, decision tree, and neural network techniques employing nomothetic and ideographic approaches. The accuracy of the approaches for predicting individual stress ratings was compared based on classification errors.
Results:
Across the group of patients, an individual's recent history of stress ratings was most heavily weighted in predicting a future stress rating in the nomothetic recurrent neural network model, whereas environmental factors such as temperature and daylight, as well as duration and frequency of bouts of exercise, were more heavily weighted in the ideographic models. The nomothetic recurrent neural network model was the highest performing nomothetic model and yielded 72% accuracy for an 80%/20% train/test split. Using the same 80/20 split, the ideographic models yielded 75% accuracy. However, restricting ideographic models to participants with more than 50 valid days in the training set, with the same 80/20 split, yielded 85% accuracy.
Conclusions:
We conclude that for some applications, nomothetic models may be useful for yielding higher initial performance while still surfacing personalized predictors of stress, before switching to ideographic models upon sufficient data collection.
... Deeper knowledge of the day-to-day effects of both weather and physical activity on stress can be valuable for creating personalized stress-reduction interventions on a just-in-time basis. Previous investigations have often focused on a nomothetic approach, pooling data to identify influential features across individuals [1,2]. However, this approach typically has a drawback: Insight into any particular individual is limited due to heterogeneous effects of factors on individual-level stress and may not be generalized due to biological variability or overfitting [3]. ...
... Some have taken an exclusively nomothetic approach; Wang et al [1] used both EMA data and automatically sensed activity and sociability data to explore correlates of stress, depression, and loneliness, but did not use a personalized machine learning approach or investigate individual predictors. Using a large set of meteorological data paired with responses to a self-report questionnaire and a mixed modeling approach, Beecher et al [2] found that increased sun exposure decreased reported distress. ...
BACKGROUND
Investigations into person-specific predictors of stress have typically taken either a population-level nomothetic approach, or an individualized ideographic approach. Nomothetic approaches can quickly identify predictors but can be hindered by heterogeneity of these predictors across individuals and across time. Ideographic approaches may result in more predictive models at the individual-level, but require a longer period of data collection to identify robust predictors.
OBJECTIVE
Our objectives were to compare predictors of stress identified through nomothetic and ideographic models and to assess whether sequentially combining nomothetic and ideographic models could yield more accurate and actionable predictions of stress than relying on either model, alone. At the same time, we sought to maintain the interpretability necessary to retrieve individual predictors of stress despite using nomothetic models.
METHODS
Data collected in a 1-year observational study of 79 low-exercising participants were used. Physical activity was continuously and objectively monitored by actigraphy. Perceived stress was recorded by participants via daily ecological momentary assessments on a mobile application. Environmental variables including daylight time, temperature, and precipitation were retrieved from public archives. Using these environmental, actigraphy, and mobile assessment data, we built machine learning models predicting individual stress ratings using linear, decision tree, and neural network techniques employing nomothetic and ideographic approaches. The accuracy of approaches for predicting individual stress ratings was compared based on classification errors.
RESULTS
Across the group of patients, the nomothetic recurrent neural network model most heavily weighted an individual’s recent history of stress ratings in predicting a future stress rating, whereas the ideographic models more heavily weighted environmental factors such as temperature and daylight, as well as duration and frequency of bouts of exercise. The nomothetic recurrent neural network model was the highest performing nomothetic model, and yielded 72% accuracy for an 80%/20% train/test split. Using the same 80/20 split, the ideographic models yielded 75% accuracy. However, restricting ideographic models to participants with greater than 50 valid days in the training set, with the same 80/20 split, yielded 85% accuracy.
CONCLUSIONS
We conclude that for some applications, nomothetic models may be useful for yielding higher initial performance while still surfacing personalized predictors of stress, before switching to ideographic models upon sufficient data collection.
... Although meteorological parameters have been extensively studied for their association with suicide [3][4][5][6][7][8][9][10][11][12][13][14][15], the literature is more limited and inconclusive on the association between those parameters and mood or other psychiatric outcomes [16][17][18][19][20][21][22][23][24]. ...
... The same association was reported between a climatic factor mostly composed of barometric pressure and depression with psychotic features [16]. Increase in daylight [19,23] and temperature [19,22] has been associated with a reduced risk of depression and mental health distress. Nevertheless, the reversed pattern has also been reported [24]. ...
Background:
Meteorological parameters and air pollen count have been associated with affective disorders and suicide. Regarding peripartum depression, the literature is restricted and inconclusive.
Methods:
This cross-sectional study included women (pregnant, n = 3843; postpartum, n = 3757) who participated in the BASIC (Biology, Affect, Stress, Imaging, and Cognition) study 2010-2015 and the UPPSAT (Uppsala-Athens) study (postpartum, n = 1565) in 2006-2007. Cases were defined according to presence of depressive symptoms during pregnancy (gestational week 32) and 6 weeks postpartum, using the Edinburgh Postnatal Depression Scale (EPDS). Exposure of sunshine, temperature, precipitation, snow coverage, and air pollen counts of durations of 1, 7, and 42 days prior to the outcome were studied for associations with depressive symptoms, using negative binomial regression.
Results:
Prior to Bonferroni correction, the concentration of mugwort pollen, both one week and six weeks before the EPDS assessment at gestational week 32, was inversely associated with depressive symptoms in pregnancy, both before and after adjustment for season. No associations were found between the exposure to meteorological parameters and pollen and depressive symptoms, at the same day of depressive symptoms' assessment, the previous week, or the six weeks prior to assessment, either during pregnancy or postpartum after Bonferroni correction.
Conclusions:
There was no evidence that neither short-term nor long-term exposure to meteorological parameters or air pollen counts were associated with self-reported peripartum depressive symptoms in Uppsala, Sweden.
... Interestingly, UV light not only causes peripheral effects, but also is associated with various neurological behaviors linked to the CNS. Specifically, moderate UV exposure has been shown to affect mood, addiction, cognition, and memory (Beecher et al., 2016;Benedetti et al., 2001;Dominiak et al., 2015;Fell et al., 2014;Keller et al., 2005;Kent et al., 2009;Parrott and Sabini, 1990). However, relatively little is known about the molecular and cellular mechanisms that mediate UV-induced neurobehavioral changes. ...
... Although overexposure to UV radiation may cause several adverse health effects, moderate UV exposure greatly benefits physical and mental health at multiple levels. Moderate UV-light exposure affects behaviors related to the CNS, such as emotion, learning, and memory (Beecher et al., 2016;Benedetti et al., 2001;Cunningham, 1979;Dominiak et al., 2015;Fell et al., 2014;Keller et al., 2005;Parrott and Sabini, 1990), although it is far from clear what mechanism mediates this phenomenon. We demonstrate that UV exposure triggers elevation of blood UCA, which in turn crosses the BBB and enters neurons to participate in the biosynthesis of GLU. ...
Sunlight exposure is known to affect mood, learning, and cognition. However, the molecular and cellular mechanisms remain elusive. Here, we show that moderate UV exposure elevated blood urocanic acid (UCA), which then crossed the blood-brain barrier. Single-cell mass spectrometry and isotopic labeling revealed a novel intra-neuronal metabolic pathway converting UCA to glutamate (GLU) after UV exposure. This UV-triggered GLU synthesis promoted its packaging into synaptic vesicles and its release at glutamatergic terminals in the motor cortex and hippocampus. Related behaviors, like rotarod learning and object recognition memory, were enhanced after UV exposure. All UV-induced metabolic, electrophysiological, and behavioral effects could be reproduced by the intravenous injection of UCA and diminished by the application of inhibitor or short hairpin RNA (shRNA) against urocanase, an enzyme critical for the conversion of UCA to GLU. These findings reveal a new GLU biosynthetic pathway, which could contribute to some of the sunlight-induced neurobehavioral changes.
... Solar radiation is also an interesting variable in that it predicts both hotter perception and thermal discomfort, but also better affective states. This is consistent with both the lay notion and empirical evidence backing sunshine as a mood booster [50], and demonstrates the complex dynamics between weather, perception, comfort, and affect again. ...
The effects of heat exposure on negative affect are thought to be central to the observed relationships between hot summer days and deleterious outcomes, such as violent crime or mental health crises. As these relationships are likely to be magnified by the effects of climate change, a better understanding of how consistent or variable the effects of hot weather on affective states is required. The current work combines data gathered from an ecological momentary assessment (EMA) study on individuals’ thermal perceptions, comfort, and affective states in outdoor environments during their daily lives with high spatiotemporal resolution climate-modeled weather variables. Using these data, associations between objective weather variables (temperature, humidity, etc.), perceived heat (thermal perception and comfort), and affective states are examined. Overall, objective weather data reasonably predicted perception and comfort, but only comfort predicted negative affective states. The variance explained across individuals was generally very low in predicting negative affect or comfort, but within-person variance explained was high. In other words, while there may be a relatively consistent relationship between temperature and psychological experience for any given person, there are significant individual differences across people. Age and gender were examined as moderators of these relationships, and while gender had no impact, participant age showed several significant interactions. Specifically, while older adults tended to experience more thermal discomfort and perceived higher temperatures as hotter, the relationship between discomfort and negative affect was lower in older adults. Taken together, these results emphasize the importance of thermal discomfort specifically in predicting negative affect, as well as the high inter-individual variability in thermal perceptions and comfort for the same ambient temperatures.
... Ultraviolet (UV) radiation is a major component of sunlight, and previous studies have con rmed that moderate exposure to UV radiation can have bene cial effects on human mood [35]. Another study revealed that the activity of striatal dopamine D2/D3 receptors was signi cantly higher in a high-sunlight exposure group than in a low-sunlight exposure group [36]. ...
Background
Recently, there has been a decreasing trend in the frequency and duration of outdoor activity among children, which has garnered concern regarding the potential impacts of this decline during mental health in early childhood. Currently, the association between outdoor activity in early childhood and the symptoms of anxiety disorders in preschoolers remains unclear. The purpose of this study was to investigated the association between the frequency and duration of outdoor activities in children aged 0-3 yearsand anxiety symptoms in preschoolers.
Methods
A cross-sectional study was conducted in 2021 using questionnaires, included 69,571 preschoolersresiding in Longhua District, Shenzhen. Data on family social demographics, outdoor activity frequency and duration in children aged 0-3 years, and the anxiety symptoms of preschoolerswere collected through parent-completed questionnaires. The association between early childhood outdoor activity and anxiety symptoms in preschoolerswas analyzed using a binary logistic regression model.
Results
Children 0–1 years of age who were outdoors < 1 times/week had a higher risk of screening positive for anxiety symptoms in preschool age compared with children who were outdoors ≥7 times/week (OR = 2.55, 95% confidence interval(CI): 2.22–2.94). Children in this age group who were outdoors <30 min/session had a higher risk of screening positive for anxiety symptoms in preschool age compared with children who were outdoors ≥120 min/ session (OR = 1.62, 95%CI: 1.38–1.90). Children 1–3 years of age, who were outdoors < 1 time/week had a higher risk of screening positive for anxiety symptoms in preschool age compared with children who were outdoors ≥7 times/week, (OR = 3.10, 95%CI: 2.72–3.54). Children in this age group who were outdoors for < 30 min/sessionhad a higher risk of screening positive for anxiety symptoms in preschool age compared with children who were outdoors time ≥120 min/ session (OR = 2.07, 95%CI: 1.73–2.48).
Conclusion
Lower-frequency and shorter-duration outdoor activity during infancy was associated with a higher risk of anxiety symptoms in preschoolers. A frequency of ≥7 outdoor activity per week and a duration of ≥120 min/session during infancy were associated with lower levels of anxiety symptoms in preschoolers.
... Our findings confirm previous findings showing that wellbeing trajectories shared some similarities in seasonal variations which reflected the rise in infections and tightened restrictions (e.g., Reis et al., 2022) as well as seasonal trends in mental health (Beecher et al., 2016). However, there was also substantial variation in how individuals' wellbeing was affected by COVID-19 pandemic (and other) stressors, mirroring heterogeneities found in German adults' mental health and quality of life trajectories (Cohrdes et al., 2022;Reis et al., 2022). ...
This study aimed to identify positive and negative experiences of adults in Germany, coping strategies, contexts and wellbeing trajectories across two years of the COVID-19 pandemic. Semi-structured interviews (n = 14 adults) were conducted during spring 2022 and thematically analysed. Experiences and wellbeing trajectories corresponded to different phases of the pandemic, individuals’ contexts, and coping strategies. Many of the negative and positive experiences were perceived long-term changes, including deteriorated health behaviours, physical and mental health, social withdrawal for some, and improved health behaviours, personal growth, improved working life for others. Experiences, coping and consequently wellbeing were strongly affected by individuals’ contexts. Cognitive adaptation to a long duration of the pandemic and sufficient support appeared key to effective coping. We recommend more structural support for those most affected, preparing the public for long-term disruptions of their lives and addressing social inequalities of the COVID-19 pandemic.
... 57 Three studies (17%) did not find a significant association between temperature and mental health or wellbeing. 53,54,66 ...
Background:
Increasing evidence indicates that ambient outdoor temperature could affect mental health, which is especially concerning in the context of climate change. We aimed to comprehensively analyse the current evidence regarding the associations between ambient temperature and mental health outcomes.
Methods:
We did a systematic review and meta-analysis of the evidence regarding associations between ambient outdoor temperature and changes in mental health outcomes. We searched WebOfScience, Embase, PsychINFO, and PubMed for articles published from database origin up to April 7, 2022. Eligible articles were epidemiological, observational studies in humans of all ages, which evaluated real-world responses to ambient outdoor temperature, and had mental health as a documented outcome; studies of manipulated or controlled temperature or those with only physical health outcomes were excluded. All eligible studies were synthesised qualitatively. If three or more studies reported the same or equivalent effect statistics and if they had equivalent exposure, outcome, and metrics, the studies were pooled in a random-effects meta-analysis. The risk of bias for individual studies was assessed using the Newcastle-Ottawa Scale. The quality of evidence across studies was assessed using the Office of Health Assessment and Translation (OHAT) approach.
Findings:
114 studies were included in the systematic review, of which 19 were suitable for meta-analysis. Three meta-analyses were conducted for suicide outcomes: a 1°C increase in mean monthly temperature was associated with an increase in incidence of 1·5% (95% CI 0·8-2·2, p<0·001; n=1 563 109, seven effects pooled from three studies); a 1°C increase in mean daily temperature was associated with an increase in incidence of 1·7% (0·3-3·0, p=0·014; n=113 523, five effects pooled from five studies); and a 1°C increase in mean monthly temperature was associated with a risk ratio of 1·01 (95% CI 1·00-1·01, p<0·001; n=111 794, six effects pooled from three studies). Three meta-analyses were conducted for hospital attendance or admission for mental illness: heatwaves versus non-heatwave periods were associated with an increase in incidence of 9·7% (95% CI 7·6-11·9, p<0·001; n=362 086, three studies); the risk ratio at the 99th percentile of daily mean temperature compared with the 50th percentile was 1·02 (95% CI 1·01-1·03, p=0·006; n=532 296, three studies); and no significant association was found between a 10°C increase in daily mean temperature and hospital attendance. In a qualitative narrative synthesis, we found that ambient outdoor temperature (including absolute temperatures, temperature variability, and heatwaves) was positively associated with attempted and completed suicides (86 studies), hospital attendance or admission for mental illness (43 studies), and worse outcomes for community mental health and wellbeing (19 studies), but much of the evidence was of low certainty with high heterogeneity.
Interpretation:
Increased temperature and temperature variability could be associated with increased cases of suicide and suicidal behaviour, hospital attendance or admission for mental illness, and poor community health and wellbeing. Climate change is likely to increase temperature anomalies, variability, and heatwaves as well as average temperatures; as such, health system leaders and policy makers must be adequately prepared and should develop adaptation strategies. More high-quality, standardised research is required to improve our understanding of these effects.
Funding:
None.
... It was reported that people living in areas with longer and higher sunlight exposure levels exhibit fewer depressive symptoms 17 and were less likely to report suicidal thought 18 Additionally, seasonal increases in sunlight duration are associated with decreases in mental health distress. 19 Sunlight was also found to play a moderating role in the relationship between PM2.5 and depression. 20 All these studies presented links between sunlight exposure and mental disorders. ...
Purpose
In recent years, mental health problems have become the most serious social problems worldwide. Past studies have proposed that some links exist between sunlight and mental health; however, relevant studies examining low-dose sunlight exposure populations are lacking. We conducted a study among a group of operating room nurses (ORNs) who work long hours in operating rooms and have limited sunlight exposure. We aim to add to and refine previous researches on the association between mental health and sunlight exposure in community population.
Patients and Methods
A total of 787 ORNs were interviewed and analyzed. Mental health, sunlight exposure duration, sociodemographic and work-related variables, and chronic diseases were evaluated. The Kessler 10 scale (K10) was used to assess participants’ mental health status, and their sunlight exposure duration was assessed using their self-reports. Multiple linear regression analysis was adopted to examine the association between sunlight exposure and mental health.
Results
The average K10 score of ORNs was 25.41. ORNs exhibit poorer mental health than other populations. Poor mental health was negatively associated with greater sunlight exposure hours per day (β=−0.378) and sleep regularity (β=−3.341). Poor mental health was positively associated with chronic disease (β=3.514).
Conclusion
This study indicated that the positive association between sunlight exposure and mental health existed. Appropriate enhancement of sunlight exposure will be beneficial to mental health. Hospitals, related organizations and individuals should pay greater attention to ORNs’ mental health and sunlight exposure conditions. More policy recommendations as well as building structure recommendations should be proposed.
... Moreover, the sample resides in the far upper Midwest, therefore, seasonal factors, such as colder weather and fewer hours of sunlight, could have affected health and mood toward the end of the Fall semester when the second survey was completed. 46,47 It is also important to consider the changes in anxiety and depression in light of rates in other populations and in terms of actual functional impact of symptoms. In this present study, we used two screener items to assess both depression and anxiety, as well as report the total scores, which allows for a clearer depiction of the magnitude of changes over time (e.g., total score increased from 3.55 to 4.32 on a 0-12 scale). ...
Objective:
Examine changes in graduate student health and well-being in the first semester.
Participants:
Full-time, first-semester graduate students (N = 74) from a midsized midwestern university.
Method:
Graduate students were surveyed prior to starting their master's program and 10 weeks later. Passion for academics, basic psychological needs, physical and mental health symptoms, positive and negative affects, and quality of life were assessed.
Results:
Need satisfaction, harmonious passion, and indicators of well-being decreased across the first semester, whereas need frustration and indicators of ill-being increased over the first semester. Obsessive passion, harmonious passion, need satisfaction, and need frustration were associated with students' well-being at the end of the semester, with need frustration being the most robust predictor.
Conclusions:
Although most graduate students reported good general health and moderately low mental health symptoms, findings suggest that a need supportive environment may contribute to better health and well-being.
... Several studies used secondary environmental data; these studies benefited from existing environmental science expertise despite the collection of environmental science data not being part of the study itself. Secondary data were used in all studies of the effects of meteorological conditions, including temperature, on mental health [59][60][61]. Secondary data were also used in measuring exposure to natural environments, assessing proximity to an environment type identified using land cover or land use classifications [62][63][64] (Figure 2). ...
Mental health is influenced by multiple complex and interacting genetic, psychological, social, and environmental factors. As such, developing state-of-the-art mental health knowledge requires collaboration across academic disciplines, including environmental science. To assess the current contribution of environmental science to this field, a scoping review of the literature on environmental influences on mental health (including conditions of cognitive development and decline) was conducted. The review protocol was developed in consultation with experts working across mental health and environmental science. The scoping review included 202 English-language papers, published between 2010 and 2020 (prior to the COVID-19 pandemic), on environmental themes that had not already been the subject of recent systematic reviews; 26 reviews on climate change, flooding, air pollution, and urban green space were additionally considered. Studies largely focused on populations in the USA, China, or Europe and involved limited environmental science input. Environmental science research methods are primarily focused on quantitative approaches utilising secondary datasets or field data. Mental health measurement was dominated by the use of Citation: Roberts, M.; Colley, K.; Currie, M.; Eastwood, A.; Li, K.-H.; Avery, L.M.; Beevers, L.C.; Braithwaite, I.; Dallimer, M.; Davies, Z.G.; et al.
... Further, 10 weeks of short-day exposure enhanced cell survival in Syrian hamsters (Huang et al. 1998) and increased adult hippocampal neurogenesis in white-footed mice (Walton et al. 2014). Sunlight exposure affects mood, learning and cognition (Kent et al. 2009;Beecher et al. 2016). However, the underlying molecular mechanisms are not well understood. ...
Ambient light is a crucial environmental factor that influences physiology and behavior in all organisms including human beings. A fair understanding of the importance of circadian rhythms and timekeeping would enable us to develop strategies for the management of disrupted circadian rhythm-associated disorders such as depression, Alzheimer’s, and Parkinson’s diseases. Circadian manipulation protocols such as bright light exposure, acute sleep deprivation and photoperiod manipulation have been reported to be beneficial in humans and animal models. This chapter briefly summarizes the current knowledge on the efficacious role of circadian rhythm manipulation strategies in facilitating behavioral recovery and the possible underlying mechanisms. We have also tried to highlight the limitations and implications of futuristic combinatorial circadian rhythm manipulation and pharmacological approaches in the management of chronodisruption-related disorders.
... According to Denissen et al., climate did not appear to affect happy emotions, but temperature, wind, and sunlight did in the study of negative emotions [16]. Additionally, Beecher et al. found that temperature and sunlight have a significant impact on individual psychology, with psychological changes strongly linked to changes in light time and temperature [17]. The primary impact of weather on individual emotions was found by Ettema et al. [18]. ...
Human perception of the meteorological environment is an important research area in the context of global climate change. Human physical and mental health can be affected by the meteorological environment, which can manifest in emotional responses. The experiment was conducted at spring in Hangzhou West Lake Scenic Area (China). Three types of weather circumstances were examined by four emotional measures. The purpose of this study was to examine how meteorological parameters influence an individual’s emotional perception, such as air temperature, ground temperature, wind direction, precipitation, and relative humidity. Box plots were used to examine the distribution of scores on each emotional scale index. Perceptual models of positive, negative, regenerative, state anxiety, trait anxiety, and subjective vitality were developed using multiple linear regressions. The results indicate that meteorological conditions have a significant impact on human emotions: (1) there are other meteorological factors that affect individual emotions, besides precipitation; (2) the meteorological factors do not affect negative emotions; and (3) on sunny days, subjective energy and positive emotions are stronger, and on rainy days, perceptions of recovery are more favorable.
... This research has used correlational studies between weather data and either small scale or nation-wide survey data or analysis of social media posts, and the mental health metrics are heterogeneous. Humidity may compound effects of heat, while moderately or 'comfortably' warm weather or more sunshine hours may benefit wellbeing (103,126,130), and could mask the impacts of temperature if studies do not adequately control for these covariates. ...
Converging global evidence highlights the dire consequences of climate change for human mental health and wellbeing. This paper summarises literature across relevant disciplines to provide a comprehensive narrative review of the multiple pathways through which climate change interacts with mental health and wellbeing. Climate change acts as a risk amplifier by disrupting the conditions known to support good mental health, including socioeconomic, cultural and environmental conditions, and living and working conditions. The disruptive influence of rising global temperatures and extreme weather events, such as experiencing a heatwave or water insecurity, compounds existing stressors experienced by individuals and communities. This has deleterious effects on people’s mental health and is particularly acute for those groups already disadvantaged within and across countries. Awareness and experiences of escalating climate threats and climate inaction can generate understandable psychological distress; though strong emotional responses can also motivate climate action. We highlight opportunities to support individuals and communities to cope with and act on climate change. Consideration of the multiple and interconnected pathways of climate impacts and their influence on mental health determinants must inform evidence-based interventions. Appropriate action that centres climate justice can reduce the current and future mental health burden, while simultaneously improving the conditions that nurture wellbeing and equality. The presented evidence adds further weight to the need for decisive climate action by decision makers across all scales.
... Seasonal changes have an impact on the relationship between climatic variables and variability in attitude. Shorter hours of sunshine may lead to negative feelings during seasonal changes (Beecher et al., 2016). Bangladesh is bestowed with immense natural beauty. ...
Humidity is one of the most significant climate factors influencing destination decisions and the distribution pattern of vacationers during various seasons. This variable influences the benefit of day-today travel industry activities and keeps up the destination competitiveness. In this paper, the univariate Seasonal Autoregressive Integrated Moving Average (SARIMA) model has been applied to conjecture month-to-month humidity for Bangladesh mainstream tourist spots up to the year 2025. Later, the influence of humidity on tourist arrival that contributes to the national economy was also assessed usi ng the Seasonal Analysis of Covariance (SANCOVA) model. Our findings indicate that the Bangladesh tourism industry is more vulnerable to seasonal variation, and this seasonality has a 72% effect on tourist arrival and a 58% effect on overall humidi ty. The findings suggest that if per unit humidity in seasonality increases, then the tourism indus try income will increase by approximately 59.463 thousand Taka (Bangladesh currency) in every season.
... Higher temperatures, however, lead to more negative attitudes which overcome comfort in summer. Seasonal fluctuations affect the link between climate factors and attitude variability (Beecher et al., 2016). ...
In this study, we aim to highlight the impact of climate change as well as seasonality on tourist’s arrival in
Bangladesh. The SANCOVA modeling framework modified by the ANCOVA model is used to examine the impact of climate
change on tourists’ arrivals. The results show seasonality has a 91% effect on tourist’s arrival in Bangladesh. The maximum and
minimum variation of climatic variables on tourists’ arrival in Bangladesh is rainfall and humidity, respectively. The winter and
summer seasons have similar and more impact on tourist’s arrival in Bangladesh. Our findings indicate that the tourism industry
of Bangladesh is more vulnerable to seasonal variation than the overall economy. The present study has significant implications
for both policymakers and tourisms destination alike to plan for tourism in Bangladesh.
... only 55% of the age data were available in the American sample,. Other demographic differences (e.g., education, SES), as well as variables associated in the literature with affective style (e.g., neurodevelopmental history, disease exposure history, social network richness, frontal EEG asymmetry, and exposure to weather phenomena) [67][68][69], might moderate our results. However, public health campaigns normally target audiences at the population level rather than the individual level, and as such, it would have been inappropriate to analyze individual differences in the current study. ...
Background
Cultural differences in affective and cognitive intrinsic motivation could pose challenges for global public health campaigns, which use cognitive or affective goals to evoke desired attitudes and proactive health-promoting actions. This study aimed to identify cross-cultural differences in affective and cognitive intrinsic motivation and discuss the potential value of this information for public health promotion.
Methods
A cross-sectional survey using cross-culturally validated need for affect (NFA) and need for cognition (NFC) scales was carried out among 1166 Chinese participants, and the results were compared with published data from 980 American participants. Additionally, we assessed a highly prevalent symbolic geriatric health condition, hearing loss, in 500 Chinese community-dwelling seniors. The Chinese NFA scale was developed following the translation-back translation procedure, and the psychometric evaluation was performed by applying confirmatory factor analysis (CFA), exploratory structural equation modeling (ESEM), correlation analysis and multigroup invariance test. MANOVA and Hedge’s g statistic were employed to compare the NFA and NFC levels between individuals from different countries and between Chinese seniors with and without hearing loss. The relation of early hearing intervention intention to NFA and NFC was also explored in the Chinese sample.
Results
A basic two-factor model of NFA adequately fit the sample data from Chinese and American cultures. The questionnaire demonstrated reasonable invariance of the factor structure and factor loadings across the groups. Those in the primary Chinese sample had lower NFA and NFC than their American peers. This difference held in the senior sample. Moreover, Chinese seniors with hearing loss had even lower NFA and NFC than those without hearing loss. Their early hearing intervention intention was low but was associated with intrinsic motivation.
Conclusions
The Need for Affect (NFA) construct may be generalized beyond its Western origins. There was a general lack of affective and cognitive intrinsic motivation in Chinese individuals, particularly in seniors with hearing loss, compared with their American peers. These differences point to a potential challenge in framing effective messages for some cultures in the geriatric public health domain. Ideally, recognizing and understanding this challenge will inspire the consideration of novel persuasive strategies for these audiences.
... Light has a powerful effect on mood. A sunny day often seems to enhance positive outlook and helping behavior (1,2), and it is well-established that bright light can be an effective treatment for mood disorders, with effects as potent as some pharmacologic treatments (3,4). Even a single halfhour exposure to bright light seems to improve mood (5). ...
Blue wavelength light has been used successfully as a treatment method for certain mood disorders, but, the underlying mechanisms behind the mood enhancing effects of light remain poorly understood. We investigated the effects of a single dose of 30 min of blue wavelength light (n = 17) vs. amber wavelength light (n = 12) exposure in a sample of healthy adults on subsequent resting-state functional and directed connectivity, and associations with changes in state affect. Individuals who received blue vs. amber wavelength light showed greater positive connectivity between the right amygdala and a region within the left dorsolateral prefrontal cortex (DLPFC). In addition, using granger causality, the findings showed that individuals who received blue wavelength light displayed greater bidirectional information flow between these two regions relative to amber light. Furthermore, the strength of amygdala-DLPFC functional connectivity was associated with greater decreases in negative mood for the blue, but not the amber light condition. Blue light exposure may positively influence mood by modulating greater information flow between the amygdala and the DLPFC, which may result in greater engagement of cognitive control strategies that are needed to perceive and regulate arousal and mood.
... Behavioral data suggest environmental factors such as climate or weather may impact human emotional states and health conditions. For example, it was demonstrated that emotional distress decreases when exposure to the sun increases [3] and during day-to-day weather variations (solar exposition, wind speed and air pressure influences self-reported life satisfaction [4] and low and high temperature levels, precipitation, humidity and cloud cover worsens the expression of feelings among social media users [5]. It was also demonstrated that environmental stressors-such as considerable increase in temperature or increased precipitation produced by climate change, especially during natural disasters-may cause mental, emotional and bodily stress among humans [6,7]. ...
The main goal of the study was to assess the relationship between affective temperaments and meteoropathy among women and examine meteorosensitivity as a mediator in this relationship. The issue of affective temperaments and meteoropathy has not been considered in the literature. The sample consisted of 450 Caucasian women gathered via the online recruitment platform. The participants’ ages ranged from 18 to 70 years (M = 30.01; SD = 9.10). The Polish version of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire was used to assess affective temperaments (depressive, cyclothymic, hyperthymic, irritable and anxious). Meteorosensitivity and meteoropathy were assessed using the Polish adaptation of the METEO-Q questionnaire. A large positive correlation was found between meteorosensitivity and meteoropathy. Medium positive correlations were found between meteorosensitivity/meteoropathy and cyclothymic and anxious temperaments. Small positive correlations were revealed between depressive and irritable temperaments and both meteorosensitivity and meteoropathy scales. No correlation was found between hyperthymic temperament and meteorosensitivity/meteoropathy. Mediation analyses indicated cyclothymic and anxious temperaments affected meteoropathy both directly and indirectly through meteorosensitivity as a mediator. The most severe meteoropathy symptoms in the studied sample were asthenia, an indefinite feeling of malaise and irritability. The results suggest affective temperaments may be related to meteoropathy symptoms in women.
... Likewise, differences between males and females have been suggested (Barrington-Leigh & Behzadnejad, 2017). In a study on students, Beecher and colleagues (Beecher et al., 2016) reported more mental health distress in students during periods of a short day length. O'Hare and colleagues (O'Hare, O'Sullivan, Flood, & Kenny, 2016) assessed a population sample of older adults and found that individual differences in reported depressive symptoms are less in those that live in areas with more hours of sunshine. ...
Several studies demonstrated effects of light on affect via projections from the retina of the eye to the circadian clock or via projections to areas involved in mood and reward. Few field studies investigated how naturally fluctuating light levels affect positive and negative mood in everyday life, but none addressed two key components of the reward system: wanting and liking. To elucidate diurnal profiles and immediate effects of dynamically changing light intensity in everyday life, subjective wanting and liking were assessed using experience sampling, while continuously monitoring environmental illuminance. Using a smartphone and light sensors, healthy volunteers (n = 27, 14 females, 23.7 ± 3.8 [M ± SD] years of age) were probed for 1 week, 9 times a day, to rate positive and negative mood, and 6 novel dedicated questions each on subjective liking and wanting. The multiband light spectrum was continuously recorded from sensors worn on the chest and intensities were averaged over the intervals between subsequent probes. Mixed effect models were used to evaluate how time of day and light intensity modulated subjective ratings. A total of 1,102 valid observations indicated that liking and wanting peaked around 6 p.m. and increased, respectively, by 13 ± 4% and 11 ± 4% across an individual’s range of experienced light intensities. More traditional mood questions were less sensitive to modulation by light intensity. Combined experience sampling and environmental monitoring opens up the possibility for field studies on light in disorders in which the reward system is highly relevant, like addiction, depression and insomnia.
... During the summer, however, higher temperatures exceeding comfort thresholds lead to more negative moods. Seasonal changes in hours of sunshine are found to account for relationships between weather and variability in mood (Beecher et al., 2016) with negative feelings of distress reported to increase during seasons with shorter hours. ...
This study examines the effects of season and weather on mood (valence and activation) and travel satisfaction (measured by the Satisfaction with Travel Scale). Analyses are presented of 562 time-sampled morning commutes to work made by 363 randomly sampled people in three different Swedish cities asking them to use smartphones to report their mood in their home before and directly after the commutes. These reports as well as satisfaction with the commute obtained in summer and winter are linked to weather data and analyzed by means of fixed-effects regression analyses. The results reveal main effects of weather (temperature and precipitation) on mood and travel satisfaction (temperature, sunshine, precipitation, and wind speed). The effects of weather on mood and travel satisfaction differ depending on travel mode. Temperature leads to a more positive mood, wind leads to higher activation for public transport users, and sunshine leads to a more negative mood for cyclists and pedestrians. Sunshine and higher temperatures make travel more relaxed although not for cycling and walking, and rain and snow lead to a higher cognitive assessed quality of travel.
Artificial intelligence has shown promise in diagnosing mental illness in young children, a challenging task given the rise in teenagers struggling with mental health. We focus on the capabilities of machine learning and natural language processing models to accurately recognize activities that affect mental health in pre-teens and adolescents, an important step towards improving symptoms of depression and anxiety. We achieved an accuracy of 86.7% for determining sentiment from child journal entries with LSTM and BERT and a MSE of 94.6 for predicting future mental health outcomes with neural networks. We develop an innovative solution of incorporating these models inside of a mobile application as a scalable framework for data collection to track shifts in overall user wellbeing.
To support resilience in contexts of migration, a deeper understanding of the experiences of both receiving communities and migrants is required. Research on the impacts of migration on community life is limited in contexts with high internal migration (i.e., migrating within one's country of origin). Evidence suggests that cultural similarity, community relationships, and access to resources may be protective factors that could be leveraged to support the mental health of internal migrants. The current study uses data drawn from a sample of pregnant Peruvian women ( N = 251), 87 of whom reported being internal migrants and 164 of whom reported being from the locale of the study (Lima, Perú). The aim was to better understand the social experience of internal migration for both local and migrant women. Inductive thematic analysis was used to examine migration experience and perceived impact of migration on community life. Internal migrants discussed three themes relative to their experiences: motivations, adjustment, and challenges. Experiences of women in receiving communities consisted of four themes related to migration: positive, negative, neutral, and mixed perceptions. Linguistic Inquiry and Word Count (LIWC-22) software was also used to assess sentiment towards migration. Across both analytic methods, migration motivations and perceptions were multifaceted and migrants reported a wide range of challenges before, during, and after migration. Findings indicated that attitudes toward migration are broadly positive, and that there is a more positive appraisal of migration's impact on the community life for internal as opposed to international migration.
As climate change exerts wide ranging health impacts, there is a surge of interest in the associations between climatic factors and mental and behavioral disorders (MBDs). Existing quantitative syntheses focus mainly on heat and high temperature exposure, neglecting the effects of other climatic factors and their synergies. The objective of this study is to conduct a systematic review and meta-analysis of the evidence of associations between climatic exposure and combined mental and behavioral health conditions and specific mental disorders (e.g., schizophrenia, dementia). A systematic search was conducted April 11-16, 2022 using Web of Science, Medline, ProQuest, EMBASE, PsycINFO, CINAHL, and Environment Complete. Screening and eligibility screening followed inclusion criteria based on population, exposure, comparator, and outcome guidelines. Risk of bias assessment was performed, a narrative synthesis was first presented for all studies, and random-effect meta-analyses were performed when at least three studies were available for a specific exposure-outcome pair. Certainty of evidence was evaluated following the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. The search process yielded 7696 initial results, from which we identified 88 studies to include in the review set. Climatic factors reported included air temperature, solar radiation/sunshine, barometric pressure, precipitation, relative humidity, wind direction/speed, and thermal comfort index. Outcomes included MBD incidences (e.g., schizophrenia, mood disorders, neurotic disorders), mental health-related mortality, and self-reported psychological states. Meta-analysis showed that heatwaves (pooled RR = 1.05, 95 % CI = 1.02-1.08) and extreme high temperatures (99th percentile: pooled RR = 1.18, 95 % CI = 1.08-1.29) were associated with higher risk of MBD. Cold extremes, however, were not associated with MBD risk. The findings further identified an association between increases in a thermal index (i.e., apparent temperature) and elevated risk of MBD (pooled RR = 1.06, 95 % CI = 1.03-1.12); specifically, a 99th percentile high temperature was associated with increased schizophrenia risk (pooled RR = 1.07, 95 % CI = 1.01-1.12). Risk of bias assessment showed most studies to have low or moderately low risks, while a few studies were rated probably high in confounding, selection bias, outcome measurement, and reporting bias. GRADE evaluation revealed moderate certainty of evidence on thermal comfort index and MBD, but low certainty related to air temperature or sunshine duration. These findings call attention to the heterogeneity of exposure measures and the utility of thermal indices that consider the synergistic effects of meteorological factors. Methodological concerns such as the linearity assumption and cumulative effects are discussed.
Rapid industrialization and urbanization trends have brought many challenges, one of the most acute of which is air pollution. Until recently, scholars have primarily focused on the toll that air pollution exacts through its health effects while ignoring air pollution's impact on consumer behavior. The scattered research in the recent year reveals that air pollution might influence consumers' decision-making process before, during, and after consumptions in both online and offline contexts. However, no research to our knowledge has reviewed the influence effect of air quality on consumer behaviors, which impedes the scholars and practitioners from acquiring knowledge from this emerging field. This informative review aims to collect and analyze the existing scattered research for air pollution effects on consumer decision-making behavior. This review illustrates that the impact of air pollution on consumer behavior is rather extensive, ranging from health risks to emotional changes, from changes in daily habits to individual and group consumption behaviors. We propose that future research can potentially explore the impact of air pollution on consumers' consumption experience and evaluation behavior and examine the differential impacts of air pollution on consumers' individual and group consumption decisions.
Under the background of climate change, the haze days in China have increased significantly, which seriously hinders the sustainable development of society and arouses wide attention from the public. However, the researches on the effect of air pollution on the stock yield of heavy pollution enterprise in key control cities are quite limited. Thus, this paper collects the AQI (air quality index) of key control cities (over prefecture-level) in China and the stock yields of listed heavy pollution enterprises in these cities from 2011 to 2016, and through multi-discontinuities regression model, testes the effect of air pollution on the stock yield of heavy pollution enterprise. The results show that: (1) severe air pollution (AQI = 300) has a significant negative influence on stock yield and the results are robust; (2) there is a time effect in the influence of air pollution on stock yield and the negative influence has become significant since 2013. This paper gives a brief discussion on the cause of it and suggests that severe air pollution should be strictly controlled. Only by facing air pollution seriously, can we eliminate air pollution with collective wisdom and concerted efforts and achieve the sustainable development of city. Being the first study to look into the effect of air pollution on stock yield in key control cities in China, this paper provides empirical reference for government supervision departments, stock investors as well as enterprises.
In urbanized settlements, ensuring access to the outdoor environment is essential to stimulate well-being responses indoors. Windows provide access to aesthetic and natural features and bring in clues about the time, weather, and seasonal conditions outdoors. Although dynamic environmental attributes are inherent outdoor view qualities, no studies have explored the effects induced by such dynamic conditions on individuals, limiting the extent to which these features might inform design guidelines for sustained indoor well-being. To address this gap, a virtual reality experiment was conducted to analyze subjective responses to lightness changes in outdoor views with respect to three view constructs (i.e., preference, recovery, and imageability). A novel framework for classifying, capturing, and analyzing urban views was extended to generate the view stimuli material consisting of dynamic and static scenes (i.e., panorama images and 360° videos). Attitudes toward dynamic and static views were tested with an adjusted rating instrument. Results showed significant interactions between view type and lightness change factors for the three view constructs presented in dynamic format. Mean scores for views presenting lightness variations were higher than those observed for identical scenes portraying no lightness variations. Low coefficients of variation for individual questions were found, suggesting the adequacy of the subjective instruments to evaluate dynamic views. Moderate to high positive Pearson correlation coefficients were found between three construct pairs, indicating links between the approaches to examine views. The findings in this study demonstrate that positive attitudes toward views are strongly mediated by the presence of luminous changes in these views.
Daily mood ratings and corresponding diary entries were studied to determine relations between common events and two independent mood factors—Positive Affect (PA) and Negative Affect (NA)—in a sample of 18 young adults over a 3-month period. In an extension of findings from earlier interindividual studies, PA (enthusiastic, delighted vs. sluggish, drowsy) was found to be associated with a wide range of daily events, whereas fewer correlations were found between these events and NA (distressed, nervous, angry vs. calm, relaxed). The relation between high PA and reported social interactions (particularly physically active social events) was especially robust, and its effects were noted repeatedly; NA was unrelated to social activity. As hypothesized, high NA was associated with physical problems; contrary to expectations, low PA also tended to be correlated with health complaints. Overall, the results reaffirm the importance of assessing NA and PA independently and suggest that PA is an interesting and important dimension that deserves more research attention. Theoretical considerations and clinical implications are discussed.
This paper seeks to analyze the influence of the weather on a person’s self-reported life satisfaction. On a theoretical level, it is claimed that ‘nice’ weather can improve the affective well-being of a person. Given this, it is argued that affects can, in turn, have an impact on that person’s general assessment of his or her life. In particular, it is expected that people would report a higher life satisfaction on days with unambiguously ‘nice’ weather. Data from three German large-scale surveys are used to test empirically to what extent self-reported life satisfaction is determined by the weather. All in all, the results are mostly consistent with the initial hypothesis. In all three samples those respondents surveyed on days with exceptionally sunny weather reported a higher life satisfaction compared to respondents interviewed on days with ‘ordinary’ weather. In two out of three samples, this difference was statistically significant. Hence, the supposed sunshine effect on peoples’ life satisfaction does indeed exist. Implications of these findings are discussed in a conclusion.
Although light therapy is effective in the treatment of seasonal affective disorder (SAD) and other mood disorders, only 53-79% of individuals with SAD meet remission criteria after light therapy. Perhaps more importantly, only 12-41% of individuals with SAD continue to use the treatment even after a previous winter of successful treatment.
Participants completed surveys regarding (1) social, cognitive, and behavioral variables used to evaluate treatment adherence for other health-related issues, expectations and credibility of light therapy, (2) a depression symptoms scale, and (3) self-reported light therapy use.
Individuals age 18 or older responded (n = 40), all reporting having been diagnosed with a mood disorder for which light therapy is indicated. Social support and self-efficacy scores were predictive of light therapy use (p's<.05).
The findings suggest that testing social support and self-efficacy in a diagnosed patient population may identify factors related to the decision to use light therapy. Treatments that impact social support and self-efficacy may improve treatment response to light therapy in SAD.
Brenner, Barry, David Cheng, Sunday Clark, and Carlos A. Camargo, Jr. Positive association between altitude and suicide in 2584 U.S.counties. High Alt. Med. Biol. 12: 31-35 2011.-Suicide is an important public health problem worldwide. Recent preliminary studies have reported a positive correlation between mean altitude and the suicide rate of the 48 contiguous U.S.states. Because intrastate altitude may have large variation, we examined all 2584 U.S. counties to evaluate whether an independent relationship between altitude and suicide exists. We hypothesized that counties at higher elevation would have higher suicide rates. This retrospective study examines 20 yr of county-specific mortality data from 1979 to 1998. County altitude was obtained from the U.S. Geologic Survey. Statistical analysis included Pearson correlation, t tests, and multivariable linear and logistic regression. Although there was a negative correlation between county altitude and all-cause mortality (r = -0.31, p < 0.001), there was a strong positive correlation between altitude and suicide rate (r = 0.50, p < 0.001). Mean altitude differed in the 50 counties, with the highest suicide rates compared to those with the lowest rates (4684 vs. 582 ft, p < 0.001). Controlling for percent of age >50 yr, percent male, percent white, median household income, and population density of each county, the higher-altitude counties had significantly higher suicide rates than the lower-altitude counties. Similar findings were observed for both firearm-related suicides (59% of suicides) and nonfirearm-related suicides. We conclude that altitude may be a novel risk factor for suicide in the contiguous United States.
The present study examines the effects of six weather parameters (temperature, wind power, sunlight, precipitation, air pressure, and photoperiod) on mood (positive affect, negative affect, and tiredness). Data were gathered from an online diary study (N = 1,233), linked to weather station data, and analyzed by means of multilevel analysis. Multivariate and univariate analyses enabled distinction between unique and shared effects. The results revealed main effects of temperature, wind power, and sunlight on negative affect. Sunlight had a main effect on tiredness and mediated the effects of precipitation and air pressure on tiredness. In terms of explained variance, however, the average effect of weather on mood was only small, though significant random variation was found across individuals, especially regarding the effect of photoperiod. However, these individual differences in weather sensitivity could not be explained by the Five Factor Model personality traits, gender, or age.
Background
This article aims to provide an introduction to emerging evidence and debate about the relationship between climate change and mental health.
Discussion and Conclusion
The authors argue that:
i) the direct impacts of climate change such as extreme weather events will have significant mental health implications;
ii) climate change is already impacting on the social, economic and environmental determinants of mental health with the most severe consequences being felt by disadvantaged communities and populations;
iii) understanding the full extent of the long term social and environmental challenges posed by climate change has the potential to create emotional distress and anxiety; and
iv) understanding the psycho-social implications of climate change is also an important starting point for informed action to prevent dangerous climate change at individual, community and societal levels.
In 1984, Jacobson, Follette, and Revenstorf defined clinically significant change as the extent to which therapy moves someone outside the range of the dysfunctional population or within the range of the functional population. In the present article, ways of operationalizing this definition are described, and examples are used to show how clients can be categorized on the basis of this definition. A reliable change index (RC) is also proposed to determine whether the magnitude of change for a given client is statistically reliable. The inclusion of the RC leads to a twofold criterion for clinically significant change.
N. S. Jacobson and P. Truax's (1991) method for evaluating the clinical significance of client change has gained some prominence in psychotherapy outcome research. However, little has been done to investigate the validity of this methodology. This study addresses this limitation by comparing (a) the perceived level of change (as subjectively reported from 3 distinct perspectives) across outcome groupings based on Jacobson and Truax's reliable change index (RCI) and (b) subjective reports of therapeutic alliance and satisfaction across outcome groupings. The results of these comparisons indicate that the RCI is effective in identifying those who make reliable improvement in therapy but is less effective in differentiating between no-changers and deteriorators. In addition, the relationship between treatment outcome and satisfaction with service is questioned.
The present study examined the effect of season of the year on depression and other moods. Previous work, primarily cross sectional or retrospective in design and involving clinically depressed or seasonally affective disordered samples, has suggested that mood changes as a function of season. However, the literature also shows conflicting and/or inconsistent findings about the extent and nature of this relationship. Importantly, these prior studies have not adequately answered the question of whether there is a seasonal effect in nondepressed people. The present study employed a longitudinal design and a large sample drawn from a normal population. The results, based on those participants for whom mood measures were collected in each season, demonstrated strong seasonal effects. Beck Depression Inventory (BDI) scores were highest in winter and lowest in summer. Ratings on scales of hostility, anger, irritability, and anxiety also showed very strong seasonal effects. Further analyses revealed that seasonal variation in BDI scores differed for females and males. Females had higher BDI scores that showed strong seasonal variation, whereas males had lower BDI scores that did not vary significantly across season of the year.
Clinically significant change refers to meaningful change in individual patient functioning during psychotherapy. Following the operational definition of clinically significant change offered by Jacobson, Follette, and Revenstorf (1984), several alternatives have been proposed because they were thought to be either more accurate or more sensitive to detecting meaningful change. In this study, we compared five methods using a sample of 386 outpatients who underwent treatment in routine clinical practice. Differences were found between methods, suggesting that the statistical method used to calculate clinical significance has an effect on estimates of meaningful change. The Jacobson method (Jacobson & Truax, 1991) provided a moderate estimate of treatment effects and was recommended for use in outcome studies and research on clinically significant change, but future research is needed to validate this statistical method.
Prior studies on the association between weather and psychological changes have produced mixed results. In part, this inconsistency may be because weather's psychological effects are moderated by two important factors: the season and time spent outside. In two correlational studies and an experiment manipulating participants' time outdoors (total N = 605), pleasant weather (higher temperature or barometric pressure) was related to higher mood, better memory, and "broadened" cognitive style during the spring as time spent outside increased. The same relationships between mood and weather were not observed during other times of year, and indeed hotter weather was associated with lower mood in the summer. These results are consistent with findings on seasonal affective disorder, and suggest that pleasant weather improves mood and broadens cognition in the spring because people have been deprived of such weather during the winter.
Light therapy and antidepressants have shown comparable efficacy in separate studies of seasonal affective disorder treatment, but few studies have directly compared the two treatments. This study compared the effectiveness of light therapy and an antidepressant within a single trial.
This double-blind, randomized, controlled trial was conducted in four Canadian centers over three winter seasons. Patients met DSM-IV criteria for major depressive disorder with a seasonal (winter) pattern and had scores > or = 23 on the 24-item Hamilton Depression Rating Scale. After a baseline observation week, eligible patients were randomly assigned to 8 weeks of double-blind treatment with either 1) 10,000-lux light treatment and a placebo capsule, or 2) 100-lux light treatment (placebo light) and fluoxetine, 20 mg/day. Light treatment was applied for 30 minutes/day in the morning with a fluorescent white-light box; placebo light boxes used neutral density filters.
A total of 96 patients were randomly assigned to a treatment condition. Intent-to-treat analysis showed overall improvement with time, with no differences between treatments. There were also no differences between the light and fluoxetine treatment groups in clinical response rates (67% for each group) or remission rates (50% and 54%, respectively). Post hoc testing found that light-treated patients had greater improvement at 1 week but not at other time points. Fluoxetine was associated with greater treatment-emergent adverse events (agitation, sleep disturbance, palpitations), but both treatments were generally well-tolerated with no differences in overall number of adverse effects.
Light treatment showed earlier response onset and lower rate of some adverse events relative to fluoxetine, but there were no other significant differences in outcome between light therapy and antidepressant medication. Although limited by lack of a double-placebo condition, this study supports the effectiveness and tolerability of both treatments for seasonal affective disorder and suggests that other clinical factors, including patient preference, should guide selection of first-line treatment.
Objective: Light therapy and antidepressants have shown comparable efficacy in separate studies of seasonal affective disorder treatment, but few studies have directly compared the two treatments. This study compared the effectiveness of light therapy and an antidepressant within a single trial. Method: This double-blind, randomized, controlled trial was conducted in four Canadian centers over three winter seasons. Patients met DSM-IV criteria for major depressive disorder with a seasonal (winter) pattern and had scores ≥23 on the 24-item Hamilton Depression Rating Scale. After a baseline observation week, eligible patients were randomly assigned to 8 weeks of double-blind treatment with either 1) 10,000-lux light treatment and a placebo capsule, or 2) 100-lux light treatment (placebo light) and fluoxetine, 20 mg/day. Light treatment was applied for 30 minutes/day in the morning with a fluorescent white-light box; placebo light boxes used neutral density filters. Results: A total of 96 patients were randomly assigned to a treatment condition. Intent-to-treat analysis showed overall improvement with time, with no differences between treatments. There were also no differences between the light and fluoxetine treatment groups in clinical response rates (67% for each group) or remission rates (50% and 54%, respectively). Post hoc testing found that light-treated patients had greater improvement at 1 week but not at other time points. Fluoxetine was associated with greater treatment-emergent adverse events (agitation, sleep disturbance, palpitations), but both treatments were generally well-tolerated with no differences in overall number of adverse effects. Conclusions: Light treatment showed earlier response onset and lower rate of some adverse events relative to fluoxetine, but there were no other significant differences in outcome between light therapy and antidepressant medication. Although limited by lack of a double-placebo condition, this study supports the effectiveness and tolerability of both treatments for seasonal affective disorder and suggests that other clinical factors, including patient preference, should guide selection of first-line treatment.
Seasonal affective disorder (SAD) is based on the theory that some depressions occur seasonally in response to reduced sunlight. SAD has attracted cultural and research attention for more than 30 years and influenced the DSM through inclusion of the seasonal variation modifier for the major depression diagnosis. This study was designed to determine if a seasonally related pattern of occurrence of major depression could be demonstrated in a population-based study. A cross-sectional U.S. survey of adults completed the Patient Health Questionnaire–8 Depression Scale. Regression models were used to determine if depression was related to measures of sunlight exposure. Depression was unrelated to latitude, season, or sunlight. Results do not support the validity of a seasonal modifier in major depression. The idea of seasonal depression may be strongly rooted in folk psychology, but it is not supported by objective data. Consideration should be given to discontinuing seasonal variation as a diagnostic modifier of major depression.
To assess the relationship between hours of sunlight and railway suicide attempts, 3-7 days before these attempts.
All railway suicide attempts causing railway suspensions or delays of 30min or more between 2002 and 2006. We used a linear probability model to assess this relationship. This study was conducted at Tokyo, Kanagawa, and Osaka prefectures in Japan. Data were collected from the railway delay incident database of the Japanese Railway Technical Research Institute and public weather database of the Japan Meteorological Agency.
About 971 railway suicides attempts occurred between 2002 and 2006 in Tokyo, Kanagawa, and Osaka. Less sunlight in the 7 days leading up to the railway suicide attempts was associated with a higher proportion of attempts (p=0.0243). Sunlight over the 3 days before an attempt had a similar trend (p=0.0888). No difference was found in sunlight hours between the days with (median: 5.6 [IQR: 1.1-8.8]) and without (median: 5.7 [IQR: 1.0-8.9]) railway suicide attempts in the evening. Finally, there was no apparent correlation between the railway suicide attempts and the monthly average sunlight hours of the attempted month or those of a month before.
Railway suicides were not the main suicidal methods in Japan, CONCLUSIONS: We observed an increased proportion of railway suicide attempts after several days without sunlight. Light exposure (blue light or bright white light) in trains may be useful in reducing railway suicides, especially when consecutive days without sunshine are forecasted.
The Outcome Questionnaire (OQ) was developed by Lambert and colleagues (1994) as a standardized measure for assessing psychotherapy outcome. Although the instrument is already being widely used in managed health care quality control, further evidence of its psychometric properties is needed. This research evaluated the concurrent and construct validity of the OQ with three patient samples and a sample of community participants. Support was found for the construct and concurrent validity of the OQ with both patients (n = 183) and nonpatients (n = 210). The data show significant differences in scores between patients and community samples, as well as differences between the various clinical samples with varying levels of pathology. Although high correlations between the OQ Total (and subscale) scores and the criterion measures were found, high intercorrelations among subscales suggest considerable shared variance between subscales. The OQ Total score appears promising as a measure of general psychological distress, although further research is needed to justify the interpretation of subscale scores in clinical settings.
The three distinct suicide cycles reported since the late 19th century have been explained using sociological and biological theories. Despite their obvious differences, both theories operate through motivation. Like other aspects of suicide, however, such cycles can also be explained by opportunity. Analysis of recent findings on age- and sex-specific suicide cycles illustrates a fundamental confound of motivation and opportunity, and underscores the need for a theory of suicide that is based on risk (risk = motivation x opportunity), and that is situated in a framework of age- and sex-specific life course contingencies.
The influence of weather on mood and mental health is commonly debated. Furthermore, studies concerning weather and suicidal behavior have given inconsistent results. Our aim was to see if daily weather changes associate with the number of suicide attempts in Finland. All suicide attempts treated in the hospitals in Helsinki, Finland, during two separate periods, 8 years apart, were included. Altogether, 3,945 suicide attempts were compared with daily weather parameters and analyzed with a Poisson regression. We found that daily atmospheric pressure correlated statistically significantly with the number of suicide attempts, and for men the correlation was negative. Taking into account the seasonal normal value during the period 1971-2000, daily temperature, global solar radiation and precipitation did not associate with the number of suicide attempts on a statistically significant level in our study. We concluded that daily atmospheric pressure may have an impact on suicidal behavior, especially on suicide attempts of men by violent methods (P < 0.001), and may explain the clustering of suicide attempts. Men seem to be more vulnerable to attempt suicide under low atmospheric pressure and women under high atmospheric pressure. We show only statistical correlations, which leaves the exact mechanisms of interaction between weather and suicidal behavior open. However, suicidal behavior should be assessed from the point of view of weather in addition to psychiatric and social aspects.
One of the most frequently investigated hypotheses of the pathophysiology underlying Seasonal Affective Disorder (SAD) is a disturbance of circadian rhythms. Since the circadian system as well as other non-visual effects is especially sensitive to blue light, a new light therapy device with blue enriched polychromatic light was tested for its efficacy to treat SAD.
Within one winter 52 patients were treated in one of three conditions: 30 min full spectrum light (9000 lx, 5000 K), 30 min blue-enriched light (9000 lx, 17,000 K), or 20 min blue-enriched light. The study lasted 22 days with 10 days of morning-light treatment on weekdays during the first 2 weeks.
Depressive symptoms (SIGH SAD) diminished over the 3-week period in all conditions, with no significant differences between conditions. The percentage responders were high, differing from 75%, 59% and 71% for the standard-LT, 30 min blue-enriched-LT, and 20 min blue-enriched-LT, respectively.
The lack of superiority of high intensity blue-enriched light over standard bright light treatment does not clearly support nor rule out the possibility of an important role for the circadian system or the blue sensitive non-visual image forming system in general, in the pathophysiology of SAD. The lack of a difference between conditions may also be the result of a saturated response to the high light intensities used. Recent data indeed suggest that low intensity blue-enriched light may be as effective as standard bright light treatment. The possibility of improving light therapy for SAD patients by applying light of shorter duration or at lower light intensities is highly relevant for optimizing treatment and will help to clarify the role of the circadian system and/or the non-image forming photoreceptors in SAD pathophysiology.
https://register.clinicaltrials.gov: NCT01048294.
It is a common and well-spread belief that people feel more depressed when the weather is bad. However, whether meteorological factors such as temperature, sunshine and rainfall can actually account for variations in the prevalence of depression in the general population has yet to be investigated. We aimed to assess the influence of weather conditions on the seasonal variation of depression observed in the general population. We used data from a large-scale depression-screening programme in the south of the Netherlands. Seasonal prevalence of DSM-IV classified major depression and sad mood in a sample of 14,478 participants from the general population was calculated, and linked to mean daily temperature, duration of sunshine and duration of rainfall in logistic regression analyses. The prevalence of major depression and sad mood showed seasonal variation, with peaks in the summer and fall. Weather conditions were not associated with mood, and did not explain the seasonal variation we found. We conclude that, contrary to popular belief, weather conditions and sad mood or depression do not seem to be associated. Future studies might use daily measures of well-being as outcome.
Daily mood ratings and corresponding diary entries were studied to determine relations between common events and two independent mood factors--Positive Affect (PA) and Negative Affect (NA)--in a sample of 18 young adults over a 3-month period. In an extension of findings from earlier interindividual studies, PA (enthusiastic, delighted vs. sluggish, drowsy) was found to be associated with a wide range of daily events, whereas fewer correlations were found between these events and NA (distressed, nervous, angry vs. calm, relaxed). The relation between high PA and reported social interactions (particularly physically active social events) was especially robust, and its effects were noted repeatedly; NA was unrelated to social activity. As hypothesized, high NA was associated with physical problems; contrary to expectations, low PA also tended to be correlated with health complaints. Overall, the results reaffirm the importance of assessing NA and PA independently and suggest that PA is an interesting and important dimension that deserves more research attention. Theoretical considerations and clinical implications are discussed.
Seasonal affective disorder (SAD) is a depressive disorder which occurs during the winter and remits in the spring and summer. It differs from non-seasonal depression in its seasonal variation and in the presence of neurovegetative symptoms such as increased appetite and hypersomnia. This review is aimed at clinical practitioners and presents a detailed description of the syndrome before discussing the assessment of SAD and the current treatment of choice of phototherapy. Particular attention is paid to the impotant issue of differential diagnosis during assessment and the practicalities involved in the administration of light therapy during treatment.
The amended (revised) Beck Depression Inventory (BDI-IA; Beck & Steer, 1993b) and the Beck Depression Inventory-II (BDI-II; Beck, Steer, & Brown, 1996) were self-administered to 140 psychiatric outpatients with various psychiatric disorders. The coefficient alphas of the BDI-IA and the BDI-II were, respectively, .89 and .91. The mean rating for Sadness on the BDI-IA was higher than it was on the BDI-II, but the mean ratings for Past Failure, Self-Dislike, Change in Sleeping Pattern, and Change in Appetite were higher on the BDI-II than they were on the BDI-IA. The mean BDI-II total score was approximately 2 points higher than it was for the BDI-IA, and the outpatients also endorsed approximately one more symptom on the BDI-II than they did on the BDI-IA. The correlations of BDI-IA and BDI-II total scores with sex, ethnicity, age, the diagnosis of a mood disorder, and the Beck Anxiety Inventory (Beck & Steer, 1993a) were within 1 point of each other for the same variables.
Although several investigators have described a milder form of seasonal affective disorder (SAD), called subsyndromal SAD, little is known about the effect of light therapy in this group. The current study evaluates 3 weeks of open treatment with light therapy in SAD and subsyndromal SAD patients.
Subjects with major or minor depression according to DSM-IV with a seasonal pattern were recruited during the winter of 1998-1999 from clinic patients and media advertising. Subjects were commenced on open treatment of morning light therapy, for 30 min daily using a new fluorescent light therapy unit that produced approximately 5,000 lux at a distance of 12 inches. The treatment lasted 3 weeks and at the end of the first and second week of treatment the duration of exposure could be increased to a maximum of 60 min at the discretion of the clinician. The Structured Interview Guide for the Hamilton Depression Rating Scale-SAD version (SIGH-SAD) was administered weekly to evaluate outcome. Response was defined in a variety of ways to reflect the fact that subsyndromal SAD subjects had milder symptoms.
Forty-six subjects entered treatment and 44 (SAD, n = 29, subsyndromal SAD, n = 15) completed at least 2 weeks. Response rates were generally similar in SAD subjects (64-69%) and subsyndromal SAD (40-67%) patients. There was a trend for longer exposure to be associated with better outcome.
Light therapy may be an effective treatment for subjects with both major and minor depression with a seasonal pattern. Optimal duration, for the light therapy unit used in this study, is likely 45-60 min daily.
To review the available literature on the association between daily and longer-term weather data and the incidence of attempted and completed suicide.
A computerized search supplemented by a cross-check of the references sections of the thereby identified papers was performed.
A total of 27 studies looking for a relationship between attempted or completed suicide and weather or climate data were found. Most of the papers reported a statistical association of suicidal acts with at least one weather factor. However, the results are not conclusive and in part contradictory.
Possibly due to the high variance in methodological approaches of the studies it is not possible to identify a specific weather condition associated with a generally higher risk for suicide. Weather and seasonal effects may interact with each other. Environmental effects on brain function and weather-related interactions of people may be involved in the occurrence of suicidal behaviour.
Seasonal Affective Disorder (SAD) is characterised by lowered mood and atypical depressive symptoms such as hypersomnia, weight gain and fatigue. These symptoms seem associated with hypothyroidism, but the results of evaluations of the thyroid function in SAD patients have been conflicting, most likely due to the very small number of observations.
In total, 83 patients fulfilling the DSM-III-R criteria for SAD were treated with bright light for 1 week in an open trial. Thyroid function was evaluated by TSH (thyroid-stimulating hormone), T(4) (thyroxine) and T(3) (triiodthyronine) levels at baseline and after 1 week of bright light treatment.
The response rate in terms of a 50% reduction of pre-treatment scores on the Hamilton Depressions Rating Scale (HAM-D(17)) was 61%. The TSH levels in all 83 patients decreased significantly from 1.57 at baseline to 1.30 at endpoint. In the group of responders (n=52) the TSH levels decreased significantly from 1.71 to 1.37, while in the group of non-responders (n=31) the decrease in TSH levels was not statistically significant.
During 1 week of bright light therapy the TSH levels in SAD patients were reduced, with the highest reduction in the group of patients responding to light therapy.
To compare perceived quality of life (QoL) in patients diagnosed with seasonal affective disorder (SAD) during the winter and summer months.
Twenty-six patients who were enrolled in an ongoing multicentre study in Canada completed 2 measures of QoL (the 20-item Medical Outcomes Study Short-Form General Health Survey [SF-20] and the Quality of Life Enjoyment and Satisfaction Questionnaire, [Q-LES-Q]) during the winter, when suffering from depression, and again during the summer months.
Both general and health-related QoL scores were significantly improved in patients with SAD during the summer months, with scores for the most part falling within normal range.
Perceived QoL in patients with SAD is markedly impaired during the winter months but shows a substantial rebound during the summer months. The findings of this study provide further evidence that SAD is a distinct diagnostic entity.
The most common way to provide bright light therapy to Swedish patients with Seasonal Affective Disorder (SAD), is treatment in a light therapy room. Since few studies have evaluated treatment provided in this setting and few have evaluated the effect of bright light in sub-clinical SAD (S-SAD), such a study including a one-month follow-up was designed.
Fifty adults recruited from a previous prevalence study and clinically assessed as having SAD or S-SAD, were randomised to treatment in a light room or to a three-week waiting-list control group. The Hamilton Depression Rating Scale-Seasonal Affective Disorders Self-rating 29-items Version (SIGH-SAD/SR) was used to measure depressive mood at baseline, directly following treatment and at the one-month follow-up.
ANCOVA with adjustment for baseline depression score, showed a significant main effect for the light room therapy group (p<0.001). Fifty-four percent (n=13/24) improved > or = 50% while no such improvement was seen in the control condition (n=0/24). After merging the two groups, repeated measures ANOVA confirmed the experimental analysis (p<0.001). At the one-month follow-up, 83.0% (n=39/47) had improved > or = 50% and 63.8% (n=30/47) had normal depression scores, i.e. < or = 8.
Light room therapy was effective in reducing depressive symptoms in subjects with winter depressive mood. Results were maintained over a period of one month.
Administration and Scoring Manual for the OQ-45.2 (Outcome Questionnaire)
- M J Lambert
- J J Morton
- D R Hatfield
- C Harmon
- E G Hamilton
- R C Reid
Sperling's Best Places
- B Sperling