Seasonal aective disorder in an Arctic community Introduction Seasonal aective disorder (SAD), as ®rst des- cribed by Rosenthal in 1984 (1), has gained increasing attention in the past two decades. Rates of SAD or subsyndromal SAD (SSAD) have been closely linked with increasing winter darkness and latitude (2±7). Elevated rates of seasonality at higher latitudes have been reported in both the northern and southern hemispheres (6, 8, 9). In contrast, other studies including those of Norwegians, Icelanders, and their Canadian descendants found the frequency of SAD at higher latitudes had not increased as predicted but was comparable with rates of the continental United States (9±15). Mersch and others found weak correlation of SAD to latitude in pooled data from European and North American studies (16, 17). A study of Finns and Lapps did not ®nd a dierence between those Finns in the north compared with the southern regions. Lapps who have resided in the more northern Lapland for generations, showed lower rates of SAD than Finns living at similar and more southern latitudes (18). In a recent review, Magnusson likewise concludes the latitude eect is small (19). Other factors such as climate, genetic vulnerability, and socio-cultural factors were proposed as important determinants of SAD. A review of available studies on the prevalence of SAD reveals two approaches to utilizing ques- tionnaires to determine rates. Investigators have most commonly used the Seasonal Pattern Assess- ment Questionnaire (SPAQ) alone (1, 3, 20±22). The SPAQ (23) had been the survey instrument most frequently used to determine prevalence of SAD. Others consider the SPAQ to be limited because of its inability to determine the presence of a major depressive episode (15, 16, 24, 25). A second method utilizes the SPAQ paired with other instruments that determine the presence of a depressive disorder (6, 26±28). Depression scales have included the Hamilton Depression Scale, Centre for Epidemiological Studies Scale for Depression (CES-D), and the Zung Depression Scale or DSM-based structured interviews (6, 7, 26±28). Palinkas found high rates of SSAD (28.4%) in healthy non-aboriginal 1-year visitors in Antarctica using the SPAQ and Ham- ilton Depression Scale but found only one case of SAD in the 70 subjects evaluated (7). Several studies combined the SPAQ and the CES-D to ®nd Haggarty JM, Cernovsky Z, Husni M, Minor K, Kermeen P, Merskey H. Seasonal aective disorder in an arctic community. Acta Psychiatr Scand 2002: 105: 378±384. ã Blackwell Munksgaard 2002. Objective: To determine the rate of seasonal-pattern depression in an Inuit community above 70°N. Method: One-hundred and eleven people from randomly selected households were surveyed for depression and anxiety and the eect of the seasons on their mood. Eighty-eight people provided replies on the in¯uence of the seasons. Results: One in ®ve (22.6%) of the community sample was found to be depressed. Of these, seven (6.3%) had seasonal aective disorder (SAD), with fall onset occurring in six of these (5.4%). Subsyndromal SAD (SSAD) occurred in 11.7%, while any eect of the seasons (seasonality) occurred in 39.6%. Persons with SSAD and seasonality were signi®cantly older than those unaected by the seasonal eect. No other signi®cant correlation of SAD, SSAD, or seasonality occurred with gender, age, and language preference. Conclusion: Seasonal mood changes in this Inuit group living in the Canadian Arctic are elevated above the rates found in other studies using similar survey methods. J. M. Haggarty 1 , Z. Cernovsky 1 , M. Husni 2 , K. Minor 3 , P. Kermeen 4 , H. Merskey 1 1 Department of Psychiatry, University of Western Ontario, London, Ontario, Canada, 2 Northwick Park Hospital, Harrow, UK, 3 Regina Beach, Saskatchewan, Canada and 4 Former C.E.O. Baffin Regional Health Board, Canada Key words: seasonality; mood; epidemiology; Arctic; Inuit Dr J. Haggarty, Lakehead Psychiatric Hospital, Thunder Bay, Ontario, Canada P7B 5G4 E-mail: jhaggart@uwo.ca Accepted for publication 8 November, 2001 Acta Psychiatr Scand 2002: 105: 378±384 Printed in UK. All rights reserved Copyright ã Blackwell Munksgaard 2002 ACTA PSYCHIATRICA SCANDINAVICA ISSN 0001-690X 378