The symptoms of recurrent brief depression, which was first described by Angst, (21) are similar to those of major depression (Table 1) with regard to both number and severity. However, they do not meet the requirement that an episode should last for 2 weeks or more. The diagnosis of recurrent brief depression has not been adopted fully in DSM-IV, but it is included in ICD-10. It should be distinguished from recurrent suicidal behaviour, for example in patients with borderline personality disorder.
Reccurrent brief depression occurs in some patients with Parkinson's disease. In contrast, post-stroke depression is similar to major depression. (22) Seasonal depression
Seasonal depression is seen most frequently in winter, and less frequently in summer. In DSM-IV, seasonal depression has been adopted as a specifier (rather than a diagnostic category) which can be applied not only to recurrent depression but also to bipolar disorder. The seasonal episodes (e.g. winter depression) have to outnumber any non-seasonal depressive episodes in the same patient. In ICD-10 only seasonal depression is briefly mentioned, and that in an annex for disorders under consideration.
According to DSM-IV, the symptoms of seasonal depression are similar to those of major depression. However, Kasper and Rosenthal(23) repeated that the symptoms differ from those of major depression, with hypersomnia, overeating, carbohydrate craving, and weight gain.
In a meta-analysis of 61 studies of seasonal patterns of suicide, Goodwin and Jamison (!8) showed that suicide is 10 to 20 times more common in spring (with a peak in May) than in winter or summer. There was also a small peak in October. This pattern is consistent with the peak times of hospital admission for depressive episodes. These findings support the view(23) that seasonal winter depression is an atypical type of major depression.
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