reviews

摘要

I recall diagnosing seasonal affective disorder (SAD) in only one patient in eight years of practice as a consultant in general adult psychiatry in Britain. Have I failed to diagnose a common psychiatric disorder? Is my NHS trust failing people with SAD by not owning a light box for them to use? Is SAD an example of psychiatrists manufacturing a diagnosis out of normal human misery? Is it a product of modern living conditions where possibly people do not spend much time outdoors in natural sunlight?Should people with SAD be prescribed a winter holiday in the sun?As a sceptic-like the World Health Organization, which does not yet recognise SAD as a distinct mental disorder-I was pleased that the book critically reviews the validity of the syndrome, its treatment, and underlying aetiology. SAD may have three unique features: a distinct prognosis (winter SAD worse in autumn/winter and better in summer); a specific response to bright light treatment; and a psychiatric disorder with a clear identifiable cause (change in seasons and lack of exposure to daylight in winter SAD) and definable biological basis. The validity of SAD depends on how much one believes the evidence for these three unique features. This book clearly presents the evidence in great detail from clinical, methodological, and basic science perspectives.