This refers to a sub specifier under Depressive Disorders. The specifier “with seasonal pattern” can be applied to the pattern of major depressive episodes within the diagnosis major depressive disorder, recurrent.

The essential feature is the onset and remission of major depressive episodes at characteristic times of the year. Formerly known (DSM-IV) as Seasonal Affective Disorder (SAD), in most cases, the episodes begin in fall or winter and remit in spring. Less commonly, there may be recurrent summer depressive episodes.

This pattern of onset and remission of episodes must have occurred during at least a 2-year period, without any nonseasonal episodes occurring during this period. In addition, the seasonal depressive episodes must substantially outnumber any nonseasonal depressive episodes over the individual’s lifetime.

This specifier does not apply to those situations in which the pattern is better explained by seasonally linked psychosocial stressors (e.g., seasonal unemployment or school schedule).

Major depressive episodes that occur in a seasonal pattern are often characterized by:

  • Prominent energy
  • Hypersomnia
  • Overeating
  • Weight gain
  • Craving carbohydrates

It is unclear whether a seasonal pattern is more likely in recurrent major depressive disorder or in bipolar disorders. The prevalence of winter-type seasonal pattern appears to vary with latitude, age, and sex.

Prevalence increases with higher latitudes.

Age is also a strong predictor of seasonality, with younger persons at higher risk for winter depressive episodes.

This entry has been adapted for DSM-5.