Lack of association between seasonality and psychopathology in psychiatric outpatients

There exists an extensive literature documenting the impact of seasonality on rates of depression, atypical depression, bulimia, and suicide. In the present report drawn from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we reviewed the results of 1500 diagnostic evaluations of patients who presented to our psychiatric outpatient practice between 1995 and 2001. We sought to determine whether seasonal fluctuations in psychopathology were discernible at the level of how patients present for psychiatric treatment. Contrary to our hypotheses, we did not find (1) higher rates of onset of major depressive disorder in the spring and fall, (2) higher rates of depressive symptoms or rates of atypical depression in the winter, (3) higher rates of bulimia in the winter, or (4) higher rates of suicidal ideation in the spring. We conclude from these results that the association between seasonality and psychopathology may not be discernible at the level of presentations to an outpatient psychiatric practice.