Yonsei Med J.  2016 May;57(3):784-789. 10.3349/ymj.2016.57.3.784.

Potential Relationship between Season of Birth and Clinical Characteristics in Major Depressive Disorder in Koreans: Results from the CRESCEND Study

Affiliations
  • 1Department of Psychiatry, Inje University Haeundae Paik Hospital, Busan, Korea.
  • 2Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, Korea.
  • 3Department of Psychiatry, Yeungnam University School of Medicine, Daegu, Korea.
  • 4Department of Psychiatry, Chonnam National University School of Medicine, Gwangju, Korea.
  • 5Department of Psychiatry, The Catholic University of Korea College of Medicine, Seoul, Korea.
  • 6Department of Psychiatry, Korea University College of Medicine, Seoul, Korea.
  • 7Department of Psychiatry, Keimyung University School of Medicine, Daegu, Korea.
  • 8Department of Preventive Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
  • 9Department of Psychiatry, Hanyang University Guri Hospital, Guri, Korea. hypyc@hanyang.ac.kr

Abstract

We aimed to examine the potential relationship between season of birth (SOB) and clinical characteristics in Korean patients with unipolar non-psychotic major depressive disorder (MDD). Using data from the Clinical Research Center for Depression (CRESCEND) study in South Korea, 891 MDD patients were divided into two groups, those born in spring/summer (n=457) and those born in autumn/winter (n=434). Measurement tools comprising the Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Brief Psychiatric Rating Scale, Scale for Suicidal Ideation, Clinical Global Impression of severity, Social and Occupation Functional Assessment Scale, WHO Quality of Life assessment instrument-abbreviated version, Alcohol Use Disorder Identification Test, and Temperament and Character Inventory were used to evaluate depression, anxiety, overall symptoms, suicidal ideation, global severity, social function, quality of life, drinking, and temperament and character, respectively. Using independent t-tests for continuous variables and χ2 tests for discrete variables, the clinical characteristics of the two groups were compared. MDD patients born in spring/summer were on average younger at onset of first depressive episode (t=2.084, p=0.038), had greater loss of concentration (χ2=4.589, p=0.032), and were more self-directed (t=2.256, p=0.025) than those born in autumn/winter. Clinically, there was a trend for the MDD patients born in spring/summer to display the contradictory characteristics of more severe clinical course and less illness burden; this may have been partly due to a paradoxical effect of the 5-HT system.

Keyword

Season of birth (SOB); major depressive disorder (MDD); age at onset; diminished concentration; self-directedness

MeSH Terms

Adult
Age of Onset
Aged
Alcohol Drinking
Bipolar Disorder/*diagnosis/*ethnology/psychology
Character
Cost of Illness
Depression
Depressive Disorder, Major/*diagnosis/*ethnology/psychology
Female
Humans
Male
Middle Aged
Personality Inventory/statistics & numerical data
*Quality of Life
Republic of Korea/epidemiology
*Seasons
Temperament

Figure

  • Fig. 1 Distribution of the study subject by month of birth, n (%).


Reference

1. Eisenberg DT, Campbell B, Mackillop J, Lum JK, Wilson DS. Season of birth and dopamine receptor gene associations with impulsivity, sensation seeking and reproductive behaviors. PLoS One. 2007; 2:e1216.
Article
2. Döme P, Kapitány B, Ignits G, Rihmer Z. Season of birth is significantly associated with the risk of completed suicide. Biol Psychiatry. 2010; 68:148–155.
Article
3. Gonda X, Fountoulakis KN, Csukly G, Dome P, Sarchiapone M, Laszik A, et al. Star-crossed? The association of the 5-HTTLPR s allele with season of birth in a healthy female population, and possible consequences for temperament, depression and suicide. J Affect Disord. 2012; 143:75–83.
Article
4. Antonsen JH, Gonda X, Dome P, Rihmer Z. Associations between season of birth and suicide: a brief review. Neuropsychopharmacol Hung. 2012; 14:177–187.
5. Davies G, Welham J, Chant D, Torrey EF, McGrath J. A systematic review and meta-analysis of Northern Hemisphere season of birth studies in schizophrenia. Schizophr Bull. 2003; 29:587–593.
Article
6. Soreca I, Cheng Y, Frank E, Fagiolini A, Kupfer DJ. Season of birth is associated with adult body mass index in patients with bipolar disorder. Chronobiol Int. 2013; 30:577–582.
Article
7. Cheng C, Lin CH, Chou PH, Tsai CJ, Lan TH, Nestadt G. Season of birth in obsessive-compulsive disorder. Depress Anxiety. 2014; 31:972–978.
Article
8. Winje E, Willoughby K, Lask B. Season of birth bias in eating disorders--fact or fiction? Int J Eat Disord. 2008; 41:479–490.
Article
9. Tonetti L, Fabbri M, Natale V. Season of birth and personality in healthy young adults. Neurosci Lett. 2009; 452:185–188.
Article
10. Riala K, Hakko H, Taanila A, Räsänen P. Season of birth and smoking: findings from the Northern Finland 1966 Birth Cohort. Chronobiol Int. 2009; 26:1660–1672.
Article
11. Park SC, Hahn SW, Hwang TY, Kim JM, Jun TY, Lee MS, et al. Does age at onset of first major depressive episode indicate the subtype of major depressive disorder?: the clinical research center for depression study. Yonsei Med J. 2014; 55:1712–1720.
Article
12. Seok JH, Lee KU, Kim W, Lee SH, Kang EH, Ham BJ, et al. Impact of early-life stress and resilience on patients with major depressive disorder. Yonsei Med J. 2012; 53:1093–1098.
Article
13. Whiteford HA, Degenhardt L, Rehm J, Baxter AJ, Ferrari AJ, Erskine HE, et al. Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. Lancet. 2013; 382:1575–1586.
Article
14. Park SC, Shinfuku N, Maramis MM, Lee MS, Park YC. Adjunctive Antipsychotic Prescriptions for Outpatients with Depressive Disorders in Asia: The Research on Asian Psychotropic Prescription Patterns for Antidepressants (REAP-AD) Study. Am J Psychiatry. 2015; 172:684–685.
Article
15. Kendler KS, Kessler RC, Walters EE, MacLean C, Neale MC, Heath AC, et al. Stressful life events, genetic liability, and onset of an episode of major depression in women. Am J Psychiatry. 1995; 152:833–842.
Article
16. Fountoulakis KN, Iacovides A, Karamouzis M, Kaprinis GS, Ierodiakonou C. Season of birth, clinical manifestations and Dexamethasone Suppression Test in unipolar major depression. Ann Gen Psychiatry. 2007; 6:20.
Article
17. Castrogiovanni P, Iapichino S, Pacchierotti C, Pieraccini F. Season of birth in psychiatry. A review. Neuropsychobiology. 1998; 37:175–181.
18. Pjrek E, Winkler D, Heiden A, Praschak-Rieder N, Willeit M, Konstantinidis A, et al. Seasonality of birth in seasonal affective disorder. J Clin Psychiatry. 2004; 65:1389–1393.
Article
19. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Press;1994.
20. First MB, Spitzer RL, Gibbon M, Wiliams JB. Structured Clinical Interview for DSM-IV Axis I Disorders - Patient Edition. New York: Biometrics Research Department, New York State Psychiatric Institute;1995.
21. Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960; 23:56–62.
Article
22. Zimmerman M, Martinez JH, Young D, Chelminski I, Dalrymple K. Severity classification on the Hamilton Depression Rating Scale. J Affect Disord. 2013; 150:384–388.
Article
23. Hamilton M. The assessment of anxiety states by rating. Br J Med Psychol. 1959; 32:50–55.
Article
24. Overall JE, Gorham DR. The brief psychiatric rating scale. Psychol Rep. 1962; 10:779–812.
Article
25. Beck AT, Kovacs M, Weissman A. Assessment of suicidal intention: the Scale for Suicide Ideation. J Consult Clin Psychol. 1979; 47:343–352.
Article
26. Guy W. Early Clinical Drug Evaluation Unit (ECDEU) Assessment Manual for Psychopharmacology. Washington, DC: US Department of Health, Education, and Welfare publication, National Institute of Mental Health;1976.
27. Goldman HH, Skodol AE, Lave TR. Revising axis V for DSM-IV: a review of measures of social functioning. Am J Psychiatry. 1992; 149:1148–1156.
Article
28. Development of the World Health Organization WHOQOL-BREF quality of life assessment. The WHOQOL Group. Psychol Med. 1998; 28:551–558.
29. Conigrave KM, Hall WD, Saunders JB. The AUDIT questionnaire: choosing a cut-off score. Alcohol Use Disorder Identification Test. Addiction. 1995; 90:1349–1356.
30. Cloninger CR, Svrakic DM, Przybeck TR. A psychobiological model of temperament and character. Arch Gen Psychiatry. 1993; 50:975–990.
Article
31. Min SK, Lee CI, Kim KI, Suh SY, Kim DK. Development of Korean version of WHO Quality of Life Scale Abbreviated Version (WHOQOL-BREF). J Korean Neuropsychiatr Assoc. 2000; 39:571–579.
32. Sung SM, Kim JH, Yang E, Abrams KY, Lyoo IK. Reliability and validity of the Korean version of the Temperament and Character Inventory. Compr Psychiatry. 2002; 43:235–243.
Article
33. Kim JM, Stewart R, Glozier N, Prince M, Kim SW, Yang SJ, et al. Physical health, depression and cognitive function as correlates of disability in an older Korean population. Int J Geriatr Psychiatry. 2005; 20:160–167.
Article
34. Yi JS, Bae SO, Ahn YM, Park DB, Noh KS, Shin HK, et al. Validity and reliability of the Korean version of the Hamilton Depression Rating Scale (K-HDRS). J Korean Neuropsychiatr Assoc. 2005; 44:456–465.
35. Lee JY, Cho MJ, Kwon JS. Global assessment of functioning scale and social and occupational functioning scale. Korean J Psychopharmacol. 2006; 17:122–127.
36. Lee HS, Kuwn JH. Validation for the Beck Scale for Suicide Ideation with Korean university students. Korean J Clin Psychol. 2009; 28:1155–1172.
Article
37. Joe KH, Chai SH, Park A, Lee HK, Shim IH, Min SH. Optimum cutoff score for screening of hazardous drinking using the Korean version of alcohol use disorder identification test (AUDIT-K). J Korean Acad Addict Psychiatry. 2009; 13:34–40.
38. Muhonen LH, Lönnqvist J, Lahti J, Alho H. Age at onset of first depressive episode as a predictor for escitalopram treatment of major depression comorbid with alcohol dependence. Psychiatry Res. 2009; 167:115–122.
Article
39. Yang F, Li Y, Xie D, Shao C, Ren J, Wu W, et al. Age at onset of major depressive disorder in Han Chinese women: relationship with clinical features and family history. J Affect Disord. 2011; 135:89–94.
Article
40. Zisook S, Lesser I, Stewart JW, Wisniewski SR, Balasubramani GK, Fava M, et al. Effect of age at onset on the course of major depressive disorder. Am J Psychiatry. 2007; 164:1539–1546.
Article
41. Zhu T, De Luca V, Gallaugher LA, Woldeyohannes HO, Soczynska JK, Szymkowicz S, et al. Admixture analysis of age at onset in major depressive disorder. Gen Hosp Psychiatry. 2012; 34:686–691.
Article
42. Korten NC, Comijs HC, Lamers F, Penninx BW. Early and late onset depression in young and middle aged adults: differential symptomatology, characteristics and risk factors? J Affect Disord. 2012; 138:259–267.
Article
43. Bi B, Xiao X, Zhang H, Gao J, Tao M, Niu H, et al. A comparison of the clinical characteristics of women with recurrent major depression with and without suicidal symptomatology. Psychol Med. 2012; 42:2591–2598.
Article
44. Wang YY, Chang YH, Lee SY, Huang CC, Lee IH, Yeh TL, et al. Symptomatological and cognitive correlates of vascular comorbidity in older-elderly (at least 75 years old) men with major depressive disorder. Kaohsiung J Med Sci. 2012; 28:607–612.
Article
45. Asano T, Baba H, Kawano R, Takei H, Maeshima H, Takahashi Y, et al. Temperament and character as predictors of recurrence in remitted patients with major depression: a 4-year prospective follow-up study. Psychiatry Res. 2015; 225:322–325.
Article
46. Rosenström T, Jylhä P, Robert Cloninger C, Hintsanen M, Elovainio M, Mantere O, et al. Temperament and character traits predict future burden of depression. J Affect Disord. 2014; 158:139–147.
Article
47. Josefsson K, Merjonen P, Jokela M, Pulkki-Råback L, Keltikangas-Järvinen L. Personality Profiles Identify Depressive Symptoms over Ten Years? A Population-Based Study. Depress Res Treat. 2011; 2011:431314.
Article
48. Watanabe SY, Iga J, Numata S, Umehara H, Nishi A, Kinoshita M, et al. Polymorphism in the promoter of the gene for the serotonin transporter affects the age of onset of major depressive disorder in the Japanese population. J Affect Disord. 2015; 183:156–158.
Article
49. Gonda X, Fountoulakis KN, Juhasz G, Rihmer Z, Lazary J, Laszik A, et al. Association of the s allele of the 5-HTTLPR with neuroticism-related traits and temperaments in a psychiatrically healthy population. Eur Arch Psychiatry Clin Neurosci. 2009; 259:106–113.
Article
50. Deakin JF. Depression and antisocial personality disorder: two contrasting disorders of 5HT function. J Neural Transm Suppl. 2003; (64):79–93.
Article
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