An Umbrella Systematic Review of Seasonality in Mood Disorders and Suicide Risk: The Impact on Demand for Primary Behavioral Health Care and Acute Psychiatric Services.
Level 2 - randomized trial
Umbrella systematic review of observational epidemiological studies
PubMed 37230063 · doi:10.4088/PCC.22r03395
What was done
An umbrella systematic review searched PubMed, CINAHL, and PsycINFO for systematic reviews evaluating seasonality, mood disorders, suicide risk, and psychiatric service utilization. From 209 initial results, 6 records met criteria and 3 additional reviews were found via reference list screening (total n = 9 reviews). Due to substantial data heterogeneity across studies, the authors conducted a qualitative synthesis.
What was found
Suicide was reported to be 11% to 23% more frequent in spring and summer. Emergency department suicide attempt presentations were 1.2 to 1.7 times higher in spring and summer compared to winter. Mania admissions were 7.4% to 16% higher in spring and summer. Conversely, admissions for bipolar depression were 1.5 times higher in winter, aligning with observed winter peaks for depressive symptoms.
Why it matters
This review highlights a divergence between seasonal peaks in depressive symptoms (winter) and acute crises such as mania and suicidality (spring/summer). These patterns can inform resource allocation and staffing for primary behavioral health and acute psychiatric care.
Limits
Meta-analysis could not be performed due to data heterogeneity across the included reviews. The abstract does not report risk-of-bias appraisals, total primary participant sample size, or geographic and hemispheric variations in the synthesized literature.
Cited by
- context Systematic reviews of patient hospitalizations show that manic episodes peak around the spring equinox and autumn equinox.
- supports Systematic reviews show that bipolar depressive episodes peak around the winter solstice when photoperiod is at its lowest.