title: Study protocol: a cross-sectional survey of seasonal affective disorder in Danish populations with and without severe visual impairments.
abstract: BACKGROUND
  People with seasonal affective disorder (SAD) experience recurrent seasonal fluctuations in energy, mood and appetite. Retinal light exposure is suggested to play an important role in the pathogenesis and treatment of SAD. The aim of the study is to determine the prevalence of SAD in persons with severe visual impairments or blindness and to compare the results to a control group without visual impairments. Moreover, the authors wish to investigate whether SAD is correlated to the degree of impairment or to the diagnosis.
  
  
  METHODS
  2781 persons with visual impairments ranging from total blindness to Snellen visual acuity 6/60 receive information letter and questionnaire by post. Completed questionnaires can be returned by post, email or telephone. For each respondent, all eye-related diagnoses will be obtained from national registries. Normally sighted and demographically matched control respondents will be contacted in a similar manner the subsequent winter season. The Seasonal Pattern Assessment Questionnaire rates seasonal variation within the six items: sleep, appetite, social activity, mood, energy and body weight. The Seasonal Pattern Assessment Questionnaire yields a Global Seasonal Score and a prevalence of SAD. Outcomes from the two groups will be compared. Moreover, outcomes from subgroups of the visually impaired population will be compared.
  
  
  BACKGROUND
  The study is approved by the Danish Data Protection Agency. Results will be published in a relevant scientific journal and be communicated to respondents and relevant institutions through cooperation with the Danish Association of the Blind.
authors.affiliation: Psychiatric Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Helle Østergaard
authors.initials: HØ
authors.lastname: Madsen
authors.forename: Henrik
authors.initials: H
authors.lastname: Dam
authors.forename: Ida
authors.initials: I
authors.lastname: Hageman