The underexplored presence of seasonal affective disorder in the southern hemisphere: A narrative review of the Australian literature

Background: Seasonal Affective Disorder (SAD) is well documented in the medical literature, particularly in more northern latitudes in agreement with proposed hypotheses for SAD's pathophysiology. However, in the southern latitudes SAD's presence remains underexplored. The second largest country in the southern hemisphere is Australia. Australia has wide ranging geographical and climatic differences that are expected to support SAD's presence. The aim of this study is therefore, to establish an evidence base for SAD in Australia.Methods: PubMed and Google Scholar were searched for published peer-review studies focussed on, or related to SAD, winter depression or seasonal variation in mood in Australia. There were no time-period restrictions.Results: Thirteen studies were identified. Studies explored the presence/nature of SAD, contributing factors, autonomic activity, treatment, and the validity of the Seasonal Pattern Assessment Questionnaire in the Australian population. An association between changes in mood and behaviour and seasonal occurrence was clearly identified, with SAD's presence varying by location. The highest percentage of study participants with SAD in a single location was observed in Tasmania, Australia's most southern state. The findings and in-terpretations of the studies included in this review are subject to the number of locations assessed, the number of studies undertaken at each location and individual study limitations.Conclusions: Ascertaining information on the prevalence and correlates of SAD in the southern hemisphere, particularly in high-risk locations could contribute to clinical literacy into the syndrome, support management practices, and promote the early identification and treatment of the disorder.