Trastorno Afectivo Estacional: “Winter Blues” y su Relación con la Glándula Pineal
DOI:
https://doi.org/10.59706/aebmedicine.v1i2.8557Keywords:
winter blues, depresión, trastorno afectivo estacional, glándula pineal, melatonina, luminoterapia, SPAQAbstract
El Trastorno Afectivo Estacional (TAE), conocido como "Winter blues" o depresión estacional, se caracteriza por episodios depresivos durante los meses fríos, vinculado a bajos niveles de melatonina. Su prevalencia varía del 0.1% al 9.7%, siendo más común en mujeres y con factores de riesgo como historia familiar, latitudes altas y edad adulta temprana. A nivel biológico, los desequilibrios en el transportador estriatal de serotonina y la glándula pineal se asocian con síntomas melancólicos y somáticos, sugiriendo la melatonina como un potencial antidepresivo endógeno. La patogenia implica desequilibrios hormonales, alteraciones en la captación retiniana de luz, factores genéticos y disfunciones neurotransmisoras.
El diagnóstico del TAE es desafiante, con síntomas iniciales sutiles compartidos con el trastorno depresivo mayor. Se utiliza el Cuestionario de Evaluación del Patrón Estacional (SPAQ), análisis de vitamina D y la exclusión de otros trastornos, junto con criterios del DSM-V para aumentar la certeza. El tratamiento incluye cambios en el estilo de vida, terapia cognitivo-conductual y terapia de luz, todos respaldados por evidencia. El tratamiento con fármacos, como los Inhibidores Selectivos de la Recaptura de Serotonina (ISRS) también se considera efectivo. La bupropión se presenta como alternativa, especialmente a manera de preventivo. Aunque se investigan nuevas terapias y medicamentos, como la melatonina de liberación prolongada y la agomelatina, se requiere más investigación para determinar su eficacia y recomendación formal en el tratamiento del TAE.
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