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- Title
Sub-threshold manic symptoms in recurrent major depressive disorder are a marker for poor outcome.
- Authors
Smith, D. J.; Forty, L.; Russell, E.; Caesar, S.; Walters, J.; Cooper, C.; Jones, I.; Jones, L.; Craddock, N.
- Abstract
Objective: A small but significant proportion of patients with major depressive disorder (MDD) report mild manic symptoms which are below the diagnostic threshold for a hypomanic episode. Method: We tested for an association between sub-threshold manic symptoms and clinical outcome in almost 600 patients with recurrent MDD who also had no known family history of bipolar disorder. Results: 9.6% of this large sample had a life-time history of sub-threshold manic symptoms. These patients were significantly more likely to have a history of poor response to antidepressants (OR 2.84; 95% CI 1.23–6.56; P < 0.02) and more likely to have experienced psychosis (OR 2.07; 95% CI 1.05–4.09; P < 0.04). They had also experienced more depressive episodes on average ( P = 0.006) and were more likely to have been admitted to hospital ( P < 0.03). Conclusion: Sub-threshold manic symptoms in patients with recurrent MDD may be a useful clinical marker for poor response to antidepressants and a more morbid long-term clinical course.
- Subjects
MENTAL depression; BIPOLAR disorder; MANIA; PSYCHIATRIC drugs; ANTIDEPRESSANTS
- Publication
Acta Psychiatrica Scandinavica, 2009, Vol 119, Issue 4, p325
- ISSN
0001-690X
- Publication type
Article
- DOI
10.1111/j.1600-0447.2008.01324.x