Treatment-induced manic switch in the course of unipolar depression can predict bipolarity: Cluster analysis based evidence

Autor: Ümit Tural, Halis Ulaş, Kemal Dumlu, Zahide Orhon, Zeliha Tunca, Ayşegül Özerdem
Rok vydání: 2011
Předmět:
Adult
Male
medicine.medical_specialty
Dsm-Iv
Bipolar Disorder
Bipolar disorder
Disorder Step-Bd
Antidepressant-Induced Mania
Spontaneous Hypomania
behavioral disciplines and activities
Treatment-induced mania
Severity
II Disorder
Cluster analysis
Clinical-Features
Internal medicine
Major Depression
mental disorders
medicine
Outpatient Depression
Cluster Analysis
Humans
Psychiatry
Treatment-Outcome-Network
Depression (differential diagnoses)
Treatment Enhancement Program
Retrospective Studies
Depressive Disorder
Depressive Disorder
Major
Depression
Mood Disorders
Retrospective cohort study
Recurrent depression
Middle Aged
medicine.disease
Antidepressive Agents
Diagnostic and Statistical Manual of Mental Disorders
Psychiatry and Mental health
Clinical Psychology
Mood disorders
Major depressive disorder
Antidepressant
Female
medicine.symptom
Complication
Psychology
Mania
Zdroj: Journal of Affective Disorders. 134:91-101
ISSN: 0165-0327
DOI: 10.1016/j.jad.2011.06.019
Popis: Background: Antidepressants are known to induce manic switch in patients with depression. Treatment-induced mania is not considered as bipolar disorder in DSM IV. The aim of this study was to assess whether clinical characteristics of patients with unipolar depression with a history of treatment-induced mania were similar to those of patients with bipolar disorder. Method: The study included 217 consecutive patients with DSM-IV mood disorders, diagnosed as: bipolar disorder type I (BP-I, n = 58) or type II (BP-II, n = 18) whose first episodes were depression, recurrent (unipolar) major depressive disorder with a history of antidepressant treatment-induced mania (switchers = stir); n = 61) and without such an event (rUD; n = 80). First, the groups were compared with regard to clinical features and course specifiers using variance and chi-square analysis. Variables that differed significantly between the four groups were included in two-step cluster analysis to explore naturally occurring subgroups in all diagnoses. Subsequently, the relationship between the naturally occurring clusters and pre-defined DSM-IV diagnoses were investigated. Results: Two-step cluster analysis revealed two different naturally occurring groups. Higher severity of depressive episodes, with higher rate of melancholic features, higher number of hospitalization and suicide attempts were represented in one cluster where switchers (77%), bipolar I (94.8%) and II (83.3%) patients clustered together. Conclusion: The findings of this study confirm that treatment-induced mania is a clinical phenomenon that belongs within-the bipolar spectrum rather than a coincidental treatment complication, and that it should be placed under "bipolar disorders" in future classification systems. Limitations: The study includes the limitations of any naturalistic retrospective study. (C) 2011 Elsevier B.V. All rights reserved.
Databáze: OpenAIRE
Externí odkaz: