Exploration of mood spectrum symptoms during a major depressive episode: The impact of contrapolarity—Results from a transdiagnostic cluster analysis on an Italian sample of unipolar and bipolar patients

Autor: Ludovico Mineo, Alessandro Rodolico, Giorgio Alfredo Spedicato, Andrea Aguglia, Simone Bolognesi, Carmen Concerto, Alessandro Cuomo, Arianna Goracci, Giuseppe Maina, Andrea Fagiolini, Mario Amore, Eugenio Aguglia
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: European Psychiatry, Vol 65 (2022)
Druh dokumentu: article
ISSN: 0924-9338
1778-3585
DOI: 10.1192/j.eurpsy.2022.20
Popis: Abstract Background Subthreshold hypomania during a major depressive episode challenges the bipolar-unipolar dichotomy. In our study we employed a cross-diagnostic cluster analysis - to identify distinct subgroups within a cohort of depressed patients. Methods A k-means cluster analysis— based on the domain scores of the Mood Spectrum Self-Report (MOODS-SR) questionnaire—was performed on a data set of 300 adults with either bipolar or unipolar depression. After identifying groups, between-clusters comparisons were conducted on MOODS-SR domains and factors and on a set of sociodemographic, clinical and psychometric variables. Results Three clusters were identified: one with intermediate depressive and poor manic symptomatology (Mild), one with severe depressive and poor manic symptomatology (Moderate), and a third one with severe depressive and intermediate manic symptomatology (Mixed). Across the clusters, bipolar patients were significantly less represented in the Mild one, while the DSM-5 “Mixed features” specifier did not differentiate the groups. When compared to the other patients, those of Mixed cluster exhibited a stronger association with most of the illness-severity, quality of life, and outcomes measures considered. After performing pairwise comparisons significant differences between “Mixed” and “Moderate” clusters were restricted to: current and disease-onset age, psychotic ideation, suicidal attempts, hospitalization numbers, impulsivity levels and comorbidity for Cluster B personality disorder. Conclusions In the present study, a clustering approach based on a spectrum exploration of mood symptomatology led to the identification of three transdiagnostic groups of patients. Consistent with our hypothesis, the magnitude of subthreshold (hypo)manic symptoms was related to a greater clinical severity, regardless of the main categorical diagnosis.
Databáze: Directory of Open Access Journals