Agitated "unipolar" major depression: prevalence, phenomenology, and outcome.

Full Abstract

OBJECTIVE:
This study aimed to explore how prevalent agitated "unipolar" major depression is, whether it belongs to the bipolar spectrum, and whether it differs from nonagitated "unipolar" major depression with respect to course and outcome.

METHOD:
The study was conducted from January 1, 1978, to December 31, 1996. From 361 patients with major depressive disorder, the authors selected those fulfilling Research Diagnostic Criteria for agitated depression. These 94 patients were compared to 94 randomly recruited patients with nonagitated major depressive disorder regarding demographic and historical features, the clinical characteristics of the index episode, the percentage of time spent in an affective episode during a prospective observation period, and the 5-year outcome. Patients with agitated major depressive disorder who had at least 2 manic/hypomanic symptoms in their index episode were compared to the other patients with agitated major depressive disorder with respect to the same variables.

RESULTS:
Patients with agitated major depressive disorder were more likely to receive antipsychotics during their index episode and spent a higher proportion of time in an affective episode during the observation period compared with patients with nonagitated major depressive disorder. The presence of at least 2 manic/hypomanic symptoms in the index episode was associated with a higher rate of family history of bipolar I disorder, a higher score for suicidal thoughts during the episode, a longer duration of the episode, and a higher affective morbidity during the observation period.

CONCLUSION:
The diagnosis of agitated major depressive disorder is not uncommon and has significant therapeutic and prognostic implications. The subgroup of patients with at least 2 manic/hypomanic symptoms may suffer from a mixed state and/or belong to the bipolar spectrum.

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Author information

Author/s: Maj, Mario (M); Pirozzi, Raffaele (R); Magliano, Lorenza (L); Fiorillo, Andrea (A); Bartoli, Luca (L);

Affiliation: Department of Psychiatry, University of Naples SUN, Italy. majmario(-atsign-)tin.it

Journal and publication information

Publication Type: Comparative Study; Journal Article

Journal: The Journal of clinical psychiatry (J Clin Psychiatry), published in United States. (Language: eng)

Reference: 2006-May; vol 67 (issue 5) : pp 712-9

Dates: Created 2006/07/17; Completed 2006/08/02; Revised 2007/01/09;

PMID: 16841620, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: J Clin Psychiatry. 2006 Dec;67(12):2034. (PMID: 17194291)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult
Antipsychotic Agents - therapeutic use
Bipolar Disorder - diagnosis; epidemiology; psychology
Cross-Sectional Studies
Depressive Disorder - diagnosis; drug therapy; epidemiology
Depressive Disorder, Major - diagnosis; drug therapy; epidemiology
Diagnosis, Differential
Family
Female
Humans

Humans
Male
Middle Aged
Prevalence
Prognosis
Psychiatric Status Rating Scales
Psychomotor Agitation - diagnosis; drug therapy; epidemiology
Suicide - psychology
Time Factors
Treatment Outcome

Associated Chemicals: Antipsychotic Agents (0)

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