The role of different patterns of psychomotor symptoms in major depressive episode: Pooled analysis of the BRIDGE and BRIDGE-II-MIX cohorts.
- Barbuti M Department of Experimental and Clinic Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy.
- Mainardi C Department of Experimental and Clinic Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy.
- Pacchiarotti I Bipolar Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
- Verdolini N Bipolar Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
- Maccariello G Department of Experimental and Clinic Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy.
- Angst J Psychiatric Hospital, University of Zurich, Zurich, Switzerland.
- Azorin JM AP HM, Psychiatric Pole, Sainte Marguerite, Marseille, France.
- Bowden CL Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
- Mosolov S Department for Therapy of Mental Disorders, Moscow Research Institute of Psychiatry, Moscow, Russia.
- Young AH Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London & South London and Maudsley NHS Foundation Trust, London, UK.
- Vieta E Bipolar Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
- Perugi G Department of Experimental and Clinic Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy.
- 2019-08-11
Published in:
- Bipolar disorders. - 2019
bipolar disorder
major depressive episode
psychomotor agitation
psychomotor retardation
Adult
Antidepressive Agents
Antimanic Agents
Bipolar Disorder
Cross-Sectional Studies
Depressive Disorder, Major
Diagnostic and Statistical Manual of Mental Disorders
Female
Humans
Logistic Models
Male
Middle Aged
Psychomotor Agitation
English
BACKGROUND
Psychomotor agitation (PA) or retardation (PR) during major depressive episodes (MDEs) have been associated with depression severity in terms of treatment-resistance and course of illness.
OBJECTIVES
We investigated the possible association of psychomotor symptoms (PMSs) during a MDE with clinical features belonging to the bipolar spectrum.
METHODS
The initial sample of 7689 MDE patients was divided into three subgroups based on the presence of PR, PA and non-psychomotor symptom (NPS). Univariate comparisons and multivariate logistic regression models were performed between subgroups.
RESULTS
A total of 3720 patients presented PR (48%), 1971 showed PA (26%) and 1998 had NPS (26%). In the PR and PA subgroups, the clinical characteristics related to bipolarity, along with the diagnosis of bipolar disorder (BD), were significantly more frequent than in the NPS subgroup. When comparing PA and PR patients, the former presented higher rates of bipolar spectrum features, such as family history of BD (OR = 1.39, CI = 1.20-1.61), manic/hypomanic switches with antidepressants (OR = 1.28, CI = 1.11-1.48), early onset of first MDE (OR = 1.40, CI = 1.26-1.57), atypical (OR = 1.23, CI = 1.07-1.42) and psychotic features (OR = 2.08, CI = 1.78-2.44), treatment with mood-stabilizers (OR = 1.39, CI = 1.24-1.55), as well as a BD diagnosis according to both the DSM-IV criteria and the bipolar specifier criteria. When logistic regression model was performed, the clinical features that significantly differentiated PA from PR were early onset of first MDE, atypical and psychotic features, treatment with mood-stabilizers and a BD diagnosis according to the bipolar specifier criteria.
CONCLUSIONS
Psychomotor symptoms could be considered as markers of bipolarity, illness severity, and treatment complexity, particularly if PA is present.
Psychomotor agitation (PA) or retardation (PR) during major depressive episodes (MDEs) have been associated with depression severity in terms of treatment-resistance and course of illness.
OBJECTIVES
We investigated the possible association of psychomotor symptoms (PMSs) during a MDE with clinical features belonging to the bipolar spectrum.
METHODS
The initial sample of 7689 MDE patients was divided into three subgroups based on the presence of PR, PA and non-psychomotor symptom (NPS). Univariate comparisons and multivariate logistic regression models were performed between subgroups.
RESULTS
A total of 3720 patients presented PR (48%), 1971 showed PA (26%) and 1998 had NPS (26%). In the PR and PA subgroups, the clinical characteristics related to bipolarity, along with the diagnosis of bipolar disorder (BD), were significantly more frequent than in the NPS subgroup. When comparing PA and PR patients, the former presented higher rates of bipolar spectrum features, such as family history of BD (OR = 1.39, CI = 1.20-1.61), manic/hypomanic switches with antidepressants (OR = 1.28, CI = 1.11-1.48), early onset of first MDE (OR = 1.40, CI = 1.26-1.57), atypical (OR = 1.23, CI = 1.07-1.42) and psychotic features (OR = 2.08, CI = 1.78-2.44), treatment with mood-stabilizers (OR = 1.39, CI = 1.24-1.55), as well as a BD diagnosis according to both the DSM-IV criteria and the bipolar specifier criteria. When logistic regression model was performed, the clinical features that significantly differentiated PA from PR were early onset of first MDE, atypical and psychotic features, treatment with mood-stabilizers and a BD diagnosis according to the bipolar specifier criteria.
CONCLUSIONS
Psychomotor symptoms could be considered as markers of bipolarity, illness severity, and treatment complexity, particularly if PA is present.
- Language
-
- English
- Open access status
- hybrid
- Identifiers
-
- DOI 10.1111/bdi.12816
- PMID 31400256
- Persistent URL
- https://sonar.ch/global/documents/91253
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