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Sub-threshold manic symptoms in recurrent major depressive disorder are a marker for poor outcome

Smith, Daniel J., Forty, Elizabeth, Russell, Elen, Caesar, S., Walters, James Tynan Rhys ORCID:, Cooper, C., Jones, Ian Richard ORCID:, Jones, L. and Craddock, Nicholas John ORCID: 2009. Sub-threshold manic symptoms in recurrent major depressive disorder are a marker for poor outcome. Acta Psychiatrica Scandinavica 119 (4) , pp. 325-329. 10.1111/j.1600-0447.2008.01324.x

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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 subthreshold 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.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
MRC Centre for Neuropsychiatric Genetics and Genomics (CNGG)
Neuroscience and Mental Health Research Institute (NMHRI)
Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Uncontrolled Keywords: bipolar; depression; prognosis; antidepressants; response
Publisher: Wiley-Blackwell
ISSN: 0001-690X
Last Modified: 06 Feb 2023 15:33

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