Psychopathological and sociodemographic features in treatment-resistant unipolar depression versus bipolar depression: a comparative study

BMC Psychiatry

Nancy Low¹  Marie Saint-Laurent¹  Theodore Kolivakis¹  Pablo Cervantes¹  Stephen Vida¹  Allan Fielding¹  Nicolas A. Nuñez²  Eduard Dumitrescu²  Maykel F. Ghabrash²  Stefano Comai²  John Tabaka²  Gabriella Gobbi²  Linda Booij² 

[1] Department of Psychiatry, Mood Disorder Clinic, McGill University Health Center, McGill University;Department of Psychiatry, Neurobiological Psychiatry Unit, McGill University Health Center (MUHC), McGill University;

关键词: Treatment-resistant depression;    Bipolar depression;    Psychopathology;    Affective disorders;    Bipolar spectrum;   

DOI  :  10.1186/s12888-018-1641-y

来源: DOAJ

【 摘 要 】

Abstract Background Some authors have hypothesized that Treatment-Resistant Unipolar Depression (TRD-UP) should be considered within the bipolar spectrum disorders and that hidden bipolarity may be a risk factor for TRD-UP. However, there are neither studies comparing clinical and sociodemographic data of patients with TRD-UP versus Bipolar (BP) disorders nor are there any examining differences versus Bipolar type I (BP-I) and Bipolar type II (BP-II). Methods Charts analysis was conducted on 194 patients followed at the Mood Disorders Clinic of the McGill University Health Center. Sociodemographic, clinical features and depression scales were collected from patients meeting DSM-IV criteria for TRD-UP (n = 100) and BP (n = 94). Binary logistic regression analysis was conducted to examine clinical predictors independently associated with the two disorders. Results Compared to BP, TRD-UP patients exhibited greater severity of depression, prevalence of anxiety and panic disorders, melancholic features, Cluster-C personality disorders, later onset of depression and fewer hospitalizations. Binary logistic regression indicated that higher comorbidity with anxiety disorders, higher depression scale scores and lower global assessment of functioning (GAF) scores, and lower number of hospitalizations and psychotherapies differentiated TRD-UP from BP patients. We also found that the rate of unemployment and the number of hospitalizations for depression was higher in BP-I than in BP-II, while the rate of suicide attempts was lower in BP-I than in BP-II depressed patients. Conclusions These results suggest that TRD-UP constitutes a distinct psychopathological condition and not necessarily a prodromal state of BP depression.

【 授权许可】

Unknown