Sub-threshold depression and antidepressants use in a community sample: searching anxiety and finding bipolar disorder

BMC Psychiatry

Research Article

Filippo Drago¹  Filippo Caraci¹  Guido Di Sciascio²  Carlo Faravelli³  Krishna M Bhat⁴  Leonardo Tondo⁵  Liliana dell'Osso⁶  Maria Francesca Moro⁷  Mauro G Carta⁷  Maria E Lecca⁷  Maria Carolina Hardoy⁸  Massimo Casacchia⁹  Matteo Balestrieri^1,10 

[1] Department of Drug Sciences, University of Catania, Italy;Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy;Department of Neurology and Psychiatry, Florence University, Firenze, Italy;Department of Neuroscience and Cell Biology, University of Texas Medical Branch, Galveston, Texas, USA;Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA;Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, Pisa, Italy;Department of Public Health, University of Cagliari, Cagliari, Italy;Department of Public Health, University of Cagliari, Cagliari, Italy;Department of Psychiatry, Reald University, Vlore, Albania;Department of Science of Health, University of L'Aquila, L'Aquila, Italy;Inter-University Center for Behavioural Neurosciences, DPMSC, University of Udine, Udine, Italy;

关键词: Bipolar Disorder;    Anxiety Disorder;    Generalize Anxiety Disorder;    Depressive Episode;    Panic Disorder;   

DOI  :  10.1186/1471-244X-11-164

 received in 2011-05-07, accepted in 2011-10-10,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundTo determine the use of antidepressants (ADs) in people with sub-threshold depression (SD); the lifetime prevalence of mania and hypomania in SD and the link between ADs use, bipolarity and anxiety disorders in SD.MethodsStudy design: community survey. Study population: samples randomly drawn, after stratification from the adult population of municipal records. Sample size: 4999 people from seven areas within six Italian regions. Tools: Questionnaire on psychotropic drug consumption, prescription; Structured Clinical Interview NP for DSM-IV modified (ANTAS); Hamilton Depression Rating Scale (HAM-D); Mood Disorder Questionnaire (MDQ); Short Form Health Survey (SF-12). SD definition: HAM-D > 10 without lifetime diagnosis of Depressive Episode (DE).ResultsSD point prevalence is 5.0%. The lifetime prevalence of mania and hypomania episodes in SD is 7.3%. Benzodiazepines (BDZ) consumption in SD is 24.1%, followed by ADs (19.7%). In SD, positive for MDQ and comorbidity with Panic Disorder (PD) or Generalized Anxiety Disorders (GAD) are associated with ADs use, whereas the association between a positive MDQ and ADs use, without a diagnosis of PD or GAD, is not significant. Only in people with DE the well-being (SF-12) is higher among those using first-line antidepressants compared to those not using any medication. In people with SD no significant differences were found in terms of SF-12 score according to drug use.ConclusionsThis study suggests caution in prescribing ADs to people with SD. In people with concomitant anxiety disorders and SD, it should be mandatory to perform a well-designed assessment and evaluate the presence of previous manic or hypomanic symptoms prior to prescribing ADs.

【 授权许可】

CC BY   
© Carta et al; licensee BioMed Central Ltd. 2011