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

Smith, D.J. , Forty, L., Russell, E., Caesar, S., Walters, J., Cooper, C., Jones, I., Jones, L. and Craddock, N. (2009) Sub-threshold manic symptoms in recurrent major depressive disorder are a marker for poor outcome. Acta Psychiatrica Scandinavica, 119(4), pp. 325-329. (doi: 10.1111/j.1600-0447.2008.01324.x)

Abstract

<b>Objective:</b>  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.<p></p> <b>Method:</b>  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.<p></p> <b>Results:</b>  9.6% of this large sample had a life-time history of sub-threshold 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).<p></p> <b>Conclusion:</b>  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: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Smith, Professor Daniel
• Authors: Smith, D.J., Forty, L., Russell, E., Caesar, S., Walters, J., Cooper, C., Jones, I., Jones, L., and Craddock, N.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
• Journal Name: Acta Psychiatrica Scandinavica
• ISSN: 0001-690X
• ISSN (Online): 1600-0447
• Published Online: 22 December 2008