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Characteristics of depressive and bipolar disorder patients with mixed features.

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Title: Characteristics of depressive and bipolar disorder patients with mixed features.
Authors: Tondo, L., Vázquez, G. H., Pinna, M., Vaccotto, P. A., Baldessarini, R. J.
Source: Acta Psychiatrica Scandinavica. Sep2018, Vol. 138 Issue 3, p243-252. 10p. 5 Charts, 1 Graph.
Subjects: Bipolar disorder, Mental depression, Irritability (Psychology), Agitation (Psychology), Hypomania, Therapeutics
Abstract: Objective: To assess differences between subjects with vs. without mixed features in major affective disorders. Methods: In 3099 out‐patient subjects with DSM‐5 major depressive disorder (MDD, n = 1921) or bipolar disorders (BD, n = 1178), we compared those with (Mx) vs. without (Non‐Mx) mixed features (agitated‐irritable depression or dysphoric [hypo]mania) in an index episode. Results: Prevalence of Mx averaged 21.9% [CI: 20.5–23.4] overall, ranking: BD‐II > BD‐I > MDD, and in BD depression ≥ [hypo]mania > MDD. Mx subjects were significantly more likely than Non‐Mx cases to (i) have other mixed episodes, (ii) have higher irritable and agitated ratings, (iii) have more substance abuse, (iv) switch into mixed episodes, (v) have more suicide attempts and higher suicidal ratings, (vi) change diagnosis from depression to BD, (vii) have higher hypomania scores when depressed or depression scores when [hypo]manic, (viii) be unmarried or separated with fewer children and siblings, (ix) be diagnosed more with BD than MDD, (x) be unemployed, (xi) have BD, suicide and divorce among first‐degree relatives, (xii) be female, (xiii) be younger at illness‐onset. Both BD and MDD Mx subjects also received antidepressants less, but antipsychotics and mood‐stabilizers more, alone and in combination with antidepressants. Conclusions: Mood disorder subjects with agitated‐irritable depression or dysphoric [hypo]mania differed from those without such mixed features, including having a less favorable clinical course and repeated mixed episodes. They may represent a distinct and prevalent, syndromal clinical subtype with prognostic and therapeutic significance. [ABSTRACT FROM AUTHOR]
Copyright of Acta Psychiatrica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Characteristics of depressive and bipolar disorder patients with mixed features.
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  Data: <searchLink fieldCode="JN" term="%22Acta+Psychiatrica+Scandinavica%22">Acta Psychiatrica Scandinavica</searchLink>. Sep2018, Vol. 138 Issue 3, p243-252. 10p. 5 Charts, 1 Graph.
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  Data: <searchLink fieldCode="DE" term="%22Bipolar+disorder%22">Bipolar disorder</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+depression%22">Mental depression</searchLink><br /><searchLink fieldCode="DE" term="%22Irritability+%28Psychology%29%22">Irritability (Psychology)</searchLink><br /><searchLink fieldCode="DE" term="%22Agitation+%28Psychology%29%22">Agitation (Psychology)</searchLink><br /><searchLink fieldCode="DE" term="%22Hypomania%22">Hypomania</searchLink><br /><searchLink fieldCode="DE" term="%22Therapeutics%22">Therapeutics</searchLink>
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  Data: Objective: To assess differences between subjects with vs. without mixed features in major affective disorders. Methods: In 3099 out‐patient subjects with DSM‐5 major depressive disorder (MDD, n = 1921) or bipolar disorders (BD, n = 1178), we compared those with (Mx) vs. without (Non‐Mx) mixed features (agitated‐irritable depression or dysphoric [hypo]mania) in an index episode. Results: Prevalence of Mx averaged 21.9% [CI: 20.5–23.4] overall, ranking: BD‐II > BD‐I > MDD, and in BD depression ≥ [hypo]mania > MDD. Mx subjects were significantly more likely than Non‐Mx cases to (i) have other mixed episodes, (ii) have higher irritable and agitated ratings, (iii) have more substance abuse, (iv) switch into mixed episodes, (v) have more suicide attempts and higher suicidal ratings, (vi) change diagnosis from depression to BD, (vii) have higher hypomania scores when depressed or depression scores when [hypo]manic, (viii) be unmarried or separated with fewer children and siblings, (ix) be diagnosed more with BD than MDD, (x) be unemployed, (xi) have BD, suicide and divorce among first‐degree relatives, (xii) be female, (xiii) be younger at illness‐onset. Both BD and MDD Mx subjects also received antidepressants less, but antipsychotics and mood‐stabilizers more, alone and in combination with antidepressants. Conclusions: Mood disorder subjects with agitated‐irritable depression or dysphoric [hypo]mania differed from those without such mixed features, including having a less favorable clinical course and repeated mixed episodes. They may represent a distinct and prevalent, syndromal clinical subtype with prognostic and therapeutic significance. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Acta Psychiatrica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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