Higher Interleukin 13 differentiates patients with a positive history of suicide attempts in major depressive disorder

Background: Undiagnosed and therefore inadequately treated hypomanic symptoms may be a leading cause of drug resistance in depression diagnosed as unipolar (major depressive disorder, MDD). The purpose of the IMPROVE study was to identify the rate of misdiagnoses in patients with treatment-resistant MDD by screening for the presence of previous hypomanic episodes, and to study the characteristics of those patients with a positive history of hypomania. Methods: Patients attending 29 psychiatric units throughout Italy with a diagnosis of MDD who were resistant to anti-depressant treatment were included in this multicentre, observational single visit study. The Hypomania Checklist 32 (HCL-32) was administered to detect underlying bipolarity. Results: Among the 466 enrolled patients, 256 (57.40%) were positive at screening for a previous hypomanic episode (HCL-32 ≥12), therefore suggesting a misdiagnosis. These patients scored higher than those with a negative history in both the “active/elated hypomania” (11.27±3.11 vs 3.57±3.05; P<0.0001) and “irritable/risk-taking hypomania” (2.87±2.03 vs 2.06±1.73; P<0.001) HCL-32 sub-scales. Patients with a positive history of hypomania were younger, had a higher number of previous depressive episodes and a higher frequency of comorbid conditions compared to those with a negative history. Conclusions: This study suggests that screening for hypomania in MDD-resistant patients facilitates identification of a notable proportion of undiagnosed cases of bipolar spectrum disorder. Patients with a positive history of hypomania at screening had a demographic/clinical bipolar-like profile that included young age, higher number of previous depressive episodes and higher frequency of comorbid conditions. They also had both higher active and irritable hypomania symptom scores.

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Impulsivity as a Risk Factor for Suicidality in Depressed Patients

European Psychiatry ◽

10.1016/j.eurpsy.2017.02.169 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S294-S295

Author(s):

M. Hambrich ◽

B. Nemes ◽

R. Soare ◽

D. Cozman

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Major Depressive Episode ◽

Suicide Attempts ◽

Sampling Procedure ◽

Major Depressive ◽

Social Burden ◽

Suicide Behavior ◽

History Of ◽

Competing Interest

IntroductionSuicide behavior is an important and preventable cause of injury, disability and death in the world, and, at the same time, a major economic and social burden for modern societies. The majority of suicide attempts and completions are associated with psychiatric disorders, especially major depressive episode. Impulsivity has been associated with suicidality in major depressive disorder patients.AimThe current study aims to evaluate impulsivity in major depressive disorder patients with a history of suicide attempts as compared to major depressive disorder patients without a history of suicide attempts.MethodsOne hundred and twelve patients with major depressive disorder, aged 51.91 ± 10.72 (70% females) were included through convenient sampling procedure from the patient population of the 3rd Psychiatry Clinic of the Cluj County Emergency Hospital. Impulsivity was assessed through Barratt Impulsiveness Scale (BIS-11).ResultsIn total, 27.8% of the patients had a history of suicide attempts. Significant differences between the two groups were obtained only for the Perseverance subscale of the BIS-11. (12.7 ± 1.8 vs. 7.13 ± 2.1, P = 0.005–Mann Whitney U-test).ConclusionsPerseverance might be a discriminating element between patients that eventually commit a suicide attempt and those that do not.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Comparison of suicide attempts in individuals with major depressive disorder with and without history of subthreshold hypomania: A nationwide community sample of Korean adults✰,✰✰

Journal of Affective Disorders ◽

10.1016/j.jad.2019.01.022 ◽

2019 ◽

Vol 248 ◽

pp. 18-25 ◽

Cited By ~ 1

Author(s):

Kwan Woo Choi ◽

Eun Jin Na ◽

Jin Pyo Hong ◽

Maeng Je Cho ◽

Maurizio Fava ◽

...

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Suicide Attempts ◽

Community Sample ◽

Major Depressive ◽

Korean Adults ◽

History Of

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Symptom Profile of Major Depressive Disorder in Women with Eating Disorders

Australian & New Zealand Journal of Psychiatry ◽

10.1080/00048670601057718 ◽

2007 ◽

Vol 41 (1) ◽

pp. 24-31 ◽

Cited By ~ 57

Author(s):

Fernando Fernandez-Aranda ◽

Andrea Poyastro Pinheiro ◽

Federica Tozzi ◽

Maria La Via ◽

Laura M. Thornton ◽

...

Keyword(s):

Eating Disorders ◽

Major Depressive Disorder ◽

Depressive Symptoms ◽

Depressive Disorder ◽

Suicide Attempts ◽

Major Depressive ◽

Symptom Profile ◽

Before And After ◽

History Of ◽

New Onset

Objective: Based on the well-documented association between eating disorders (EDs) and affective disorders, the patterns of comorbidity of EDs and major depressive disorder (MDD) were investigated. The temporal relation between EDs and MDD onset was analyzed to determine differences in the course and nature of MDD when experienced prior to versus after the onset of the ED. Method: Lifetime MDD and depressive symptoms were assessed in 1371 women with a history of ED. The prevalence of MDD was first explored across ED subtypes, and ages of onset of MDD and EDs were compared. Depressive symptoms were examined in individuals who developed MDD before and after ED onset. Results: The lifetime prevalence of MDD was 72.9%. Among those with lifetime MDD (n =963), 34.5% reported MDD onset before the onset of ED. Those who experienced MDD first reported greater psychomotor agitation (OR =1.53; 95%CI =1.14–2.06), and thoughts of own death (but not suicide attempts or ideation; OR =1.73; 95%CI =1.31–2.30). Among individuals who had MDD before ED, 26.5% had the MDD onset during the year before the onset of ED; 67% of individuals had the onset of both disorders within the same 3 year window. Conclusion: Clinicians treating individuals with new-onset ED or MDD should remain vigilant for the emergence of additional psychopathology, especially during the initial 3 year window following the onset of the first disorder.

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