Twelve-month prevalence and disability of DSM-IV bipolar disorder in an Australian general population survey

2004 ◽  
Vol 34 (5) ◽  
pp. 777-785 ◽  
Author(s):  
P. B. MITCHELL ◽  
T. SLADE ◽  
G. ANDREWS
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
National Survey ◽  
Large Scale ◽  
Well Being ◽  
Major Depressive ◽  
Co Morbidity ◽  
Dsm Iv ◽  
Days Out Of Role

Background. There have been few large-scale epidemiological studies which have examined the prevalence of bipolar disorder. The authors report 12-month prevalence data for DSM-IV bipolar disorder from the Australian National Survey of Mental Health and Well-Being.Method. The broad methodology of the Australian National Survey has been described previously. Ten thousand, six hundred and forty-one people participated. The 12-month prevalence of euphoric bipolar disorder (I and II) – similar to the euphoric-grandiose syndrome of Kessler and co-workers – was determined. Those so identified were compared with subjects with major depressive disorder and the rest of the sample, on rates of co-morbidity with anxiety and substance use disorders as well as demographic features and measures of disability and service utilization. Polychotomous logistic regression was used to study the relationship between the three samples and these dependent variables.Results. There was a 12-month prevalence of 0·5% for bipolar disorder. Compared with subjects with major depressive disorder, those with bipolar disorder were distinguished by a more equal gender ratio; a greater likelihood of being widowed, separated or divorced; higher rates of drug abuse or dependence; greater disability as measured by days out of role; increased rates of treatment with medicines; and higher lifetime rates of suicide attempts.Conclusions. This large national survey highlights the marked functional impairment caused by bipolar disorder, even when compared with major depressive disorder.

scholarly journals Association between antidepressant resistance in unipolar depression and subsequent bipolar disorder: cohort study

2012 ◽  
Vol 200 (1) ◽  
pp. 45-51 ◽  
Author(s):  
Cheng-Ta Li ◽  
Ya-Mei Bai ◽  
Yu-Lin Huang ◽  
Ying-Sheue Chen ◽  
Tzeng-Ji Chen ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Large Scale ◽  
Antidepressant Treatment ◽  
Poor Response ◽  
Unipolar Depression ◽  
Major Depressive ◽  
Antidepressant Use ◽  
Nationally Representative

BackgroundPeople with major depressive disorder who fail to respond to adequate trials of antidepressant treatment may harbour hidden bipolar disorder.AimsWe aimed to compare the rates of a change in diagnosis to bipolar disorder among people with major depressive disorder with stratified responses to antidepressants during an 8-year follow-up period.MethodInformation on individuals with major depressive disorder identified during 2000 (cohort 2000, n = 1485) and 2003 (cohort 2003, n = 2459) were collected from a nationally representative cohort of 1 000 000 health service users in Taiwan. Participants responding well to antidepressants were compared with those showing poor responses to adequate trials of antidepressants.ResultsIn 7.6–12.1% of those with a diagnosis of unipolar major depressive disorder this diagnosis was subsequently changed to bipolar disorder, with a mean time to change of 1.89–2.98 years. Difficult-to-treat participants presented higher rates of change to a bipolar diagnosis (25.6% in cohort 2000; 26.6% in cohort 2003) than easy-to-treat participants (8.8–8.9% in cohort 2000; 6.8–8.6% in cohort 2003; P<0.0001). Regression analysis showed that the variable most strongly associated with the change in diagnosis was antidepressant use history. The difficult-to-treat participants were associated most with diagnostic changing (cohort 2000: odds ratio (OR) = 1.88 (95% CI 1.12–3.16); cohort 2003: OR = 4.94 (95% CI 2.81–8.68)).ConclusionsThis is the first large-scale study to report an association between antidepressant response history and subsequent change in diagnosis from major depressive disorder to bipolar disorder. Our findings support the view that a history of poor response to antidepressants in unipolar depression could be a useful predictor for bipolar diathesis.

Do characteristics of patients with major depressive disorder differ between primary and psychiatric care?

2007 ◽  
Vol 37 (6) ◽  
pp. 893-904 ◽  
Author(s):  
MARIA S. VUORILEHTO ◽  
TARJA K. MELARTIN ◽  
HEIKKI J. RYTSÄLÄ ◽  
ERKKI T. ISOMETSÄ
Keyword(s):  
Primary Care ◽  
Major Depressive Disorder ◽  
Personality Disorder ◽  
Depressive Disorder ◽  
Psychiatric Care ◽  
Major Depressive ◽  
Co Morbidity ◽  
Axis I ◽  
Dsm Iv ◽  
Treatment Settings

Background. Despite the need for rational allocation of resources and cooperation between different treatment settings, clinical differences in patients with major depressive disorder (MDD) between primary and psychiatric care remain obscure. We investigated these differences in representative patient populations from primary care versus secondary level psychiatric care in the city of Vantaa, Finland.Method. We compared MDD patients from primary care in the Vantaa Primary Care Depression Study (PC-VDS) (n=79) with psychiatric out-patients (n=223) and in-patients (n=46) in the Vantaa Depression Study (VDS). DSM-IV diagnoses were assigned by the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I in PC-VDS) or Schedules for Clinical Assessment in Neuropsychiatry (SCAN in VDS), and SCID-II interviews. Comparable information was collected on depression severity, Axis I and II co-morbidity, suicidal behaviour, preceding clinical course, and attitudes towards and pathways to treatment.Results. Prevalence of psychotic subtype and severity of depression were highest among in-patients, but otherwise few clinical differences between psychiatric and primary care patients were detected. Suicide attempts, alcohol dependence, and cluster A personality disorder were associated with treatment in psychiatric care, whereas cluster B personality disorder was associated with primary care treatment. Patients' choice of the initial point of contact for current depressive symptoms seemed to be independent of prior clinical history or attitude towards treatment.Conclusions. Severe, suicidal and psychotic depression cluster in psychiatric in-patient settings, as expected. However, MDD patients in primary care or psychiatric out-patient settings may not differ markedly in their clinical characteristics. This apparent blurring of boundaries between treatment settings calls for enhanced cooperation between settings, and clearer and more structured division of labour.

Between a rock-a-bye and a hard place: mood disorders during the peripartum period

CNS Spectrums ◽  
2017 ◽  
Vol 22 (S1) ◽  
pp. 49-64 ◽  
Author(s):  
Michael Thomson ◽  
Verinder Sharma
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Mood Disorders ◽  
Postpartum Period ◽  
Treatment Plan ◽  
Well Being ◽  
Screening Tools ◽  
Major Depressive ◽  
Medication Exposure

Mood disorders including major depressive disorder and bipolar disorder are common during and after pregnancy. Timely identification and appropriate management of mood episodes is essential to maximize maternal well-being and minimize adverse outcomes. Failure to do so results in maternal suffering and impaired child bonding, and has the potential for devastating outcomes including suicide and infanticide. Women are routinely screened for unipolar depression during or after pregnancy but not for bipolar disorder, in spite of the fact that childbirth is associated with a major risk for onset or exacerbation of bipolar disorder. Delays in detection as well as misdiagnosis of bipolar disorder as major depressive disorder may put women at risk of many adverse consequences, including symptom exacerbation, psychiatric hospitalization, and suicide. A thorough psychiatric assessment is necessary to establish diagnosis, to address safety issues, and to formulate a treatment plan. Treatment of mood disorders during pregnancy is complicated by the potential risks of fetal exposure to psychotropic medications, and the use of these medications during the postpartum period may result in infant medication exposure through breastmilk. These risks of psychotropic medication exposure must be weighed against the risk of untreated mood disorders. This review will discuss the pathophysiology, epidemiology, diagnosis, and treatment of mood disorders during pregnancy and the postpartum period. Screening tools that can be used in the primary care and obstetrics settings to assist in identifying women with peripartum mood disorders will also be discussed.

A prospective latent analysis study of Axis I psychiatric co-morbidity of DSM-IV major depressive disorder

2013 ◽  
Vol 44 (5) ◽  
pp. 949-959 ◽  
Author(s):  
T. Melartin ◽  
O. Mantere ◽  
M Ketokivi ◽  
E. Isometsä
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Depressive Disorder ◽  
Time Window ◽  
Depression And Anxiety ◽  
Major Depressive ◽  
Individual Level ◽  
Co Morbidity ◽  
Axis I ◽  
Dsm Iv

BackgroundWe tested the degree to which longitudinal observations fit two hypotheses of psychiatric co-morbidity in DSM-IV major depressive disorder (MDD) among adult patients: (1) Axis I co-morbidity is dependent on major depressive episode (MDE) course, and (2) Axis I co-morbidity is independent of MDE course.MethodIn the Vantaa Depression Study (VDS), 269 psychiatric secondary-care patients with a DSM-IV MDD were evaluated with the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) at intake and at 6 and 18 months. Three evaluations of co-morbidity were available for 193 out of 259 living patients (75%). A latent curve model (LCM) was used to examine individual-level changes in depressive and anxiety symptoms across time. Outcome of MDD was modeled in terms of categorical DSM-IV diagnosis and Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HAMD) scores, and co-morbidity in terms of categorical DSM-IV anxiety and alcohol use disorder (AUD) diagnoses and Beck Anxiety Inventory (BAI) scores.ResultsDepression and anxiety correlated cross-sectionally at baseline. Longitudinally, changes in depression and anxiety correlated in both the 0–6 and 6–18 months time windows. Higher baseline depression raised the likelihood of an AUD at 6 months, and patients with more depressive symptoms in the 0–6 months time window were more likely to have had an AUD at 6 months, which further linked to less improvement in depression symptoms in the 6–18 months time window.ConclusionsLongitudinal and individual-level courses of both internalizing and externalizing disorders in adult patients with MDD seem to be dependent, albeit to differing degrees, on the course of depressive symptoms.

Co-morbidity and stability of melancholic features in DSM-IV major depressive disorder

2004 ◽  
Vol 34 (8) ◽  
pp. 1443-1452 ◽  
Author(s):  
TARJA MELARTIN ◽  
ULLA LESKELÄ ◽  
HEIKKI RYTSÄLÄ ◽  
PETTERI SOKERO ◽  
PAULA LESTELÄ-MIELONEN ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Major Depressive ◽  
Course Of Illness ◽  
Descriptive Validity ◽  
Co Morbidity ◽  
Axis I ◽  
Dsm Iv ◽  
Course Of Depression

Background. The descriptive validity of the melancholic features specifier of the DSM-IV major depressive disorder (MDD) is uncertain. Little is known about its relationship to psychiatric co-morbidity, stability across episodes, or strength in predicting course of illness.Method. The Vantaa Depression Study (VDS) is a prospective, naturalistic cohort study of 269 patients with a new episode of DSM-IV MDD who were interviewed with SCAN and SCID-II between 1 February 1997 and 31 May 1998, and again at 6 and 18 months. Ninety-seven (36%) MDD patients met DSM-IV criteria for the melancholic features specifier, and were contrasted with 172 (64%) subjects with a non-melancholic MDD. The duration of the index episode was examined using a life chart.Results. We found no difference in rates of any current co-morbid Axis I or II disorders between melancholic and non-melancholic depressed patients. Of those who had melancholic features at the index episode and subsequent episodes during the 18-month follow-up, only 22% (5/23) presented melancholic features during the latter. The non-melancholic subtype switched to melancholic in 25% (8/32) of cases. Differences in the course of melancholic and non-melancholic depression were very minor.Conclusions. The descriptive validity of the DSM-IV melancholic features specifier may be questionable in MDD. There appear to be no major differences in current co-morbidity, or course of depression between melancholic and non-melancholic patients. The consistency of DSM-IV melancholic features across episodes appears weak.

scholarly journals Diabetes mellitus in people with schizophrenia, bipolar disorder and major depressive disorder: a systematic review and large scale meta-analysis

2016 ◽  
Vol 15 (2) ◽  
pp. 166-174 ◽  
Author(s):  
Davy Vancampfort ◽  
Christoph U. Correll ◽  
Britta Galling ◽  
Michel Probst ◽  
Marc De Hert ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Large Scale ◽  
Meta Analysis ◽  
Major Depressive
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