Posted by capricorn on July 11, 2006, at 15:01:27
10/07/2006 - Symptoms of depression act as markers of bipolar II disorder
2006 JUL 9 - -- Symptoms of depression can act as markers of bipolar II disorder. "Under-diagnosis and misdiagnosis of bipolar II disorder as a major depressive disorder are frequently reported.
Medical Letter on the CDC & FDA via NewsEdge Corporation :2006 JUL 9 - (NewsRx.com) -- Symptoms of depression can act as markers of bipolar II disorder.
"Under-diagnosis and misdiagnosis of bipolar II disorder (BP-II) as a major depressive disorder (MDD) are frequently reported. The study aim was to find which symptoms of depression could be possible cross-sectional markers of BP4-II, in order to reduce under-diagnosing BP-H. Consecutive 379 BP-II and 271 MDD major depressive episode (MDE) outpatients were interviewed with the Structured Clinical Interview for DSM-IV, the Hypomania Interview Guide, and the Family History Screen, by a senior psychiatrist in a private practice," a researcher in Italy reports.
"Inside-MDE hypomanic symptoms (elevated mood and increased self-esteem always absent by definition) were systematically assessed," said Franco Benazzi at the Hecker Psychiatry Research Center. "Mixed depression was defined as an MDE plus three or more inside-MDE hypomanic symptoms, a definition validated by Akiskal and Benazzi. The MDE symptoms significantly more common in BP-II versus MDD were weight gain, increased eating, hypersomnia, psychomotor agitation, worthlessness, and diminished ability to concentrate."
Benazzi reported, "The inside-MDE hypomanic symptoms significantly more common in BP-II were distractibility, racing/crowded thoughts, irritability, psychomotor agitation, more talkativeness, increased risky and goal-directed activities. Multiple logistic regression showed that hypersomnia, racing/crowded thoughts, irritability, and psychomotor agitation were independent predictors of BP-II. Irritability had the most balanced combination of sensitivity and specificity predicting BP-H. Psychomotor agitation had the highest specificity but the lowest sensitivity."
"Racing/crowded thoughts had the highest sensitivity but the lowest specificity," noted Benazzi. These symptoms had a similar positive predictive value (PPV) for BP-II, which was around 70% (PPV is more clinically useful than sensitivity and specificity), which in turn was similar to the PPV of mixed depression and atypical depression (two diagnostic clinical markers of BP-II). All possible combinations of these symptoms had a PPV similar to that of the individual symptoms. The validity as BP-II markers of these symptoms was supported by a significant association with bipolar family history."
Benazzi concluded, "Hypersomnia, racing/crowded thoughts, irritability, and psychomotor agitation may be useful, cross-sectional markers of BP-II. Finding these symptoms in depression should lead the clinician to careful probing for history of hypomania, which should reduce the BP-II misdiagnosed as MDD. Results may also have treatment impacts, as antidepressants used alone (i.e., no concurrent mood stabilizing agent) in BP-II depression misdiagnosed as MDD may increase cycling."
(Symptoms of depression as possible markers of bipolar II disorder. Prog Neuropsychopharmacol Biol Psychiatry, 2006;30(3):471-477).
For additional information, contact Franco Benazzi, Via Pozzetto 17, I-48010 Cervia, RA, Italy. E-mail: FrancoBenazzi
FBenazzi.it.
is: Pergamon-Elsevier Science Ltd., The Boulevard, Langford Lane, Kidlington, Oxford OX5 1GB, England.
Keywords: Forli, Italy, Mental Health, Bipolar Disorder Diagnosis, Major Depressive Disorder, Antidepressants, Bipolar Disorder Type II, Depressive Mixed State, Hypersomnia, Irritability, Racing Thoughts, Psychomotor Agitation, Diagnostics.
poster:capricorn
thread:666094
URL: http://www.dr-bob.org/babble/20060709/msgs/666094.html