More Liberal “with Mixed Features” Threshold for Bipolar Depression May Be Not Only More Inclusive, But Also More Clinically Relevant. - 09/06/15
Résumé |
Aims |
Assess prevalence and clinical relevance of ’with mixed features” using a more liberal (2 opposite pole symptoms) compared to the more conservative DSM-5 (3 opposite pole symptoms) threshold in depressed bipolar disorder (BD) patients.
Methods |
BD outpatients were assessed with the Systematic Treatment Enhancement Program for BD (STEP-BD) Affective Disorders Evaluation. Prevalence and clinical correlates of baseline depressive episodes ’with mixed features” were compared using a more liberal threshold and the more conservative DSM-5 threshold.
Results |
Among 503 BD patients, 151 (30.8%) had baseline syndromal major depressive episodes, among whom ’with mixed features” occurred in 22.5% (34/151) using a more liberal threshold, but in only 9.9% (15/151) using the more conservative DSM-5 threshold. Hence, the rate of ’with mixed features” for depressive episodes using the more liberal compared to the conservative threshold was more than twice (2.3 times) as high (Chi-square=8.8, p=0.004). Moreover, the more liberal threshold yielded more important statistically significant clinical correlates of ’with mixed features” compared to pure depressive episodes, which were not significant using the more conservative DSM-5 threshold. Specifically, using the more liberal threshold, mixed compared to pure depression was associated with more anxiety disorder comorbidity and alcohol use disorder comorbidity, and less antidepressant use.
Conclusions |
Further studies are warranted to assess our preliminary observation that a more liberal ’with mixed features” threshold for bipolar depression may be more inclusive and have more clinical relevance.
Le texte complet de cet article est disponible en PDF.Vol 30 - N° S1
P. 449 - mars 2015 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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