Major depressive disorder with subthreshold bipolarity in the National Comorbidity Survey Replication - PubMed (original) (raw)

Comparative Study

Major depressive disorder with subthreshold bipolarity in the National Comorbidity Survey Replication

Jules Angst et al. Am J Psychiatry. 2010 Oct.

Abstract

Objective: There is growing clinical and epidemiologic evidence that major mood disorders form a spectrum from major depressive disorder to pure mania. The authors examined the prevalence and clinical correlates of major depressive disorder with subthreshold bipolarity compared with pure major depressive disorder in the National Comorbidity Survey Replication (NCS-R).

Method: The NCS-R is a nationally representative face-to-face household survey of the U.S. population conducted between February 2001, and April 2003. Lifetime history of mood disorders, symptoms, and clinical indicators of severity were collected using version 3.0 of the World Health Organization's Composite International Diagnostic Interview.

Results: Nearly 40% of study participants with a history of major depressive disorder had a history of subthreshold hypo-mania. This subgroup had a younger age at onset, more episodes of depression, and higher rates of comorbidity than those without a history of hypomania and lower levels of clinical severity than those with bipolar II disorder.

Conclusions: These findings demonstrate heterogeneity in major depressive disorder and support the validity of inclusion of subthreshold mania in the diagnostic classification. The broadening of criteria for bipolar disorder would have important implications for research and clinical practice.

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Figure 1. Mean Age Onset of Mania/Hypomania and Depression by Mood Disorder Spectrum Subgroups

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References

    1. Merikangas KR, Akiskal HS, Angst J, Greenberg PE, Hirschfeld RM, Petukhova M, et al. Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey replication. [erratum appears in Arch Gen Psychiatry. 2007 Sep;64(9):1039] Archives of General Psychiatry. 2007;64(5):543–52. - PMC - PubMed
    1. Angst J, Gamma A, Benazzi F, Ajdacic V, Eich D, Rossler W. Toward a re-definition of sub-threshold bipolarity: Epidemiology and proposed criteria for bipolar-II, minor bipolar disorders and hypomania. Journal of Affective Disorders. [Journal; Peer Reviewed Journal] 2003 Jan;73(1-2):133–46. - PubMed
    1. Lewinsohn PM, Klein DN, Seeley JR. Bipolar disorders in a community sample of older adolescents: prevalence, phenomenology, comorbidity, and course. J Am Acad Child Adolesc Psychiatry. 1995 Apr;34(4):454–63. - PubMed
    1. Merikangas KR, Herrell R, Swendsen J, Rossler W, Ajdacic-Gross V, Angst J. Specificity of bipolar spectrum conditions in the comorbidity of mood and substance use disorders: results from the Zurich cohort study. Arch Gen Psychiatry. 2008 Jan;65(1):47–52. - PubMed
    1. Szadoczky E, Papp Z, Vitrai J, Rihmer Z, Furedi J. The prevalence of major depressive and bipolar disorders in Hungary. Results from a national epidemiologic survey. J Affect Disord. 1998 Sep;50(2-3):153–62. - PubMed

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