The high prevalence of “Soft” bipolar (II) features in atypical depression

Perugi, Giulio; Akiskal, Hagop S.; Lattanzi, Lorenzo; Cecconi, D.; Mastrocinque, C.; Patronelli, A.; Vignoli, S.; Bemi, E.

doi:10.1016/s0010-440x(98)90080-3

Cited by 259 publications

(161 citation statements)

References 37 publications

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“…Subsequent studies of treatment-seeking patients also found patients with atypical depression have an earlier age of onset (Posternak and Zimmerman, 2002;Perugi et al, 1998;Benazzi, 1999) and a more chronic illness (McGinn et al, 1996;Posternak and Zimmerman, 2002) than other depressed patients. Corroboration by epidemiological studies (Angst et al, 2002;Matza et al, 2003;Kendler et al, 1996) suggests these findings are not artifacts of self-selection or referral bias.…”

Section: Course Of Illnessmentioning

confidence: 96%

DSM-IV Depression with Atypical Features: Is It Valid?

Stewart

McGrath

Quitkin³

et al. 2009

Neuropsychopharmacol

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Atypical features were incorporated into the American Psychiatric Association's Diagnostic and Statistical Manual, Fourth Edition (DSM-IV, 1994) as an illness specifier for major depression and dysthymia. The validity of depression with atypical features was supported by differences relative to depression with melancholic features in syndromal symptoms, course of illness, biology, family history, and treatment response. This paper reviews post-DSM-IV literature relevant to the validity of depression with atypical features. Most studies support the pre-DSM-IV findings. Again, course of illness, biological, family, and treatment differences are shown between melancholia and depression with atypical features. Several biologic studies report nondepressed controls have mean values between depressed subjects having atypical features and other depressed patients. This suggests atypical depression is a distinct depressive group rather than a milder form of melancholia. In addition, some studies show distinctions between depressed subjects with atypical features and those having neither atypical nor melancholic features. As depression with atypical features separates not only from melancholia but also from other depressed groups and controls over a range of meaningful distinctions, we conclude it is a valid clinical syndrome, useful both heuristically and in driving treatment decisions.

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Section: Course Of Illnessmentioning

confidence: 96%

DSM-IV Depression with Atypical Features: Is It Valid?

Stewart

McGrath

Quitkin³

et al. 2009

Neuropsychopharmacol

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“…Conversely, some studies have found a high prevalence of BDD in depressed patients, especially those with the atypical subtype, although findings have varied considerably. In a study of 86 outpatients and day hospital patients with a major depressive episode with atypical features, 42% had lifetime BDD (Perugi et al, 1998). Two studies of outpatients with MDD (n=80, Phillips et al, 1996;and n=350, Nierenberg et al, 2002) both found that 14% of patients with atypical MDD had BDD; in the Nierenberg et al study, BDD was significantly more frequent in atypical MDD (14%) than in non-atypical MDD (5%).…”

Section: Introductionmentioning

confidence: 97%

Clinical features and correlates of major depressive disorder in individuals with body dysmorphic disorder

Phillips

Didie

Menard

2007

Journal of Affective Disorders

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Background-Body dysmorphic disorder (BDD) and major depressive disorder (MDD) appear highly comorbid. However, MDD in individuals with BDD has received little investigation.Methods-The prevalence and characteristics of comorbid MDD were assessed in 178 BDD subjects. BDD subjects with current comorbid MDD (n=68) were compared to BDD subjects without current comorbid MDD (n=96) on demographic and clinical characteristics. Predictors of current MDD were determined using logistic regression.Results-74.2% of subjects had lifetime MDD, and 38.2% had current MDD. The melancholic subtype was most common, and a majority of depressed subjects had recurrent episodes. Mean onset of BDD occurred at a younger age than MDD. Subjects with current comorbid MDD had many similarities to those without MDD, although those with comorbid MDD had more severe BDD. Subjects with comorbid MDD were also more likely to have an anxiety or personality disorder, as well as a family history of MDD. They also had greater social anxiety, suicidality, and poorer functioning and quality of life. Current MDD was independently predicted by a personality disorder and more severe BDD.Limitations-It is unclear how generalizable the results are to the community or to subjects ascertained for MDD who have comorbid BDD. The study lacked a comparison group such as MDD subjects without BDD.Conclusions-MDD is common in individuals with BDD. Individuals with current MDD had greater morbidity in some clinically important domains, including suicidality, functioning, and quality of life. A personality disorder and more severe BDD independently predicted the presence of current MDD.

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“…[13][14][15][16][17][18][19][20][21][22] For patients diagnosed with bipolar disorder, the lag between initial treatment-seeking and the correct diagnosis is often more than 10 years. 23,24 The treatment and clinical implications of the failure to recognize bipolar disorder in depressed patients include the underprescription of mood stabilizing medications, an increased risk of rapid cycling, and increased costs of care.…”

Section: Detecting Past Episodes Of Hypomania In Depressed Patients Amentioning

confidence: 99%

Would Broadening the Diagnostic Criteria for Bipolar Disorder Do More Harm Than Good? Implications From Longitudinal Studies of Subthreshold Conditions

Zimmerman

2012

J. Clin. Psychiatry

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The high prevalence of “Soft” bipolar (II) features in atypical depression

Cited by 259 publications

References 37 publications

DSM-IV Depression with Atypical Features: Is It Valid?

DSM-IV Depression with Atypical Features: Is It Valid?

Clinical features and correlates of major depressive disorder in individuals with body dysmorphic disorder

Would Broadening the Diagnostic Criteria for Bipolar Disorder Do More Harm Than Good? Implications From Longitudinal Studies of Subthreshold Conditions

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