Journal
JOURNAL OF AFFECTIVE DISORDERS
Volume 135, Issue 1-3, Pages 241-250Publisher
ELSEVIER
DOI: 10.1016/j.jad.2011.07.027
Keywords
Psychosis; Bipolar; Unipolar; Major depression; Mood disorders
Categories
Funding
- National Found for Scientific Research, Belgium-Fonds National de la Recherche Scientifique [3.4553.01]
- Janssen-Cilag
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Background: The nosological and clinical implications of psychotic features in the course of mood disorders have been widely debated. Currently, no specification exists for defining a subgroup of lifetime Psychotic Mood Disorder (PMD) patients. Methods: A total of 2178 patients were examined, including subjects with Bipolar Disorder (BP) type I (n = 519) and II (n = 207) and Major Depressive Disorder (n = 1452). Patients were divided between PMD (n = 645) and non-psychotic Mood Disorders (MD) (n=1533) by the lifetime presence of at least one mood episode with psychotic features. Subjects having a depressive episode at the time of assessment were also examined: HAM-D and YMRS scores were compared between MD and PMD subjects, both with and without current psychotic features. Results: A diagnosis of BP-I, a higher familial load for BP, a higher number of mood episodes lifetime, and a higher prevalence of OCD and somatic comorbidities were all associated to PMD. A diagnosis of BP (OR=4.48) was the only significant predictor for psychosis. PMD with non-psychotic depression were apparently less severe than MD patients and had a lower rate of non-responders to AD treatment. Sub-threshold manic symptoms and suicidal risk were also more pronounced among PMD. Limitations: The lack of information about number and polarity of previous psychotic mood episodes may be the major limitations of our study. Conclusions: BP diagnosis is the most significant predictor for psychosis in mood disorders. Non-psychotic mood episodes in PMD patients may be characterized by a distinctive symptom profile and, possibly, a different response to treatment. (C) 2011 Elsevier B.V. All rights reserved.
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