Citation

Bertetto N, Rosso G, Blengino G, Bogetto F, Maina G. Minerva Psichiatr. 2013; 54(1): 83-92.

Copyright

(Copyright © 2013, Italian Society of Social Psychiatry, Publisher Edizioni Minerva Medica)

DOI

unavailable

PMID

unavailable

Abstract

Aim. The aim of this study was to elucidate the relationship between mixed manic or hypomanic episodes and the use of antidepressants before their onset.

METHODS. We enrolled a sample of 117 bipolar inpatients with a DSM-IV manic or hypomanic episode. Patients have been grouped according to the presence or absence of mixed features: mixed (hypo)mania was defined as a (hypo)manic episode with evidence of at least three depressive symptoms, according to criteria proposed by Elroy et al. A comparison between the two subgroups has been performed on socio-demographic and clinical characteristics and on psychopharmacologic treatments during the month before the onset of the symptomatology.

RESULTS. Fifty-three percent of patients with mixed (hypo)mania and 25.5% patients with "pure" (hypo)mania assumed at least one antidepressant before the onset of the symptomatology (P=0.003). No statistically significant differences were found concerning mood stabilizers, antipsychotics and benzodiazepine. Further, patients with mixed (hypo)mania differ from patients with "pure" (hypo)manic episodes concerning the following domains: higher number of previous mixed episodes (1.15 vs. 0.33: P<0.001), higher rate of suicide attempt in current episode (6% vs. 0%: P=0.013) and of psychiatric lifetime comorbidity (66.7% vs. 29.4%: P<0.001), higher mean score at the CGI-BP (4.76 vs. 4.27, P=0.003) and lower mean score at the GAF (41.61 vs. 48.78, P=0.003).

CONCLUSION. Our data support the hypothesis that the use of antidepressants is related to the onset of mixed (hypo)manic episodes more than pure (hypo)manic episodes. This is a further evidence that the use of antidepressants should be limited as much as possible in bipolar disorder, especially in euthymic patient with previous mixed episodes or suicide attempts.

Language: it

Keywords

human; bipolar disorder; Bipolar disorder; Antidepressive agents; Mental disorders; suicide attempt; comorbidity; article; major clinical study; symptomatology; antidepressant agent; neuroleptic agent; psychopharmacology; hospital patient; benzodiazepine derivative; hypomania; DSM-IV; mood stabilizer; treatment duration; mixed mania and depression