TY  - JOUR
PY  - 2018//
TI  - Sub-threshold bipolar disorder in medication-free young subjects with major depression: clinical characteristics and antidepressant treatment response
JO  - Journal of psychiatric research
A1  - Koirala, Parashar
A1  - Hu, Bo
A1  - Altinay, Murat
A1  - Li, Manshi
A1  - DiVita, Amy L.
A1  - Bryant, Kelly A.
A1  - Karne, Harish S.
A1  - Fiedorowicz, Jess G.
A1  - Anand, Amit
SP  - 1
EP  - 8
VL  - 110
IS  - 
N2  - BACKGROUND: This study, for the first time, compared illness and antidepressant response characteristics of young subjects with major depression (MDD) at low (LRMDD) or high-risk (HRMDD) for developing bipolar disorder with characteristics of young bipolar (BPD) subjects and healthy controls (HC). <br><br>METHODS: One hundred and six young (15-30 yr), medication-free subjects MDD subjects (HRMDD, N = 51; LRMDD, N = 55) were compared with 32 BPD (Type I: 14; Type II: 18) as well as 49 HC subjects. Baseline illness characteristics and frequency of comorbid conditions were examined using Analysis of Variance and Cochran-Armitage trend test. Additionally, in MDD subjects, the effect of open-label antidepressant treatment for up to 24 months with periodic assessments was compared between HRMDD and LRMDD groups for treatment response, remission and (hypo)mania switch while controlling for attrition. <br><br>RESULTS: Significant gradation from LRMDD to HRMDD to BPD groups was found for increasing occurrence of alcohol dependence (p = 0.006), comorbid PTSD (p = 0.006), borderline personality traits (p = 0.001), and occurrence of melancholic features (p < 0.005). Antidepressant treatment response was similar between the two groups except that for the 12-month period HRMDD showed a trend for a lower response. Switch to (hypo)mania was infrequent in both groups though the HRMDD showed a higher occurrence of spikes in (hypo)mania symptoms (>25% increase in YMRS scores)(p = 0.04). <br><br>CONCLUSION: Findings of the study indicate that a substantial proportion of young MDD subjects share BPD illness characteristics. These HRMDD subjects, if treated with antidepressants, need to be monitored for development of BPD. TRIAL REGISTRATION: NCT01811147.<br><br>Copyright © 2018. Published by Elsevier Ltd.<p />  <p>Language: en</p>
LA  - en
SN  - 0022-3956
UR  - http://dx.doi.org/10.1016/j.jpsychires.2018.12.006
ID  - ref1
ER  -