Exploration of mood spectrum symptoms during a major depressive episode: The impact of contrapolarity—Results from a transdiagnostic cluster analysis on an Italian sample of unipolar and bipolar patients
Abstract Background Subthreshold hypomania during a major depressive episode challenges the bipolar-unipolar dichotomy. In our study we employed a cross-diagnostic cluster analysis - to identify distinct subgroups within a cohort of depressed patients. Methods A k-means cluster analysis— based o...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2022-01-01
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| Series: | European Psychiatry |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933822000207/type/journal_article |
| _version_ | 1827994959669624832 |
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| author | Ludovico Mineo Alessandro Rodolico Giorgio Alfredo Spedicato Andrea Aguglia Simone Bolognesi Carmen Concerto Alessandro Cuomo Arianna Goracci Giuseppe Maina Andrea Fagiolini Mario Amore Eugenio Aguglia |
| author_facet | Ludovico Mineo Alessandro Rodolico Giorgio Alfredo Spedicato Andrea Aguglia Simone Bolognesi Carmen Concerto Alessandro Cuomo Arianna Goracci Giuseppe Maina Andrea Fagiolini Mario Amore Eugenio Aguglia |
| author_sort | Ludovico Mineo |
| collection | DOAJ |
| description |
Abstract
Background
Subthreshold hypomania during a major depressive episode challenges the bipolar-unipolar dichotomy. In our study we employed a cross-diagnostic cluster analysis - to identify distinct subgroups within a cohort of depressed patients.
Methods
A k-means cluster analysis— based on the domain scores of the Mood Spectrum Self-Report (MOODS-SR) questionnaire—was performed on a data set of 300 adults with either bipolar or unipolar depression. After identifying groups, between-clusters comparisons were conducted on MOODS-SR domains and factors and on a set of sociodemographic, clinical and psychometric variables.
Results
Three clusters were identified: one with intermediate depressive and poor manic symptomatology (Mild), one with severe depressive and poor manic symptomatology (Moderate), and a third one with severe depressive and intermediate manic symptomatology (Mixed). Across the clusters, bipolar patients were significantly less represented in the Mild one, while the DSM-5 “Mixed features” specifier did not differentiate the groups. When compared to the other patients, those of Mixed cluster exhibited a stronger association with most of the illness-severity, quality of life, and outcomes measures considered. After performing pairwise comparisons significant differences between “Mixed” and “Moderate” clusters were restricted to: current and disease-onset age, psychotic ideation, suicidal attempts, hospitalization numbers, impulsivity levels and comorbidity for Cluster B personality disorder.
Conclusions
In the present study, a clustering approach based on a spectrum exploration of mood symptomatology led to the identification of three transdiagnostic groups of patients. Consistent with our hypothesis, the magnitude of subthreshold (hypo)manic symptoms was related to a greater clinical severity, regardless of the main categorical diagnosis.
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| first_indexed | 2024-04-10T04:49:05Z |
| format | Article |
| id | doaj.art-2ab615e0bdd0454cb15a54dbbbb36dbc |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-04-10T04:49:05Z |
| publishDate | 2022-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-2ab615e0bdd0454cb15a54dbbbb36dbc2023-03-09T12:33:56ZengCambridge University PressEuropean Psychiatry0924-93381778-35852022-01-016510.1192/j.eurpsy.2022.20Exploration of mood spectrum symptoms during a major depressive episode: The impact of contrapolarity—Results from a transdiagnostic cluster analysis on an Italian sample of unipolar and bipolar patientsLudovico Mineo0https://orcid.org/0000-0002-9692-2696Alessandro Rodolico1https://orcid.org/0000-0003-2196-0601Giorgio Alfredo Spedicato2https://orcid.org/0000-0002-0315-8888Andrea Aguglia3https://orcid.org/0000-0002-2003-2101Simone Bolognesi4Carmen Concerto5https://orcid.org/0000-0002-7426-5250Alessandro Cuomo6Arianna Goracci7Giuseppe Maina8Andrea Fagiolini9https://orcid.org/0000-0001-5827-0853Mario Amore10Eugenio Aguglia11Department of Clinical and Experimental Medicine, University of Catania, Catania, ItalyDepartment of Clinical and Experimental Medicine, University of Catania, Catania, ItalyDepartment of Banking and Insurance, Catholic University of Milan, Milan, ItalyDepartment of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy IRCCS Ospedale Policlinico San Martino, Department of Neurosciences, Genoa, ItalyDepartment of Molecular Medicine, University of Siena, Siena, ItalyDepartment of Clinical and Experimental Medicine, University of Catania, Catania, ItalyDepartment of Molecular Medicine, University of Siena, Siena, ItalyDepartment of Molecular Medicine, University of Siena, Siena, ItalyRita Levi Montalcini Department of Neuroscience, University of Turin, University Hospital San Luigi Gonzaga, Turin, ItalyDepartment of Molecular Medicine, University of Siena, Siena, ItalyDepartment of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy IRCCS Ospedale Policlinico San Martino, Department of Neurosciences, Genoa, ItalyDepartment of Clinical and Experimental Medicine, University of Catania, Catania, Italy Abstract Background Subthreshold hypomania during a major depressive episode challenges the bipolar-unipolar dichotomy. In our study we employed a cross-diagnostic cluster analysis - to identify distinct subgroups within a cohort of depressed patients. Methods A k-means cluster analysis— based on the domain scores of the Mood Spectrum Self-Report (MOODS-SR) questionnaire—was performed on a data set of 300 adults with either bipolar or unipolar depression. After identifying groups, between-clusters comparisons were conducted on MOODS-SR domains and factors and on a set of sociodemographic, clinical and psychometric variables. Results Three clusters were identified: one with intermediate depressive and poor manic symptomatology (Mild), one with severe depressive and poor manic symptomatology (Moderate), and a third one with severe depressive and intermediate manic symptomatology (Mixed). Across the clusters, bipolar patients were significantly less represented in the Mild one, while the DSM-5 “Mixed features” specifier did not differentiate the groups. When compared to the other patients, those of Mixed cluster exhibited a stronger association with most of the illness-severity, quality of life, and outcomes measures considered. After performing pairwise comparisons significant differences between “Mixed” and “Moderate” clusters were restricted to: current and disease-onset age, psychotic ideation, suicidal attempts, hospitalization numbers, impulsivity levels and comorbidity for Cluster B personality disorder. Conclusions In the present study, a clustering approach based on a spectrum exploration of mood symptomatology led to the identification of three transdiagnostic groups of patients. Consistent with our hypothesis, the magnitude of subthreshold (hypo)manic symptoms was related to a greater clinical severity, regardless of the main categorical diagnosis. https://www.cambridge.org/core/product/identifier/S0924933822000207/type/journal_articleMixed depressionMood spectrumSubthreshold hypomania“with mixed features” specifiercluster analysis |
| spellingShingle | Ludovico Mineo Alessandro Rodolico Giorgio Alfredo Spedicato Andrea Aguglia Simone Bolognesi Carmen Concerto Alessandro Cuomo Arianna Goracci Giuseppe Maina Andrea Fagiolini Mario Amore Eugenio Aguglia Exploration of mood spectrum symptoms during a major depressive episode: The impact of contrapolarity—Results from a transdiagnostic cluster analysis on an Italian sample of unipolar and bipolar patients European Psychiatry Mixed depression Mood spectrum Subthreshold hypomania “with mixed features” specifier cluster analysis |
| title | Exploration of mood spectrum symptoms during a major depressive episode: The impact of contrapolarity—Results from a transdiagnostic cluster analysis on an Italian sample of unipolar and bipolar patients |
| title_full | Exploration of mood spectrum symptoms during a major depressive episode: The impact of contrapolarity—Results from a transdiagnostic cluster analysis on an Italian sample of unipolar and bipolar patients |
| title_fullStr | Exploration of mood spectrum symptoms during a major depressive episode: The impact of contrapolarity—Results from a transdiagnostic cluster analysis on an Italian sample of unipolar and bipolar patients |
| title_full_unstemmed | Exploration of mood spectrum symptoms during a major depressive episode: The impact of contrapolarity—Results from a transdiagnostic cluster analysis on an Italian sample of unipolar and bipolar patients |
| title_short | Exploration of mood spectrum symptoms during a major depressive episode: The impact of contrapolarity—Results from a transdiagnostic cluster analysis on an Italian sample of unipolar and bipolar patients |
| title_sort | exploration of mood spectrum symptoms during a major depressive episode the impact of contrapolarity results from a transdiagnostic cluster analysis on an italian sample of unipolar and bipolar patients |
| topic | Mixed depression Mood spectrum Subthreshold hypomania “with mixed features” specifier cluster analysis |
| url | https://www.cambridge.org/core/product/identifier/S0924933822000207/type/journal_article |
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