Are anxious and mixed depression two sides of the same coin? Similarities and differences in patients with bipolar I, II and unipolar disorders
Abstract Background Diagnostic criteria are not always useful to discriminate major depression with anxious distress (ADS-D; Diagnostic and Statistical Manual for Mental Disorders, version-5 [DSM-5] criteria) from mixed depression (Koukopoulos’ criteria; KMX-D). So, clinicians need alternative tools...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2023-01-01
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| Series: | European Psychiatry |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933823024458/type/journal_article |
| _version_ | 1797668510087774208 |
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| author | Antonio Tundo Laura Musetti Sophia Betrò Erika Cambiali Rocco de Filippis Donatella Marazziti Federico Mucci Luca Proietti Liliana Dell’Osso |
| author_facet | Antonio Tundo Laura Musetti Sophia Betrò Erika Cambiali Rocco de Filippis Donatella Marazziti Federico Mucci Luca Proietti Liliana Dell’Osso |
| author_sort | Antonio Tundo |
| collection | DOAJ |
| description | Abstract
Background
Diagnostic criteria are not always useful to discriminate major depression with anxious distress (ADS-D; Diagnostic and Statistical Manual for Mental Disorders, version-5 [DSM-5] criteria) from mixed depression (Koukopoulos’ criteria; KMX-D). So, clinicians need alternative tools to improve their diagnostic ability and to choose the most appropriate treatment. The aim of the present study is to identify socio-demographic and clinical features that discriminate patients with ADS-D from those with KMX-D.
Methods
Two hundred and forty-one consecutive outpatients with unipolar (51%) and bipolar (49%) disorder, fulfilling DSM-5 criteria for a current major depressive episode (MDE) and with a 21-item Hamilton Depression Rating Scale score ≥ 14, were recruited and treated in a prospective observational study.
Results
Ten percent of patients met criteria for KMX-D, 22% ADS-D, and 37% for both. Irritable premorbid temperament, mixed depression polarity at onset, mixed depression recurrence, and a high number of mania symptoms at intake were typical features of patients with KMX-D. Depressive polarity at onset, a low number of mania symptoms at intake, and generalized anxiety disorder comorbidity were typical features of patients with ADS-D. Multinomial logistic regression confirmed that higher rate of irritable temperament and higher Young Mania Rating Scale total score differentiated patients with KMX-D from patients with pure MDE.
Conclusion
Our findings suggest some clinical features that could help differentiate between ADS-D and KMX-D in patients meeting both conditions and to select the appropriate treatment. However, the small sample size may have limited the power to detect differences between the groups. Further research is needed to confirm the results of present study.
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| first_indexed | 2024-03-11T20:30:15Z |
| format | Article |
| id | doaj.art-7053b83809fd45da9b83db4da626e964 |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T20:30:15Z |
| publishDate | 2023-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-7053b83809fd45da9b83db4da626e9642023-10-02T09:30:49ZengCambridge University PressEuropean Psychiatry0924-93381778-35852023-01-016610.1192/j.eurpsy.2023.2445Are anxious and mixed depression two sides of the same coin? Similarities and differences in patients with bipolar I, II and unipolar disordersAntonio Tundo0https://orcid.org/0000-0002-0612-734XLaura Musetti1Sophia Betrò2https://orcid.org/0000-0002-5944-1906Erika Cambiali3Rocco de Filippis4https://orcid.org/0000-0001-9101-072XDonatella Marazziti5Federico Mucci6Luca Proietti7https://orcid.org/0000-0003-4270-3145Liliana Dell’Osso8Istituto di Psicopatologia, Rome, ItalyDepartment of Clinical and Experimental Medicine, University of Pisa, Pisa, ItalyIstituto di Psicopatologia, Rome, ItalyDepartment of Clinical and Experimental Medicine, University of Pisa, Pisa, ItalyIstituto di Psicopatologia, Rome, ItalyDepartment of Clinical and Experimental Medicine, University of Pisa, Pisa, ItalyDepartment of Biotechnology, Chemistry and Pharmacy, University of Siena, Siena, ItalyIstituto di Psicopatologia, Rome, ItalyDepartment of Clinical and Experimental Medicine, University of Pisa, Pisa, ItalyAbstract Background Diagnostic criteria are not always useful to discriminate major depression with anxious distress (ADS-D; Diagnostic and Statistical Manual for Mental Disorders, version-5 [DSM-5] criteria) from mixed depression (Koukopoulos’ criteria; KMX-D). So, clinicians need alternative tools to improve their diagnostic ability and to choose the most appropriate treatment. The aim of the present study is to identify socio-demographic and clinical features that discriminate patients with ADS-D from those with KMX-D. Methods Two hundred and forty-one consecutive outpatients with unipolar (51%) and bipolar (49%) disorder, fulfilling DSM-5 criteria for a current major depressive episode (MDE) and with a 21-item Hamilton Depression Rating Scale score ≥ 14, were recruited and treated in a prospective observational study. Results Ten percent of patients met criteria for KMX-D, 22% ADS-D, and 37% for both. Irritable premorbid temperament, mixed depression polarity at onset, mixed depression recurrence, and a high number of mania symptoms at intake were typical features of patients with KMX-D. Depressive polarity at onset, a low number of mania symptoms at intake, and generalized anxiety disorder comorbidity were typical features of patients with ADS-D. Multinomial logistic regression confirmed that higher rate of irritable temperament and higher Young Mania Rating Scale total score differentiated patients with KMX-D from patients with pure MDE. Conclusion Our findings suggest some clinical features that could help differentiate between ADS-D and KMX-D in patients meeting both conditions and to select the appropriate treatment. However, the small sample size may have limited the power to detect differences between the groups. Further research is needed to confirm the results of present study. https://www.cambridge.org/core/product/identifier/S0924933823024458/type/journal_articleanxious depressionanxious distress specifiermajor depressive episodemixed depression |
| spellingShingle | Antonio Tundo Laura Musetti Sophia Betrò Erika Cambiali Rocco de Filippis Donatella Marazziti Federico Mucci Luca Proietti Liliana Dell’Osso Are anxious and mixed depression two sides of the same coin? Similarities and differences in patients with bipolar I, II and unipolar disorders European Psychiatry anxious depression anxious distress specifier major depressive episode mixed depression |
| title | Are anxious and mixed depression two sides of the same coin? Similarities and differences in patients with bipolar I, II and unipolar disorders |
| title_full | Are anxious and mixed depression two sides of the same coin? Similarities and differences in patients with bipolar I, II and unipolar disorders |
| title_fullStr | Are anxious and mixed depression two sides of the same coin? Similarities and differences in patients with bipolar I, II and unipolar disorders |
| title_full_unstemmed | Are anxious and mixed depression two sides of the same coin? Similarities and differences in patients with bipolar I, II and unipolar disorders |
| title_short | Are anxious and mixed depression two sides of the same coin? Similarities and differences in patients with bipolar I, II and unipolar disorders |
| title_sort | are anxious and mixed depression two sides of the same coin similarities and differences in patients with bipolar i ii and unipolar disorders |
| topic | anxious depression anxious distress specifier major depressive episode mixed depression |
| url | https://www.cambridge.org/core/product/identifier/S0924933823024458/type/journal_article |
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