Post-traumatic stress disorder and childhood emotional abuse are markers of subthreshold bipolarity and worse treatment outcome in major depressive disorder.
Journal
International clinical psychopharmacology
ISSN: 1473-5857
Titre abrégé: Int Clin Psychopharmacol
Pays: England
ID NLM: 8609061
Informations de publication
Date de publication:
01 01 2022
01 01 2022
Historique:
pubmed:
24
10
2021
medline:
11
3
2022
entrez:
23
10
2021
Statut:
ppublish
Résumé
Post-traumatic stress disorder (PTSD) and childhood maltreatment (CMT: parental neglect; emotional, physical and sexual abuse) have been linked to bipolar disorder but they are also common in major depressive disorder (MDD). Our objective was to investigate their association with the bipolar spectrum and antidepressant treatment outcome in 482 outpatients with DSM-IV MDD treated in the Combining Medications to Enhance Depression Outcomes trial for 28 weeks Bipolar spectrum score included age of onset <21 years, subthreshold hypomania (a period of elated or irritable mood with at least two concurrent hypomanic symptoms, which did not fulfill DSM criteria for hypomanic/manic episode) and depressive mixed state (DMX). PTSD subjects (n = 107; 22%) had more severe depression (P < 0.0001), work and social impairment (P = 0.0031), comorbid anxiety disorders (P < 0.0001) and increased suicidality (P = 0.0003). Bipolar spectrum score was higher with PTSD comorbidity (P = 0.0063) and childhood emotional abuse (P = 0.0001). PTSD comorbidity was associated with residual suicidality (P = 0.0218) after 6 weeks of antidepressant use whereas childhood emotional abuse [odds ratio (OR), 1.01-2.22], subthreshold hypomania (OR, 1.04-4.09) and DMX (OR, 1.00-4.19) were predictors of mood switch. These results corroborate the role of PTSD and childhood emotional abuse as markers of bipolar spectrum and prognostic factors during antidepressant treatment.
Identifiants
pubmed: 34686642
doi: 10.1097/YIC.0000000000000380
pii: 00004850-202201000-00001
pmc: PMC9648980
doi:
Banques de données
ClinicalTrials.gov
['NCT00590863']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1-8Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
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