Subsyndromal depressive symptoms in patients with bipolar and unipolar disorder during clinical remission

• Published in: Journal of affective disorders Vol. 107; no. 1; pp. 169 - 174
• Main Authors: Vieta, E, Sánchez-Moreno, J, Lahuerta, J, Zaragoza, S
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier B.V 01.04.2008; Elsevier
• Subjects: Adult; Adult and adolescent clinical studies; Age of Onset; Biological and medical sciences; Bipolar affective disorder; Bipolar disorder; Bipolar Disorder - diagnosis; Bipolar Disorder - psychology; Bipolar disorders; Control group; Depression; Depression - diagnosis; Depression - epidemiology; Depression - psychology; Depressive Disorder - diagnosis; Depressive Disorder - psychology; Depressive Disorder, Major - diagnosis; Depressive Disorder, Major - psychology; Detection; Diagnosis, Differential; Diagnostic and Statistical Manual of Mental Disorders; Female; Follow-Up Studies; Healthy subjects; Humans; Major depression; Male; Medical sciences; Middle Aged; Mood disorders; Prevalence; Psychiatric Status Rating Scales - statistics & numerical data; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychometrics; Psychopathology. Psychiatry; Remission; Severity of Illness Index; Subsyndromal depression; Symptoms; Unipolar disorders; Bipolar disorder; Healthy subjects; Control group; Detection; Major depression; Subsyndromal depression; Mood disorder; Human; Healthy subject; Depression; Symptomatology; Remission; Comparative study
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2007.08.007

Abstract Background Subsyndromal depressive symptoms seem to be quite prevalent in mood disorders although very few studies have assessed them in patients considered to be in remission by clinical and psychometric criteria. This study sought to evaluate the presence of subsyndromal depressive symptoms in bipolar and unipolar patients in clinical remission. Methods One-hundred seventy-six patients with DSM-IV bipolar (62 bipolar I, 58 bipolar II) or unipolar mayor depression ( n = 58) in clinical remission and 60 healthy subjects were assessed using several psychometric instruments including the 17 items Hamilton Depression Rating Scale (HDRS). To be considered in clinical remission patients assessed with the Clinical Impression for Bipolar Disorder-Modified (CGI-BP-M) had to be stable for 6 months and scoring 6 or less in the Young Mania Rating Scale (YMRS) and 8 or less in the HDRS. Results Both Unipolar Disorder (UD) and Bipolar Disorder (BD) patients in clinical remission presented statistically significant higher HRSD scores, than healthy subjects. The HRSD scores were statistically higher in UD patients under remission than in BD patients. The subsyndromal symptoms more strongly associated with a clinical diagnosis of either UD or BD were Depressed Mood, Somatic Anxiety, Impact on Work and Activities, Psychic Anxiety, Gastrointestinal and Somatic Symptoms, Retardation during the Interview and Genital Symptoms. Conclusion Subsyndromal depressive symptoms are present in affective disorder patients, both UD and BD, who apparently are in clinical remission. Remitted unipolar patients may have more residual symptoms than bipolar patients, particularly in items related to anxiety and somatic complaints.