Psychopathological and sociodemographic features in treatment-resistant unipolar depression versus bipolar depression: A comparative study

NA Nuñez, S Comai, E Dumitrescu, MF Ghabrash, J Tabaka, M Saint-Laurent, S Vida, T Kolivakis, A Fielding, N Low, P Cervantes, L Booij, G Gobbi

Research output: Contribution to journalArticle

Abstract

Background: Some authors have hypothesized that Treatment-Resistant Unipolar Depression (TRD-UP) should be considered within the bipolar spectrum disorders and that hidden bipolarity may be a risk factor for TRD-UP. However, there are neither studies comparing clinical and sociodemographic data of patients with TRD-UP versus Bipolar (BP) disorders nor are there any examining differences versus Bipolar type I (BP-I) and Bipolar type II (BP-II). Methods: Charts analysis was conducted on 194 patients followed at the Mood Disorders Clinic of the McGill University Health Center. Sociodemographic, clinical features and depression scales were collected from patients meeting DSM-IV criteria for TRD-UP (n = 100) and BP (n = 94). Binary logistic regression analysis was conducted to examine clinical predictors independently associated with the two disorders. Results: Compared to BP, TRD-UP patients exhibited greater severity of depression, prevalence of anxiety and panic disorders, melancholic features, Cluster-C personality disorders, later onset of depression and fewer hospitalizations. Binary logistic regression indicated that higher comorbidity with anxiety disorders, higher depression scale scores and lower global assessment of functioning (GAF) scores, and lower number of hospitalizations and psychotherapies differentiated TRD-UP from BP patients. We also found that the rate of unemployment and the number of hospitalizations for depression was higher in BP-I than in BP-II, while the rate of suicide attempts was lower in BP-I than in BP-II depressed patients. Conclusions: These results suggest that TRD-UP constitutes a distinct psychopathological condition and not necessarily a prodromal state of BP depression. © 2018 The Author(s).
Original languageEnglish
Article number68
JournalBMC Psychiatry
Volume18
Issue number1
DOIs
Publication statusPublished - 2018

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Treatment-Resistant Depressive Disorder
Depressive Disorder
Bipolar Disorder
Depression
Hospitalization
Anxiety Disorders
Logistic Models
Prodromal Symptoms
Unemployment
Panic Disorder
Personality Disorders
Mood Disorders
Psychotherapy
Diagnostic and Statistical Manual of Mental Disorders
Suicide
Comorbidity
Regression Analysis
Health

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Psychopathological and sociodemographic features in treatment-resistant unipolar depression versus bipolar depression: A comparative study. / Nuñez, NA; Comai, S; Dumitrescu, E; Ghabrash, MF; Tabaka, J; Saint-Laurent, M; Vida, S; Kolivakis, T; Fielding, A; Low, N; Cervantes, P; Booij, L; Gobbi, G.

In: BMC Psychiatry, Vol. 18, No. 1, 68, 2018.

Research output: Contribution to journalArticle

Nuñez, NA, Comai, S, Dumitrescu, E, Ghabrash, MF, Tabaka, J, Saint-Laurent, M, Vida, S, Kolivakis, T, Fielding, A, Low, N, Cervantes, P, Booij, L & Gobbi, G 2018, 'Psychopathological and sociodemographic features in treatment-resistant unipolar depression versus bipolar depression: A comparative study', BMC Psychiatry, vol. 18, no. 1, 68. https://doi.org/10.1186/s12888-018-1641-y
Nuñez, NA ; Comai, S ; Dumitrescu, E ; Ghabrash, MF ; Tabaka, J ; Saint-Laurent, M ; Vida, S ; Kolivakis, T ; Fielding, A ; Low, N ; Cervantes, P ; Booij, L ; Gobbi, G. / Psychopathological and sociodemographic features in treatment-resistant unipolar depression versus bipolar depression: A comparative study. In: BMC Psychiatry. 2018 ; Vol. 18, No. 1.
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AU - Ghabrash, MF

AU - Tabaka, J

AU - Saint-Laurent, M

AU - Vida, S

AU - Kolivakis, T

AU - Fielding, A

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AU - Booij, L

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N2 - Background: Some authors have hypothesized that Treatment-Resistant Unipolar Depression (TRD-UP) should be considered within the bipolar spectrum disorders and that hidden bipolarity may be a risk factor for TRD-UP. However, there are neither studies comparing clinical and sociodemographic data of patients with TRD-UP versus Bipolar (BP) disorders nor are there any examining differences versus Bipolar type I (BP-I) and Bipolar type II (BP-II). Methods: Charts analysis was conducted on 194 patients followed at the Mood Disorders Clinic of the McGill University Health Center. Sociodemographic, clinical features and depression scales were collected from patients meeting DSM-IV criteria for TRD-UP (n = 100) and BP (n = 94). Binary logistic regression analysis was conducted to examine clinical predictors independently associated with the two disorders. Results: Compared to BP, TRD-UP patients exhibited greater severity of depression, prevalence of anxiety and panic disorders, melancholic features, Cluster-C personality disorders, later onset of depression and fewer hospitalizations. Binary logistic regression indicated that higher comorbidity with anxiety disorders, higher depression scale scores and lower global assessment of functioning (GAF) scores, and lower number of hospitalizations and psychotherapies differentiated TRD-UP from BP patients. We also found that the rate of unemployment and the number of hospitalizations for depression was higher in BP-I than in BP-II, while the rate of suicide attempts was lower in BP-I than in BP-II depressed patients. Conclusions: These results suggest that TRD-UP constitutes a distinct psychopathological condition and not necessarily a prodromal state of BP depression. © 2018 The Author(s).

AB - Background: Some authors have hypothesized that Treatment-Resistant Unipolar Depression (TRD-UP) should be considered within the bipolar spectrum disorders and that hidden bipolarity may be a risk factor for TRD-UP. However, there are neither studies comparing clinical and sociodemographic data of patients with TRD-UP versus Bipolar (BP) disorders nor are there any examining differences versus Bipolar type I (BP-I) and Bipolar type II (BP-II). Methods: Charts analysis was conducted on 194 patients followed at the Mood Disorders Clinic of the McGill University Health Center. Sociodemographic, clinical features and depression scales were collected from patients meeting DSM-IV criteria for TRD-UP (n = 100) and BP (n = 94). Binary logistic regression analysis was conducted to examine clinical predictors independently associated with the two disorders. Results: Compared to BP, TRD-UP patients exhibited greater severity of depression, prevalence of anxiety and panic disorders, melancholic features, Cluster-C personality disorders, later onset of depression and fewer hospitalizations. Binary logistic regression indicated that higher comorbidity with anxiety disorders, higher depression scale scores and lower global assessment of functioning (GAF) scores, and lower number of hospitalizations and psychotherapies differentiated TRD-UP from BP patients. We also found that the rate of unemployment and the number of hospitalizations for depression was higher in BP-I than in BP-II, while the rate of suicide attempts was lower in BP-I than in BP-II depressed patients. Conclusions: These results suggest that TRD-UP constitutes a distinct psychopathological condition and not necessarily a prodromal state of BP depression. © 2018 The Author(s).

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