Sub-threshold depression and antidepressants use in a community sample: Searching anxiety and finding bipolar disorder

Mauro G. Carta, Leonardo Tondo, Matteo Balestrieri, Filippo Caraci, Liliana Dell'Osso, Guido Di Sciascio, Carlo Faravelli, Maria C. Hardoy, Maria E. Lecca, Maria F. Moro, Krishna M. Bhat, Massimo Casacchia, Filippo Drago

Research output: Contribution to journalArticle

Abstract

Background: To determine the use of antidepressants (ADs) in people with sub-threshold depression (SD); the lifetime prevalence of mania and hypomania in SD and the link between ADs use, bipolarity and anxiety disorders in SD.Methods: Study design: community survey. Study population: samples randomly drawn, after stratification from the adult population of municipal records. Sample size: 4999 people from seven areas within six Italian regions. Tools: Questionnaire on psychotropic drug consumption, prescription; Structured Clinical Interview NP for DSM-IV modified (ANTAS); Hamilton Depression Rating Scale (HAM-D); Mood Disorder Questionnaire (MDQ); Short Form Health Survey (SF-12). SD definition: HAM-D > 10 without lifetime diagnosis of Depressive Episode (DE).Results: SD point prevalence is 5.0%. The lifetime prevalence of mania and hypomania episodes in SD is 7.3%. Benzodiazepines (BDZ) consumption in SD is 24.1%, followed by ADs (19.7%). In SD, positive for MDQ and comorbidity with Panic Disorder (PD) or Generalized Anxiety Disorders (GAD) are associated with ADs use, whereas the association between a positive MDQ and ADs use, without a diagnosis of PD or GAD, is not significant. Only in people with DE the well-being (SF-12) is higher among those using first-line antidepressants compared to those not using any medication. In people with SD no significant differences were found in terms of SF-12 score according to drug use.Conclusions: This study suggests caution in prescribing ADs to people with SD. In people with concomitant anxiety disorders and SD, it should be mandatory to perform a well-designed assessment and evaluate the presence of previous manic or hypomanic symptoms prior to prescribing ADs.

Original languageEnglish
Article number164
JournalBMC Psychiatry
Volume11
DOIs
Publication statusPublished - Oct 10 2011

ASJC Scopus subject areas

  • Psychiatry and Mental health

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    Carta, M. G., Tondo, L., Balestrieri, M., Caraci, F., Dell'Osso, L., Di Sciascio, G., Faravelli, C., Hardoy, M. C., Lecca, M. E., Moro, M. F., Bhat, K. M., Casacchia, M., & Drago, F. (2011). Sub-threshold depression and antidepressants use in a community sample: Searching anxiety and finding bipolar disorder. BMC Psychiatry, 11, [164]. https://doi.org/10.1186/1471-244X-11-164