Major Depressive Disorder With Subthreshold Bipolarity in the National Comorbidity Survey Replication
- 1 October 2010
- journal article
- research article
- Published by American Psychiatric Association Publishing in American Journal of Psychiatry
- Vol. 167 (10), 1194-1201
- https://doi.org/10.1176/appi.ajp.2010.09071011
Abstract
Objective: There is growing clinical and epidemiologic evidence that major mood disorders form a spectrum from major depressive disorder to pure mania. The authors examined the prevalence and clinical correlates of major depressive disorder with subthreshold bipolarity compared with pure major depressive disorder in the National Comorbidity Survey Replication (NCS-R). Method: The NCS-R is a nationally representative face-to-face household survey of the U.S. population conducted between February 2001, and April 2003. Lifetime history of mood disorders, symptoms, and clinical indicators of severity were collected using version 3.0 of the World Health Organization's Composite International Diagnostic Interview. Results: Nearly 40% of study participants with a history of major depressive disorder had a history of subthreshold hypo-mania. This subgroup had a younger age at onset, more episodes of depression, and higher rates of comorbidity than those without a history of hypomania and lower levels of clinical severity than those with bipolar II disorder. Conclusions: These findings demonstrate heterogeneity in major depressive disorder and support the validity of inclusion of subthreshold mania in the diagnostic classification. The broadening of criteria for bipolar disorder would have important implications for research and clinical practice.Keywords
This publication has 35 references indexed in Scilit:
- Antidepressants and suicidality in younger adults – is bipolar illness the missing link?Acta Psychiatrica Scandinavica, 2009
- Are antidepressants safe in the treatment of bipolar depression? A critical evaluation of their potential risk to induce switch into mania or cycle accelerationActa Psychiatrica Scandinavica, 2008
- Clinical and Economic Effects of Unrecognized or Inadequately Treated Bipolar DisorderJournal of Psychiatric Practice, 2008
- Long‐term outcome of patients with bipolar disorder commenced on lithium prophylaxis during hospitalization: a complete 15‐year register‐based follow‐upBipolar Disorders, 2008
- Lifetime and 12-Month Prevalence of Bipolar Spectrum Disorder in the National Comorbidity Survey ReplicationArchives of General Psychiatry, 2007
- Validity of the assessment of bipolar spectrum disorders in the WHO CIDI 3.0Journal of Affective Disorders, 2006
- Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey ReplicationArchives of General Psychiatry, 2005
- Is there evidence for a latent class called ‘hypomanic temperament’?Journal of Affective Disorders, 2003
- Assessing Psychiatric Impairment in Primary Care with the Sheehan Disability ScaleThe International Journal of Psychiatry in Medicine, 1997
- A Rating Scale for Mania: Reliability, Validity and SensitivityThe British Journal of Psychiatry, 1978