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Rate and significance of hypomanic switches in unipolar melancholic depression

Published online by Cambridge University Press:  16 April 2020

JM Menchon ,
C Gasto ,
J Vallejo ,
R Catalan ,
A Otero  and
E Vieta
JM Menchon
Affiliation:
Department of Psychiatry, Hospital de Bellvitge, Feixa Llarga, s/r. 08907 – L'Hospitalet de Llobregat, Barcelona
C Gasto
Affiliation:
Department of Psychiatry and Medical Psychobiology, University of Barcelona, Subdivision of Psychiatry and Psychology, Hospital Clínic i Provincial, Barcelona
J Vallejo
Affiliation:
Hospital de Bellvitge, Barcelona, Department of Psychiatry and Medical Psychobiology, University of Barcelona
R Catalan
Affiliation:
Subdivision of Psychiatry and Psychology, Hospital Clínic i Provincial, Barcelona
A Otero
Affiliation:
Department of Psychiatry and Medical Psychobiology, University of Barcelona, Subdivision of Psychiatry and Psychology, Hospital Clínic i Provincial, Barcelona, Spain
E Vieta
Affiliation:
Department of Psychiatry and Medical Psychobiology, University of Barcelona, Subdivision of Psychiatry and Psychology, Hospital Clínic i Provincial, Barcelona, Spain
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Summary

One hundred and sixteen patients with RDC unipolar recurrent depressive disorder, melancholic subtype, were treated with imipramine or phenelzine and followed-up for six months. None of the patients had a first-degree relative with bipolar I disorder. Twenty-six patients (22.4%) presented an hypomanic episode (‘hypomanic group’). This group of patients, when depressed, had a significantly lower age of onset of the disorder and higher response to antidepressant therapy than patients who did not present an hypomanic episode. Significantly more patients (88%) of the ‘hypomanic group’ had at least one first-degree relative with a history of major depressive disorder. These patients displayed some of the typical features of bipolar II disorder. Overall results support the continuum in clinical phenomena between unipolar and bipolar disorders.

Keywords

hypomaniamelancholiaunipolar depressionfamily history
Type
Original article
Information
European Psychiatry , Volume 8 , Issue 3 , 1993 , pp. 125 - 129
Copyright
Copyright © Elsevier, Paris 1993

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References

Akiskal, HS (1981) Subaffective disorders: dysthymic, cyclothymic and bipolar II disorders in the “borderline” realm. Psychiatr Clin North Am 4, 25–46CrossRefGoogle ScholarPubMed
Akiskal, HS (1983) Dysthymic disorder: psychopathology of proposed chronic depressive subtypes. Am J Psychiatry 140, 11–20Google ScholarPubMed
Akiskal, HSDjenderedjian, AHRosenthal, RHKhani, MK (1977) Cyclothymic disorder: validating criteria for inclusion in the bipolar affective group. Am J Psychiatry 134, 1227–1233Google ScholarPubMed
Akiskal, HSKhani, MKScott-Strauss, A (1979) Cyclothymic temperamental disorders. Psychiatr Clin North Am 2, 527–554CrossRefGoogle Scholar
Akiskal, HSWalker, PWPuzantian, VRKing, DRosenthal, TLDranon, M (1983) Bipolar outcome in the course of depressive illness. J Affect Disord 5, 115–128CrossRefGoogle ScholarPubMed
Andreasen, NCEndicott, JSpitzer, RLWinokur, G (1977) The family history method using diagnostic criteria. Arch Gen Psychiatry 34, 1229–1235CrossRefGoogle ScholarPubMed
Andreasen, NCGrove, WMShapiro, RWKeller, MBHirschfeld, RMAMcDonald-Scott, P (1981) Reliability of lifetime diagnosis. Arch Gen Psychiatry 38, 400–405CrossRefGoogle ScholarPubMed
Andreasen, NCRice, JEndicott, JCoyrell, WGrove, WMReich, T (1987) Familial rates of affective disorder. Arch Gen Psychiatry 44, 461–469CrossRefGoogle ScholarPubMed
Angst, J (1986) The course of major depression, atypical bipolar disorder, and bipolar disorder. In : New Results in Depression Research (Hippius, HKlerman, GLMatussek, N eds). Spinger-Verlag, Berlin, 26–35CrossRefGoogle Scholar
Braddock, L (1986) The dexamethasone suppression test. Fact and artefact. Br J Psychiatry 148, 363–374CrossRefGoogle ScholarPubMed
Bunney, WE (1978) Psychopharmacology of the switch process in affective illness. In: Psychopharmacology: A Generation of Progress (Lipton, MADiMascio, AKillam, KF eds). Raven Press, New York, 1249–1259Google Scholar
Carroll, BJFeinberg, MGreden, JTarika, JAlbala, AHaskett, RJames, NKronfol, ZLohr, NSteiner, MDe Vigne, JYoung, E (1981) A specific laboratory test for the diagnosis of melancholia: standardization, validation, and clinical utility. Arch Gen Psychiatry 38, 15–22CrossRefGoogle Scholar
Checkley, S (1985) Biological markers in depression. In: Recent Advances in Clinical Psychiatry (Granville-Grossman, K ed). Churchill Livingstone, Edinburgh, 201–224Google Scholar
Coyrell, WEndicott, JReich, TAndreasen, NKeller, M (1984) A family study of bipolar II disorder. Br J Psychiatry, 145 49–54CrossRefGoogle Scholar
Dam, H (1988) Dexamethasone suppression test. Acta Psychiatr Scand 78 (suppl 345), 38–44CrossRefGoogle Scholar
Dunner, DLFleiss, JLFieve, RR (1976) The course of development of mania in patients with recurrent depression. Am J Psychiatry 133, 905–908Google ScholarPubMed
Dunner, DLGershon, ESGoodwin, FK (1970) Heritable factors in the severity of affective illness. Sci Proc Am Psychiatr Assoc 123, 187–188Google Scholar
Gershon, ESHamovit, JGuroff, JJDibble, ELeckman, JFSceery, WTargum, SDNurnberger, JIGoldin, LRBunney, WE (1982) A family study of schizoaffective, bipolar I, bipolar II, unipolar, and normal control probands. Arch Gen Psychiatry 39, 1157–1167CrossRefGoogle ScholarPubMed
Hamilton, M (1960) A rating scale for depression. J Neurol Neurosurg Psychiatry 23, 56–62CrossRefGoogle Scholar
Klerman, GL (1981) The spectrum of mania. Comp Psychiatry 22, 11–20CrossRefGoogle ScholarPubMed
Kupfer, DJCarpenter, LLFrank, E (1988) Possible role of antidepressants in precipitating mania and hypomania in recurrent depression. Am J Psychiatry 145, 804–808Google ScholarPubMed
Wehr, TAGoodwin, FK (1987) Can antidepressants cause mania and worsen the course of affective illness? Am J Psychiatry 144, 1403–1411Google ScholarPubMed
Whybrow, PAkiskal, HSMckinney, W (1984) Clinical and familial subtypes of mood disorders: Observation, opinion, and purpose, In; Mood Disorders. Toward a New Psychobiology (Whybrow, PAkiskal, HSMckinney, W eds). Plenum Press, New York, 43–63CrossRefGoogle Scholar
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