Detection of subclinical depression in bipolar disorder

Journal article


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Publication Details

Subtitle: a cross-sectional, 4-month prospective follow-up study at community mental health services (SIN-DEPRES).
Author list: Jurado Barba R
Publisher: Physicians Postgraduate Press
Publication year: 2010
Journal: Journal of Clinical Psychiatry (0160-6689)
Volume number: 71
Issue number: 11
Start page: 1465
End page: 1474
Number of pages: 10
ISSN: 0160-6689
Languages: English-Great Britain (EN-GB)


OBJECTIVE: The aim of this study was to assess the prevalence and the
impact of depressive symptoms on the functional outcome of bipolar
disorder outpatients in remission. METHOD: A cross-sectional,
prospective 16-week study of a cohort of 739 euthymic bipolar disorder
patients (DSM-IV-TR criteria) recruited by 94 investigators was
conducted. Clinical stability was assessed at baseline and at week 16
with the modified Clinical Global Impressions Scale-Bipolar Version, and
depressive symptoms were assessed at baseline with the 17-item Hamilton
Depression Rating Scale (HDRS-17 [primary endpoint measure]), the
Montgomery-Asberg Depression Rating Scale (MADRS), and the self-applied
Center for Epidemiologic Studies-Depression Scale (CES-D). Functional
status was evaluated with the Social and Occupational Functioning
Assessment Scale (SOFAS) and Social Adaptation Self-evaluation Scale
(SASS). The study was conducted from April 2006 to March 2007. RESULTS:
Subclinical depressive symptoms (SDS) were detected on the HDRS-17 in
16.9% of the sample. In symptom-free patients, the incidence of new SDS
after 16 weeks was 20% (MADRS score > 7). At baseline, SDS patients
compared to non-SDS patients presented with poorer social-occupational
performance (SOFAS score mean difference, -11.9; 95% CI, -14.2 to -9.6)
and poorer social adjustment (SASS score mean difference, -5.6; 95% CI,
-7.1 to -4.1). Depressive symptoms were inversely related to functional
status and social adjustment: MADRS-SOFAS correlation coefficients, r =
-0.54 (P < .0001), and MADRS-SASS correlation coefficients, r = -0.42
(P < .0001). The self-applied survey identified additional cases
with depressive symptoms, showing an SDS total prevalence of 44.9%.
CONCLUSIONS: Depressive symptoms in apparently remitted bipolar disorder
outpatients are not rare and result in a decline in occupational
outcome and social maladjustment.


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Last updated on 2019-13-08 at 00:45