Association between anxious distress in a major depressive episode and bipolarity

Hiroko Sugawara,1 Takahiro Tsutsumi,2 Ken Inada,2 Jun Ishigooka,2 Mamoru Hashimoto,1 Minoru Takebayashi,1,3 Katsuji Nishimura2 1Department of Neuropsychiatry, Faculty of Life Science, Kumamoto University, Kumamoto, Japan; 2Department of Psychiatry, Tokyo Women’s Medical University Hospita...

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Autores principales:	Sugawara H, Tsutsumi T, Inada K, Ishigooka J, Hashimoto M, Takebayashi M, Nishimura K
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	anxious distress mixed features major depressive episode bipolarity Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/a10aa3bc6c51423ea1e3ffbe20a50073
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spelling	oai:doaj.org-article:a10aa3bc6c51423ea1e3ffbe20a500732021-12-02T00:26:55ZAssociation between anxious distress in a major depressive episode and bipolarity1178-2021https://doaj.org/article/a10aa3bc6c51423ea1e3ffbe20a500732019-01-01T00:00:00Zhttps://www.dovepress.com/association-between-anxious-distress-in-a-major-depressive-episode-and-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Hiroko Sugawara,1 Takahiro Tsutsumi,2 Ken Inada,2 Jun Ishigooka,2 Mamoru Hashimoto,1 Minoru Takebayashi,1,3 Katsuji Nishimura2 1Department of Neuropsychiatry, Faculty of Life Science, Kumamoto University, Kumamoto, Japan; 2Department of Psychiatry, Tokyo Women’s Medical University Hospital, Tokyo, Japan; 3Division of Psychiatry and Neuroscience, Institute for Clinical Research, National Hospital Organization Kure Medical Center, Hiroshima, Japan Purpose: Mixed features in a major depressive episode (MDE) predict bipolar disorder (BD). The mixed features specifier included in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) could be restrictive because it excludes the symptoms common to both mania/hypomania and depression, including psychomotor agitation. On the other hand, an anxious distress (ANXD) specifier has also been introduced in the DSM-5, and psychomotor agitation has been defined as a severity of ANXD. In this study, we retrospectively investigated the association between presence of ANXD in an MDE and bipolarity. Patients and methods: The subjects were patients admitted with an MDE to the Department of Psychiatry at Tokyo Women’s Medical University Hospital from December 2014 to March 2016. Eligible patients were older than 20 years of age and met the DSM-5 criteria for major depressive disorder or BD. All data were extracted from medical records. The subjects were grouped according to whether they did or did not have ANXD. The demographics and clinical features of these groups were compared. Severity of illness was evaluated according to the Hamilton Rating Scale for Depression (HRSD) score on admission. Results: ANXD was present in 31 and absent in 33 of 64 patients with MDE. The HRSD score was significantly higher in the group with ANXD than in the group without ANXD (P=0.0041). Mixed features (P=0.0050) and suicide attempts (P=0.0206) were significantly more common in the group with ANXD than in the group without ANXD. Conclusion: We found that the presence of ANXD in an MDE was associated with greater severity and more mixed features and suicide attempts. It is important to evaluate a patient with an MDE for ANXD so that a diagnosis of mixed depression is not missed. More studies in larger samples are needed to investigate further the association between ANXD in MDE and bipolarity. Keywords: anxious distress, mixed features, major depressive episode, bipolaritySugawara HTsutsumi TInada KIshigooka JHashimoto MTakebayashi MNishimura KDove Medical Pressarticleanxious distressmixed featuresmajor depressive episodebipolarityNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 15, Pp 267-270 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	anxious distress mixed features major depressive episode bipolarity Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	anxious distress mixed features major depressive episode bipolarity Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Sugawara H Tsutsumi T Inada K Ishigooka J Hashimoto M Takebayashi M Nishimura K Association between anxious distress in a major depressive episode and bipolarity
description	Hiroko Sugawara,1 Takahiro Tsutsumi,2 Ken Inada,2 Jun Ishigooka,2 Mamoru Hashimoto,1 Minoru Takebayashi,1,3 Katsuji Nishimura2 1Department of Neuropsychiatry, Faculty of Life Science, Kumamoto University, Kumamoto, Japan; 2Department of Psychiatry, Tokyo Women’s Medical University Hospital, Tokyo, Japan; 3Division of Psychiatry and Neuroscience, Institute for Clinical Research, National Hospital Organization Kure Medical Center, Hiroshima, Japan Purpose: Mixed features in a major depressive episode (MDE) predict bipolar disorder (BD). The mixed features specifier included in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) could be restrictive because it excludes the symptoms common to both mania/hypomania and depression, including psychomotor agitation. On the other hand, an anxious distress (ANXD) specifier has also been introduced in the DSM-5, and psychomotor agitation has been defined as a severity of ANXD. In this study, we retrospectively investigated the association between presence of ANXD in an MDE and bipolarity. Patients and methods: The subjects were patients admitted with an MDE to the Department of Psychiatry at Tokyo Women’s Medical University Hospital from December 2014 to March 2016. Eligible patients were older than 20 years of age and met the DSM-5 criteria for major depressive disorder or BD. All data were extracted from medical records. The subjects were grouped according to whether they did or did not have ANXD. The demographics and clinical features of these groups were compared. Severity of illness was evaluated according to the Hamilton Rating Scale for Depression (HRSD) score on admission. Results: ANXD was present in 31 and absent in 33 of 64 patients with MDE. The HRSD score was significantly higher in the group with ANXD than in the group without ANXD (P=0.0041). Mixed features (P=0.0050) and suicide attempts (P=0.0206) were significantly more common in the group with ANXD than in the group without ANXD. Conclusion: We found that the presence of ANXD in an MDE was associated with greater severity and more mixed features and suicide attempts. It is important to evaluate a patient with an MDE for ANXD so that a diagnosis of mixed depression is not missed. More studies in larger samples are needed to investigate further the association between ANXD in MDE and bipolarity. Keywords: anxious distress, mixed features, major depressive episode, bipolarity
format	article
author	Sugawara H Tsutsumi T Inada K Ishigooka J Hashimoto M Takebayashi M Nishimura K
author_facet	Sugawara H Tsutsumi T Inada K Ishigooka J Hashimoto M Takebayashi M Nishimura K
author_sort	Sugawara H
title	Association between anxious distress in a major depressive episode and bipolarity
title_short	Association between anxious distress in a major depressive episode and bipolarity
title_full	Association between anxious distress in a major depressive episode and bipolarity
title_fullStr	Association between anxious distress in a major depressive episode and bipolarity
title_full_unstemmed	Association between anxious distress in a major depressive episode and bipolarity
title_sort	association between anxious distress in a major depressive episode and bipolarity
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/a10aa3bc6c51423ea1e3ffbe20a50073
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Association between anxious distress in a major depressive episode and bipolarity

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