Mixed depressive features predict maniform switch during treatment of depression in bipolar I disorder.
BACKGROUND
Case observations imply that depressed patients with mixed features are of high risk for maniform switch during acute treatment.


METHODS
The medical records of 158 bipolar I depressives were examined with respect to mixed depressive features at admission, naturalistic medications, and maniform switch during inpatient treatment.


RESULTS
Besides pharmacological variables, the number of mixed depressive symptoms (flight of ideas, racing thoughts, logorrhea, aggression, excessive social contact, increased drive, irritability, and distractibility) at admission was associated with a higher risk for, and the acceleration of, maniform switch during inpatient treatment.


CONCLUSIONS
This was a retrospective study in patients receiving naturalistic treatment. The cohort was hospital based and thus not representative of the full range of bipolar affective disorder.


CONCLUSIONS
In line with recent studies, our results underline the factors inherent in subjects at a higher risk of switch. Investigation of the relationships between several inherent factors and their interactions with pharmacological treatments may be important in resolving the controversy surrounding antidepressant-induced mania. Further validation studies on mixed depression are warranted.
Bottlender
Ronald
R
Department of Psychiatry, Ludwig-Maximilians University, Munich, Germany.
Sato
Tetsuya
T
Kleindienst
Nikolaus
N
Strauss
Anton
A
Möller
Hans Jürgen
HJ
D001714:Bipolar Disorder / Q000628:therapy*; D015331:Cohort Studies; D003865:Major Depressive Disorder / Q000628:therapy*; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011597:Psychomotor Performance; D012189:Retrospective Studies