title: Do social anxiety disorder patients belong to a bipolar spectrum subgroup?
abstract: BACKGROUND
  It has been proposed that all forms of bipolar disorder-perhaps all primary affective disorders-are best conceptualized as a spectrum of related illness, clinically overlapping but not necessarily genetically uniform illnesses. We aim to describe with retrospective methodology the demographic, clinical, and therapeutic response in a group of social anxiety disorder (SA) patients who improves while taking antidepressants and compare them with bipolar II (B-II) patients.
  
  
  METHODS
  57 SA outpatients (DSM-IV) were diagnosed and naturalistic efficacious treated with selective serotonin reuptake inhibitors (SSRI). Their demographic, clinical features and therapeutic response were compared with 41 DSM-IV bipolar II patients in their starting evaluations in our outpatient clinic in the Federal University of Rio de Janeiro, Brazil.
  
  
  RESULTS
  There is a sub-group of SA patients who improves while taking antidepressants and presents a clear hypomanic phase. Their improvement is identical to a mild/moderate hypomanic state. Without the antidepressant, the symptoms of SA return. The SA and B-II patients have a similar number of previous depressive episodes, alcohol abuse, suicide attempts, and family history for mood disorder.
  
  
  CONCLUSIONS
  It is a retrospective data description based on a naturalist follow-up.
  
  
  CONCLUSIONS
  Some SA patients have demographic, clinical and therapeutic features similar to B-II patients and they might just be a Bipolar-III sub-group with a higher level of complains to social situations and without spontaneous hypomania during lifetime.
authors.affiliation: Institute of Psychiatry, Federal University of Rio de Janeiro, R. Visconde de Pirajá, 407/702, Rio de Janeiro-RJ-22410-003, Brazil.
authors.forename: Alexandre M
authors.initials: AM
authors.lastname: Valença
authors.forename: Antonio E
authors.initials: AE
authors.lastname: Nardi
authors.forename: Isabella
authors.initials: I
authors.lastname: Nascimento
authors.forename: Fabiana L
authors.initials: FL
authors.lastname: Lopes
authors.forename: Rafael C
authors.initials: RC
authors.lastname: Freire
authors.forename: Marco A
authors.initials: MA
authors.lastname: Mezzasalma
authors.forename: André B
authors.initials: AB
authors.lastname: Veras
authors.forename: Marcio
authors.initials: M
authors.lastname: Versiani
mesh_terms: D000328:Adult; D000428:Alcohol Drinking; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000145:classification / Q000188:drug therapy* / Q000523:psychology*; D003710:Demography; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010698:Phobic Disorders / Q000145:classification / Q000188:drug therapy* / Q000523:psychology*; D011379:Prognosis; D012189:Retrospective Studies; D013406:Suicide, Attempted; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents