[The relationships between socio-demographic and clinical data and the bipolar spectrum features in treatment resistant patients. A pilot study].
OBJECTIVE
To asses the relationships between sociodemographic and clinical data and the bipolar spectrum features in treatment resistant patients. (A sub-analysis of data of the pilot study for the multi-center TRES-DEP (Treatment Resistant Depression) Project.


METHODS
50 drug-resistant 18-65 year old patients, fulfilling ICD-10 criteria for depressive episode or recurrent depressive disorder (F32, F33) were included in the study. Drug resistance was defined as non-response to two adequate antidepressant treatments. The main exclusion criteria were: > 18 scores in the 17-item Hamilton Depression Rating Scale, treatment with mood stabilizers, the diagnosis of: substance misuse, dementia, severe neurological or other somatic disease. The presence of bipolar spectrum was detected by the Mood Disorder Questionnaire (MDQ) and the Hypomania Checklist Scale (HCL).


RESULTS
Statistically significant more drug-resistant patients fulfilling MDQ bipolar spectrum criteria (MDQ (+))comparing to patients without bipolar spectrum features by MDQ (MDQ(-)): 1) considered the last remission as partial or reported lack of remission (100% vs. 21%; p<0.05), 2) reported treatment non-adherence (41 vs. 18%, p=0.055). Moreover there were more suicidal attempts in MDQ(+) patients (0.86+/-1.28 vs. 0.25+/-0.59; p<0.05).


CONCLUSIONS
Results of the study suggest that the presence of bipolar spectrum may worsen the course and outcome of drug-resistant depression. A further multicenter study is needed.
Dudek
Dominika
D
Klinika Psychiatrii Dorosłych CM UJ, Kraków.
Siwek
Marcin
M
Borowiecka-Kluza
Joanna
J
D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000150:complications* / Q000175:diagnosis*; D003866:Depressive Disorder / Q000150:complications* / Q000188:drug therapy; D004351:Drug Resistance; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D010865:Pilot Projects; D011788:Quality of Life; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
D014150:Antipsychotic Agents