title: Sub-threshold depression and antidepressants use in a community sample: searching anxiety and finding bipolar disorder.
abstract: BACKGROUND
  To determine the use of antidepressants (ADs) in people with sub-threshold depression (SD); the lifetime prevalence of mania and hypomania in SD and the link between ADs use, bipolarity and anxiety disorders in SD.
  
  
  METHODS
  
  
  
  METHODS
  community survey.
  
  
  METHODS
  samples randomly drawn, after stratification from the adult population of municipal records.
  
  
  METHODS
  4999 people from seven areas within six Italian regions. Tools: Questionnaire on psychotropic drug consumption, prescription; Structured Clinical Interview NP for DSM-IV modified (ANTAS); Hamilton Depression Rating Scale (HAM-D); Mood Disorder Questionnaire (MDQ); Short Form Health Survey (SF-12). SD definition: HAM-D > 10 without lifetime diagnosis of Depressive Episode (DE).
  
  
  RESULTS
  SD point prevalence is 5.0%. The lifetime prevalence of mania and hypomania episodes in SD is 7.3%. Benzodiazepines (BDZ) consumption in SD is 24.1%, followed by ADs (19.7%). In SD, positive for MDQ and comorbidity with Panic Disorder (PD) or Generalized Anxiety Disorders (GAD) are associated with ADs use, whereas the association between a positive MDQ and ADs use, without a diagnosis of PD or GAD, is not significant. Only in people with DE the well-being (SF-12) is higher among those using first-line antidepressants compared to those not using any medication. In people with SD no significant differences were found in terms of SF-12 score according to drug use.
  
  
  CONCLUSIONS
  This study suggests caution in prescribing ADs to people with SD. In people with concomitant anxiety disorders and SD, it should be mandatory to perform a well-designed assessment and evaluate the presence of previous manic or hypomanic symptoms prior to prescribing ADs.
authors: Department of Public Health, University of Cagliari, Cagliari, Italy. mgcarta@tiscali.it
authors: Mauro G
authors: MG
authors: Carta
authors: Leonardo
authors: L
authors: Tondo
authors: Matteo
authors: M
authors: Balestrieri
authors: Filippo
authors: F
authors: Caraci
authors: Liliana
authors: L
authors: Dell'osso
authors: Guido
authors: G
authors: Di Sciascio
authors: Carlo
authors: C
authors: Faravelli
authors: Maria Carolina
authors: MC
authors: Hardoy
authors: Maria E
authors: ME
authors: Lecca
authors: Maria Francesca
authors: MF
authors: Moro
authors: Krishna M
authors: KM
authors: Bhat
authors: Massimo
authors: M
authors: Casacchia
authors: Filippo
authors: F
authors: Drago
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D001569:Benzodiazepines / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000150:complications / Q000453:epidemiology*; D003863:Depression / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006306:Health Surveys / Q000706:statistics & numerical data; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012111:Residence Characteristics / Q000706:statistics & numerical data*
chemical_list: D000928:Antidepressive Agents; D001569:Benzodiazepines