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Biomedical subjects

F Benazzi

Publications and source records attributed to F Benazzi.

At least 19 recordsLinked to original sources
PubMed2001

Age at onset of bipolar II depressive mixed state.

Depressive mixed state (DMS) (a major depressive episode [MDE] with some concurrent hypomanic symptoms) is understudied. The aims of the study were to find if the prevalence of DMS, and its clinical correlates, in bipolar II depressed outpatients changed according to bipolar II age at onset. A consecutive sample of 92 bipolar II MDE outpatients were interviewed with the Structured Clinical Interview for DSM-IV. DMS was defined as an MDE with two or more concurrent hypomanic symptoms (DMS2). Prevalence of DMS2 in bipolar II with onset after 30 and 40 years was significantly lower than prevalence in bipolar II with onset before 31 and 41 years. There was a significant negative association between DMS2 and age at onset. There were no significantly different clinical correlates between DMS2 in bipolar II with onset after 30 and before 31 years. Limitations of the study include use of a single interviewer, non-blind assessment, cross-sectional design and bipolar II diagnosis based on history. DMS2 was more likely in bipolar II with a younger age at onset. Different bipolar II ages at onset did not have an effect on DMS2 clinical correlates.

Adult↗
PubMed2001

Early-onset versus late-onset bipolar II chronic depression.

Age at onset is an important dimension in the classification of mood disorders. Recent findings on early-onset (EO) versus late-onset (LO) unipolar chronic depressions support this subtyping. The aim of the present study was to determine clinical differences between EO and LO bipolar II chronic depression and to support this subtyping also in bipolar II. Eighty-seven consecutive bipolar II chronic depression outpatients were interviewed with the Structured Clinical Interview for DSM-IV, the Montgomery Asberg Depression Rating Scale, and the Global Assessment of Functioning scale. EO cut-offs were 21 and 23 years of age. Variables, studied with linear and logistic regression, were age, gender, age at onset, illness duration, recurrences, atypical, melancholic, and psychotic features, axis I comorbidity, and severity. Lower age at onset was significantly associated with lower age, longer illness duration, less psychosis, less severity, more atypical features, and more axis I comorbidity. Results support the subtyping of bipolar II chronic depression in EO and LO on the basis of different clinical features.

Adolescent↗
PubMed2001

Is 4 days the minimum duration of hypomania in bipolar II disorder?

DSM-IV requires that bipolar II disorder has hypomania with a minimum duration of 4 days, a cutoff not based on data. The study aim was to test if hypomania lasting 2 to 3 days could identify a group of bipolar II with typical clinical features of bipolar disorders. Consecutively, 65 unipolar and 103 bipolar II major depressive episode (MDE) outpatients were interviewed with the Structured Clinical Interview for DSM-IV. Almost all had had 2 to 3 days of hypomania, and all had had more than one hypomania. Typical clinical variables distinguishing bipolar from unipolar disorders (age at onset, atypical features, and recurrences) were compared. Bipolar II had significantly lower age at onset, more recurrences, and more atypical features. Findings suggest that hypomania lasting 2 to 3 days may identify a bipolar II group having typical features of bipolar disorders.

Adult↗
PubMed2001

Atypical depression with hypomanic symptoms.

BACKGROUND: Depressive mixed states (major depressive episodes with some hypomanic symptoms) (DMS) are not classified in DSM-IV and are understudied. The aims of this study were to find the prevalence and clinical features of DMS in atypical depression. METHODS: A total of 87 bipolar II and unipolar depressed outpatients were interviewed within the DSM-IV Structured Clinical Interview. RESULTS: More than two hypomanic symptoms were present in 50.0% of the atypical and 20.3% of the non-atypical depression cases (P=0.006). DMS mainly included irritable mood, distractibility, racing thoughts, and increased talking. LIMITATIONS: There was a single interviewer, and it was a non-blind, cross-sectional assessment, with bipolar II reliability. CONCLUSIONS: Findings have treatment implications, as antidepressants may worsen DMS, and mood stabilizers may improve it.

Adult↗
PubMed2001

Delineating bipolar II mixed states in the Ravenna-San Diego collaborative study: the relative prevalence and diagnostic significance of hypomanic features during major depressive episodes.

BACKGROUND: Depressive mixed state (DMX), defined by hypomanic features during a major depressive episode (MDE) is under-researched. Accordingly, study aims were to find DMX prevalence in unipolar major depressive disorder (MDD) and bipolar II depressive phase, to delineate the most common hypomanic signs and symptoms during DMX, and to assess their sensitivity and specificity for the diagnosis of DMX and bipolar II. METHODS: 161 unipolar and bipolar II MDE psychotropic drug- and substance-free consecutive outpatients were interviewed during an MDE with the Structured Clinical Interview for DSM-IV. DMX was defined at two threshold levels as an MDE with two or more (DMX2), and with three or more (DMX3) simultaneous intra-episode hypomanic signs and symptoms. RESULTS: DMX2 was present in 73.1% of bipolar II, and in 42.1% of unipolar MDD (P<0.000); DMX3 was present in 46.3% of bipolar II, and in 7.8% of unipolar MDD (P<0.000). The most common hypomanic manifestations during MDE were irritability, distractibility, and racing thoughts. Irritability had the best combination of sensitivity and specificity for the diagnosis of DMX2 and DMX3. Various combinations of irritability, distractibility, and racing thoughts correctly classified the highest number of DMX2 and DMX3, and had the strongest predictive power. DMX2 had high sensitivity and low specificity for bipolar II, whereas DMX3 had low sensitivity (46.3%) and high specificity (92.1%). LIMITATIONS: Single interviewer, cross-sectional assessment, and interviewing clinician not blind to patients' unipolar vs. bipolar status. CONCLUSIONS: When conservatively defined (>or = 3 intra-episode hypomanic signs and symptoms during MDE), DMX is prevalent in the natural history of bipolar II but uncommon in unipolar MDD. These findings have treatment implications, because of growing concerns that antidepressants may worsen DMX, which in turn may respond better to mood stabilizers. These data also have methodological implications for diagnostic practice: rather than solely depending on the vagaries of the patient's memory for past hypomanic episodes, the search for hypomanic features--ostensibly elation would not be one of those--during an index depressive episode could enhance the detection of bipolar II in otherwise pseudo-unipolar patients. Strict adherence to current clinical diagnostic interview instruments (e.g. the SCID) would make such detection difficult, if not impossible.

Adult↗
PubMed2001

Bipolar II depression in late life: prevalence and clinical features in 525 depressed outpatients.

BACKGROUND: Late-life bipolar II depression has not been well studied. The aim of the present study was to find the prevalence of late-life (50 years or more) bipolar II depression among unipolar and bipolar depressed outpatients, and to compare it with bipolar II depression in younger patients, looking for differences supporting the subtyping of bipolar II depression according to age at onset. METHODS: Consecutive 525 patients presenting for treatment of a major depressive episode were interviewed with the Structured Clinical Interview for DSM-IV, the Montgomery Asberg Depression Rating Scale, and the Global Assessment of Functioning Scale. RESULTS: Among patients less than 50 years, 53.4% had bipolar II depression. Among patients 50 years or more, 32.9% had bipolar II depression (significant difference). Atypical features were present in 60.9% of bipolar II patients less than 50 years, and in 26.1% of those 50 years or more (significant difference). Bipolar II patients 50 years or more had significantly higher age at onset than those less than 50 years. Bipolar II and unipolar patients 50 years or more were not significantly different, apart from comorbidity. Bipolar II patients less than 50 years had significantly more atypical features than unipolar ones. LIMITATIONS: Single interviewer, single nonblind assessment, cross-sectional assessment, exclusion of substance abuse and severe personality disorder patients, comorbidity not systematically assessed, modification of DSM-IV duration criterion for hypomania. CONCLUSIONS: Findings suggest that bipolar II depression and atypical features are less common in late life. Differences in age at onset and atypical features support the subtyping of bipolar II depression according to age at onset.

Adult↗
PubMed2001

Factor analysis of the Montgomery Asberg Depression Rating Scale in 251 bipolar II and 306 unipolar depressed outpatients.

Symptomatological differences between bipolar II (n = 251) and unipolar (n = 306) depressed outpatients, interviewed with the Structured Clinical Interview for DSM-IV, were studied by Montgomery Asberg Depression Rating Scale factor analysis. Different factors were found in bipolar II [factor 1 (apparent sadness, reported sadness), factor 2 (reduced sleep, reduced appetite), factor 3 (concentration difficulties, lassitude, inability to feel, pessimistic thoughts, and suicidal thoughts)], and in unipolar [factor 1 (apparent sadness, reported sadness, inability to feel, suicidal thoughts), factor 2 (concentration difficulties, lassitude, inability to feel, pessimistic thoughts), factor 3 (inner tension, reduced sleep)]. Different factor structure (between bipolar II and unipolar depression) supports previous findings that response to antidepressants and biology may be different in bipolar II and unipolar depression.

Adult↗
PubMed2001

Course and outcome of bipolar II disorder: a retrospective study.

To study course and outcome of Bipolar II disorder, 217 major depressive episode (MDE) patients were interviewed with Structured Clinical Interview for DSM-IV. Patients with more than three MDE and patients with fewer MDE were compared. Patients with more than three MDE were 77.8%. Comparisons, controlled for confounding effects of age and illness duration, found that patients with many MDE had significantly lower age at onset and more chronicity. Results support subtyping of Bipolar II in a small good-outcome group, and a large moderate-poor-outcome group.

Adult↗
PubMed2001

Depressive mixed state: testing different definitions.

The aim of this study was to test different definitions of depressive mixed state (DMX) (major depressive episode (MDE) with some concurrent hypomanic symptoms), to find which one could better define DMX. Unipolar and bipolar II MDE outpatients (n = 168) were interviewed with the DSM-IV Structured Clinical Interview. Depressive mixed state was defined as a MDE with two or more (DMX2), and as a MDE with three or more (DMX3) concurrent hypomanic symptoms. DMX2 was present in 71.8% bipolar II patients, and in 41.5% unipolar (P < 0.01). DMX3 was present in 46.6% of bipolar II, and in 7.6% unipolar patients (P < 0.01). DMX2 and DMX3 had almost the same significant and non-significant associations with study variables (diagnosis, gender, age, age at onset, illness duration, MDE recurrences, axis I comorbidity, MDE severity, depression chronicity, hypomanic, MDE, psychotic, melancholic, and atypical symptoms and features). DMX3 was more strongly associated with bipolar II than DMX2 (odds ratio 10.4 vs 3.5). Findings suggest that DMX3 may be a better definition of DMX due to its stronger association with bipolar II disorder. Findings have important clinical and treatment implications because antidepressants may worsen DMX, and the presence of DMX may induce clinicians to assess systematically and carefully the history of past hypomania.

Adult↗
PubMed2000

Sensitivity and specificity of DSM-IV atypical features for bipolar II disorder diagnosis.

The aim of the study was to find the sensitivity and the specificity of DSM-IV atypical features (mood reactivity, weight gain, appetite increase, hypersomnia, leaden paralysis, interpersonal rejection sensitivity) for the diagnosis of bipolar II disorder. Consecutive 557 unipolar (54.9%) and bipolar II (45.0%) major depressive episode (MDE) outpatients were interviewed with the Structured Clinical Interview for DSM-IV and the Global Assessment of Functioning Scale. Bipolar II was diagnosed broadly, with a minimum duration of hypomania of at least some days, instead of the 4 days required by DSM-IV. MDE with atypical features was significantly more common in bipolar II patients. For the diagnosis of bipolar II disorder, MDE with atypical features, sensitivity was 0.45, and specificity was 0. 74. Among individual atypical features, hypersomnia had the best combination of sensitivity (0.35) and specificity (0.81). Combinations of two and three features did not improve sensitivity and specificity. As the diagnosis of past hypomania may not be very reliable from a patient's interview, atypical features may be an important marker of bipolar II disorder.

Adult↗
PubMed2000

Late-life chronic depression: a 399-case study in private practice.

OBJECTIVE: Aims of the study were to find the prevalence of chronic depression in elderly patients compared with younger patients, and to compare chronic depression between elderly and younger patients, to find if there were clinical differences. A major feature of the study was the inclusion of a large number of bipolar II patients, usually not included in previous studies. METHODS: Three hundred and ninety-nine consecutive unipolar (N=200) and bipolar II (N=199) depression outpatients were interviewed with the Structured Clinical Interview for DSM-IV and depression rating scales in a private practice. RESULTS: Chronic depression was more common in elderly patients than in younger patients (53.6% vs 40.1%, p=0.0299). Late-life chronic depression patients had later age at onset, longer duration of illness, fewer bipolar II cases, more unipolar cases and more relapses than younger chronic depression patients. CONCLUSIONS: Results suggest that late-life depression is more likely to be chronic than depression in younger patients. The subtyping of chronic depression according to age seems supported by a different age at onset and some clinical differences.

Adult↗
PubMed2000

Depression with DSM-IV atypical features: a marker for bipolar II disorder.

The aim of the study was to find the prevalence of atypical features in bipolar II depression versus unipolar depression. Five hundred and fifty seven unipolar and bipolar II depressed outpatients were interviewed with the Structured Clinical Interview for DSM-IV, the Montgomery Asberg Depression Rating Scale, and the Global Assessment of Functioning Scale. DSM-IV atypical features were significantly more common in bipolar II patients than in unipolar patients (45.4% vs 25.4%, odds ratio 2.4). As the diagnosis of bipolar II disorder is often based on diagnosis of past hypomania, which may not be very reliable. depression with atypical features may point to bipolar II disorder diagnosis.

Adult↗