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Related Experiment Videos

Agitated depression in bipolar II disorder.

Franco Benazzi1

  • 1E. Hecker Outpatient Psychiatry Center, Ravenna, Italy. FrancoBenazzi@FBenazzi.it

The World Journal of Biological Psychiatry : the Official Journal of the World Federation of Societies of Biological Psychiatry
|September 17, 2005
PubMed
Summary

Agitated depression (AD) in bipolar II disorder (BP-II) often presents with hypomanic symptoms and distinct family history, suggesting potential for subtyping. This may inform treatment, prioritizing mood stabilizers over antidepressants alone.

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Neuroscience

Background:

  • Bipolar II disorder (BP-II) is characterized by major depressive episodes (MDE) and hypomanic episodes.
  • Agitated depression (AD) is a specifier for MDE, but its diagnostic utility in BP-II requires further investigation.
  • Understanding AD's characteristics may improve diagnostic accuracy and treatment strategies for BP-II.

Purpose of the Study:

  • To evaluate the diagnostic validity and clinical utility of agitated depression (AD) as a subtype within bipolar II disorder (BP-II).
  • To explore the association between AD and the presence of concurrent hypomanic symptoms in BP-II patients.
  • To examine differences in demographic and familial factors between patients with and without AD.

Main Methods:

  • A cohort of 320 BP-II outpatients experiencing MDE were assessed using structured clinical interviews and a family history screen.

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  • Agitated depression (AD) was defined as MDE accompanied by psychomotor agitation.
  • Mixed depression was defined by the presence of four or more hypomanic symptoms during an MDE.

    • Main Results:

    • Agitated depression (AD) was identified in 35.0% of the BP-II sample.
    • A significant majority (75.8%) of AD cases also met criteria for mixed depression, compared to only 14.3% of non-AD cases (P=0.0000).
    • Patients with AD exhibited higher mean age, greater prevalence of females, more recurrent episodes, a positive family history of bipolar I disorder, and more concurrent hypomanic symptoms compared to non-AD patients.

    Conclusions:

    • The findings suggest that agitated depression (AD) may represent a distinct subtype within bipolar II disorder (BP-II), characterized by a higher frequency of hypomanic symptoms and specific familial patterns.
    • This potential subtyping of AD in BP-II could influence clinical practice.
    • Treatment considerations may involve utilizing mood-stabilizing agents to manage agitation before initiating antidepressant monotherapy in BP-II patients with AD.