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A factor analytic study in bipolar depression, and response to lamotrigine
Philip B Mitchell1, Dusan Hadzi-Pavlovic, Gary Evoniuk
11 School of Psychiatry, University of New South Wales, Sydney, Australia.
CNS Spectrums
|May 25, 2013
Summary
This study identified seven factors of the Hamilton Depression Rating Scale (HDRS) in bipolar depression. Lamotrigine treatment effectively improved depressive cognitions and psychomotor retardation in patients with bipolar depression.
Area of Science:
- Psychiatry
- Clinical Psychology
- Psychopharmacology
Background:
- The Hamilton Depression Rating Scale (HDRS) is widely used but lacks factor analytic studies in bipolar I depression.
- No previous research has investigated the utility of HDRS-derived factors in predicting treatment response in bipolar depression.
Purpose of the Study:
- To identify and compare factors of the 31-item HDRS (HDRS-31) in large samples of patients with bipolar depression and Major Depressive Disorder (MDD).
- To examine the responsiveness of these HDRS factors to lamotrigine versus placebo in patients with bipolar depression.
Main Methods:
- Exploratory factor analyses were conducted on baseline HDRS-31 scores from two large, double-blind, placebo-controlled trials.
- Treatment response was assessed using mixed-effects models and t-tests, examining changes in total scores and HDRS factors.
Main Results:
- Seven HDRS-31 factors were identified: depressive cognitions, psychomotor retardation, insomnia, hypersomnia, appetite/weight change, anxiety, and anergia.
- Lamotrigine demonstrated a significant therapeutic effect on "depressive cognitions" (from week 3) and "psychomotor retardation" (from week 4) in bipolar depression.
Conclusions:
- Seven distinct factors of the HDRS were identified in a large sample of patients experiencing bipolar depression.
- Clinical benefits of lamotrigine in acute bipolar depression appear primarily related to improvements in depressive cognitions and psychomotor slowing.
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