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Switch from depression to mania--a record study over decades between 1920 and 1982
Psychopathology
|January 1, 1985
Summary
This study found no evidence that depression treatments cause a switch to mania or hypomania. Bipolar patients are more likely to switch than unipolar patients, but this rate has not increased over time.
Area of Science:
- Psychiatry
- Clinical Psychology
Background:
- Hospital admissions for depression and mania have increased over decades.
- Clinicians observe more spontaneous switches from depression to mania, suggesting a potential treatment effect.
Purpose of the Study:
- To analyze the switch rate from depression to hypomania/mania in a large cohort.
- To investigate predisposing factors for switching behavior.
- To determine if switch rates have increased over time, potentially due to treatment.
Main Methods:
- Analysis of 908 hospital records for depression admissions between 1920 and 1982.
- Calculation of switch rates to hypomania or mania.
- Loglinear and univariate analyses to assess trends and predisposing factors.
Main Results:
- 7.0% of patients admitted for depression switched to hypomania (5.3%) or mania (1.7%).
- Bipolar patients exhibited an 8-fold higher switch rate (28.9%) compared to unipolar patients (3.7%).
- No significant increase in switch rates was observed across decades (1920-1982).
Conclusions:
- There is no evidence to support a treatment-induced switch from depression to hypomania/mania.
- Bipolarity is associated with a higher likelihood of switching, correlating with more previous episodes and readmissions.
- Switch rates have remained stable over time, independent of treatment era.