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The role of different patterns of psychomotor symptoms in major depressive episode: Pooled analysis of the BRIDGE and BRIDGE‐II‐MIX cohorts
Author(s) -
Barbuti Margherita,
Mainardi Cecilia,
Pacchiarotti Isabella,
Verdolini Norma,
Maccariello Giuseppe,
Angst Jules,
Azorin JeanMichel,
Bowden Charles L.,
Mosolov Sergey,
Young Allan H.,
Vieta Eduard,
Perugi Giulio
Publication year - 2019
Publication title -
bipolar disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.285
H-Index - 129
eISSN - 1399-5618
pISSN - 1398-5647
DOI - 10.1111/bdi.12816
Subject(s) - bipolar disorder , psychomotor learning , major depressive episode , logistic regression , depression (economics) , psychomotor retardation , mood , psychology , psychomotor agitation , psychiatry , medicine , bipolar ii disorder , mania , bipolar i disorder , univariate analysis , pediatrics , multivariate analysis , cognition , alternative medicine , pathology , economics , macroeconomics
Background Psychomotor agitation (PA) or retardation (PR) during major depressive episodes (MDEs) have been associated with depression severity in terms of treatment‐resistance and course of illness. Objectives We investigated the possible association of psychomotor symptoms (PMSs) during a MDE with clinical features belonging to the bipolar spectrum. Methods The initial sample of 7689 MDE patients was divided into three subgroups based on the presence of PR, PA and non‐psychomotor symptom (NPS). Univariate comparisons and multivariate logistic regression models were performed between subgroups. Results A total of 3720 patients presented PR (48%), 1971 showed PA (26%) and 1998 had NPS (26%). In the PR and PA subgroups, the clinical characteristics related to bipolarity, along with the diagnosis of bipolar disorder (BD), were significantly more frequent than in the NPS subgroup. When comparing PA and PR patients, the former presented higher rates of bipolar spectrum features, such as family history of BD (OR = 1.39, CI = 1.20‐1.61), manic/hypomanic switches with antidepressants (OR = 1.28, CI = 1.11‐1.48), early onset of first MDE (OR = 1.40, CI = 1.26‐1.57), atypical (OR = 1.23, CI = 1.07‐1.42) and psychotic features (OR = 2.08, CI = 1.78‐2.44), treatment with mood‐stabilizers (OR = 1.39, CI = 1.24‐1.55), as well as a BD diagnosis according to both the DSM‐IV criteria and the bipolar specifier criteria. When logistic regression model was performed, the clinical features that significantly differentiated PA from PR were early onset of first MDE, atypical and psychotic features, treatment with mood‐stabilizers and a BD diagnosis according to the bipolar specifier criteria. Conclusions Psychomotor symptoms could be considered as markers of bipolarity, illness severity, and treatment complexity, particularly if PA is present.