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CS02-01 - Diagnosis and Comorbidity: Progress Towards a New Diagnostic Classification of Mood Disorders

Published online by Cambridge University Press:  17 April 2020

J. Angst ,
P. Zimmermann ,
K. Merikangas  and
A. Gamma
J. Angst
Affiliation:
Research Department, Zurich University Psychiatric Hospital, Zurich, Switzerland
P. Zimmermann
Affiliation:
Max Planck Institute of Psychiatry, Munich, Germany
K. Merikangas
Affiliation:
National Institute of Mental Health, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA
A. Gamma
Affiliation:
Research Department, Zurich University Psychiatric Hospital, Zurich, Switzerland

Abstract

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Objectives

Our knowledge of the comorbidity of mood disorders depends heavily on their diagnostic classification, which is currently in a state of flux.

Method

A diagnostic specifier for bipolarity was developed and applied to data collected on major depression in several studies: Zurich Study, EDSP Study Munich, NCS-R Study USA, and Bridge Study (Vieta et al. 2010).

Results

In all four studies, about 40% of DSM-IV major depressive disorder diagnoses were re-classified as sub-threshold bipolar II disorders, resulting in a major change in comorbidity. The comorbidity of major depression with substance use disorder (SUD) (especially alcohol use) and panic disorder shifted substantially towards an association with hidden bipolar depression. The highest comorbidity was found in bipolar-I disorders. Pure and preponderantly manic or hypomanic subjects seem to be protected against comorbidity with anxiety disorders but are at risk for SUD.

Conclusions

The current classification of mood disorders over-estimates a diagnosis of pure depression. New data suggest that 40% to 50% of all subjects with mood disorders are bipolars. This has a considerable impact on comorbidity, treatment and future research. Self-assessment instruments for the detection of hypomania are recommendable.

Type
Translating research findings into clinical practice
Information
European Psychiatry , Volume 25 , Issue S1: 18th European Congress of Psychiatry. February 27, March 2, 2010 - Munich, Germany , 2010 , 25-E158
Copyright
Copyright © European Psychiatric Association 2010

References

Vieta et al., 2010 Vieta et al. 2010: Poster EPA Munich 2010.Google Scholar
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