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Rate and significance of hypomanic switches in unipolar melancholic depression

Published online by Cambridge University Press:  16 April 2020

JM Menchon
Affiliation:
Department of Psychiatry, Hospital de Bellvitge, Feixa Llarga, s/r. 08907 – L'Hospitalet de Llobregat, Barcelona
C Gasto
Affiliation:
Department of Psychiatry and Medical Psychobiology, University of Barcelona, Subdivision of Psychiatry and Psychology, Hospital Clínic i Provincial, Barcelona
J Vallejo
Affiliation:
Hospital de Bellvitge, Barcelona, Department of Psychiatry and Medical Psychobiology, University of Barcelona
R Catalan
Affiliation:
Subdivision of Psychiatry and Psychology, Hospital Clínic i Provincial, Barcelona
A Otero
Affiliation:
Department of Psychiatry and Medical Psychobiology, University of Barcelona, Subdivision of Psychiatry and Psychology, Hospital Clínic i Provincial, Barcelona, Spain
E Vieta
Affiliation:
Department of Psychiatry and Medical Psychobiology, University of Barcelona, Subdivision of Psychiatry and Psychology, Hospital Clínic i Provincial, Barcelona, Spain
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Summary

One hundred and sixteen patients with RDC unipolar recurrent depressive disorder, melancholic subtype, were treated with imipramine or phenelzine and followed-up for six months. None of the patients had a first-degree relative with bipolar I disorder. Twenty-six patients (22.4%) presented an hypomanic episode (‘hypomanic group’). This group of patients, when depressed, had a significantly lower age of onset of the disorder and higher response to antidepressant therapy than patients who did not present an hypomanic episode. Significantly more patients (88%) of the ‘hypomanic group’ had at least one first-degree relative with a history of major depressive disorder. These patients displayed some of the typical features of bipolar II disorder. Overall results support the continuum in clinical phenomena between unipolar and bipolar disorders.

Type
Original article
Copyright
Copyright © Elsevier, Paris 1993

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