Predicting Diagnostic Change Among Patients Diagnosed With First-Episode<i>DSM-IV-TR</i>Major Depressive Disorder With Psychotic Features

Salvatore, Paola; Baldessarini, Ross J.; Khalsa, Hari-Mandir K.; Amore, Mario; Vittorio, Cristina Di; Ferraro, Gabriella; Maggini, Carlo; Tohen, Mauricio

doi:10.4088/jcp.12m08328

Cited by 36 publications

(37 citation statements)

References 41 publications

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“…This finding is also consistent with findings reported by Salvatore et al (2013) in older adults and a study by Fiedorowicz et al (2011), documenting that subsyndromal symptoms of mania in patients with MDD of any age are predictive of manic switches. Likewise, Birmaher et al (2009) have documented that even minor manifestations of mania significantly increased the risk of development of fully syndromatic bipolar-I disorder over time.…”

Section: Discussionsupporting

confidence: 92%

“…Likewise, Birmaher et al (2009) have documented that even minor manifestations of mania significantly increased the risk of development of fully syndromatic bipolar-I disorder over time. Whereas Strober et al (1982;1993) study is the only pediatric study that reported that the presence of psychotic symptoms in adolescents with MDD was a significant predictor of manic switching, there is a sizeable adult literature that documents that psychotic symptoms represent a strong predictor of manic switching (Akiskal et al, 1983;Coryell et al, 1995b;Fiedorowicz et al, 2011;Salvatore et al, 2013). It is noteworthy, however, that most of the reviewed studies excluded children with psychotic features during enrollment, limiting the scope of the available data for analysis.…”

Section: Discussionmentioning

confidence: 99%

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Can manic switches be predicted in pediatric major depression? A systematic literature review

Uchida

Serra

Zayas

et al. 2015

Journal of Affective Disorders

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Can manic switches be predicted in pediatric major depression? A systematic literature review

Uchida

Serra

Zayas

et al. 2015

Journal of Affective Disorders

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“…The nonspecificity and variability of symptoms over time are frequent causes of misdiagnosis in patients with bipolar disorder (BD) [1, 2]. Although more frequent in BD, psychotic symptoms may be present in some patients with major depressive disorder (MDD) [3].…”

Section: Introductionmentioning

confidence: 99%

Neuroanatomical Classification in a Population-Based Sample of Psychotic Major Depression and Bipolar I Disorder with 1 Year of Diagnostic Stability

Serpa

Schaufelberger

et al. 2014

BioMed Research International

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The presence of psychotic features in the course of a depressive disorder is known to increase the risk for bipolarity, but the early identification of such cases remains challenging in clinical practice. In the present study, we evaluated the diagnostic performance of a neuroanatomical pattern classification method in the discrimination between psychotic major depressive disorder (MDD), bipolar I disorder (BD-I), and healthy controls (HC) using a homogenous sample of patients at an early course of their illness. Twenty-three cases of first-episode psychotic mania (BD-I) and 19 individuals with a first episode of psychotic MDD whose diagnosis remained stable during 1 year of followup underwent 1.5 T MRI at baseline. A previously validated multivariate classifier based on support vector machine (SVM) was employed and measures of diagnostic performance were obtained for the discrimination between each diagnostic group and subsamples of age- and gender-matched controls recruited in the same neighborhood of the patients. Based on T1-weighted images only, the SVM-classifier afforded poor discrimination in all 3 pairwise comparisons: BD-I versus HC; MDD versus HC; and BD-I versus MDD. Thus, at the population level and using structural MRI only, we failed to achieve good discrimination between BD-I, psychotic MDD, and HC in this proof of concept study.

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“…In addition to antecedent characteristics and affective presentations as risk factors for suicidal behavior, suicidal psychotic subjects were most likely to meet diagnostic criteria for bipolar mixed-states or psychotic major depression (Table 3). These mood-states, though separated by current nosological conventions, may be closely related in that manic-depressive mixed-states appear to have more in common with psychotic major depression than with mania [18,35,36,37]. This study is limited in the numbers of subjects and of suicide attempts in some psychotic disorders.…”

Section: Discussionmentioning

confidence: 99%

“…These assessments were made without preconceptions about the nature or timing of antecedent or presenting psychopathological phenomena in relation to type of presenting episode. The first author (PS) carried out comprehensive reviews of all available documents providing information about antecedent and first-episode clinical phenomena for all 516 first-episode psychotic subjects in random order over a three-year period, while held blind to initial and later diagnoses [17,18]. …”

Section: Methodsmentioning

confidence: 99%

Negative Affective Features in 516 Cases of First Psychotic Disorder Episodes: Relationship to Suicidal Risk

Salvatore¹

2013

J Depress Anxiety

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Objectives Plausible candidates of psychopathological phenomena that may associate with or anticipate suicidal risk, include negative affects, including admixtures of dysphoria, depression and anxiety described mainly in nonpsychotic disorders. We ascertained the distribution of such affective features in various first-episode psychotic disorders and correlated these and other clinical and antecedent features with intake suicidal status. Methods We evaluated 516 adult subjects in first-lifetime episodes of various DSM-IV-TR psychotic disorders. Blinded, protocol-guided, assessments of clinical features ascertained in SCID examinations, self- and family reports and clinical records supported analyses of associations of suicide attempts at first-psychotic episodes with antecedent and intake clinical characteristics, including negative affects and diagnoses, using standard bivariate and multivariate methods. Results Negative affective features in various combinations were prevalent (90%) and at >75% in both affective and nonaffective psychotic disorders; anxious depression was most common (22%). We identified antecedent and intake clinical factors preliminarily associated with suicide attempts. Factors remaining independently associated in multivariate logistic modelling (ranked by OR) were: (a) prior suicide attempt, (b) prior aggressive assault, (c) bipolar-mixed state or psychotic major depression diagnosis, (d) prior dysphoria, (e) intake dysphoric-anxiousdepression, (f) prior impulsivity, (g) previous affective instability, (h) previous nonpsychotic depression, (i) previous decline in vital drive, and (j) prior sleep disturbances. Conclusions Various types and combinations of negative affective features (especially anxious depression with and without dysphoria) were prevalent across nonaffective as well as affective first psychotic episodes and strongly associated with suicide attempts. These findings extend previous observations in nonpsychotic disorders.

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Predicting Diagnostic Change Among Patients Diagnosed With First-EpisodeDSM-IV-TRMajor Depressive Disorder With Psychotic Features

Cited by 36 publications

References 41 publications

Can manic switches be predicted in pediatric major depression? A systematic literature review

Can manic switches be predicted in pediatric major depression? A systematic literature review

Neuroanatomical Classification in a Population-Based Sample of Psychotic Major Depression and Bipolar I Disorder with 1 Year of Diagnostic Stability

Negative Affective Features in 516 Cases of First Psychotic Disorder Episodes: Relationship to Suicidal Risk

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