Psychotic versus non-psychotic major depressive disorder: A comparative naturalistic study

Buoli, Massimiliano; Caldiroli, Alice; Altamura, Alfredo Carlo

doi:10.1016/j.ajp.2013.02.003

Cited by 34 publications

(21 citation statements)

References 27 publications

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“…Twelve studies met our high quality criteria , whereas eight studies were rated as of low quality . The fixed‐effects pooled OR in the former studies was 2.26 (95% CI: 1.84–2.77), whereas their random effect pooled OR was 2.23 (95% CI: 1.63–3.04), with I 2 statistic being 42.4%.…”

Section: Resultsmentioning

confidence: 96%

“…As regards the differences in suicidal attempts with respect to age, the fixed‐effects pooled OR of the three studies with only elderly patients was 2.11 (95% CI: 1.23–3.63) and the random‐effects pooled OR 2.12 (95% CI: 1.06–4.27), with the I 2 statistic being 54.6%. The corresponding fixed‐effects pooled OR of the remaining 17 studies which included younger adults was 2.11 (95% CI: 1.80–2.48), and the random‐effects pooled OR was 2.01 (95% CI: 1.54–2.63) with the I 2 statistic being 54.6%. The difference was not statistically significant (meta‐regression P = 0.888); thus, age of patients does not seem to act as an effect modifier (Table ).…”

Section: Resultsmentioning

confidence: 99%

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Psychotic (delusional) depression and suicidal attempts: a systematic review and meta‐analysis

Gournellis

Tournikioti

Touloumi

et al. 2017

Acta Psychiatr Scand

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Section: Resultsmentioning

confidence: 96%

Section: Resultsmentioning

confidence: 99%

Psychotic (delusional) depression and suicidal attempts: a systematic review and meta‐analysis

Gournellis

Tournikioti

Touloumi

et al. 2017

Acta Psychiatr Scand

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“…It has been demonstrated that BD‐P patients had worse outcome than non‐psychotic bipolar disorder (BD‐NP)/unipolar patients, but better than schizophrenia (SCZ) patients . Furthermore, the risk of relapse in depressed patients was greater for BD‐P patients than for BD‐NP patients and the presence of psychotic symptoms in patients with a major depressive episode was predictive of non‐remission after a standard psychopharmacological treatment …”

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confidence: 99%

Biological aspects and candidate biomarkers for psychotic bipolar disorder: A systematic review

Buoli

Caldiroli

Melter

et al. 2016

Psychiatry Clin Neurosci

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Aim:We carried out a systematic review of the available literature about potential biomarkers of psychotic bipolar disorder (BD-P), a specific subset presenting worse outcome and greater risk of relapse than non-psychotic bipolar disorder (BD-NP). Methods:We searched the main psychiatric databases (PubMed, ISI Web of Knowledge, PsychInfo). Only original articles with the main topic of BD-P compared to schizophrenia/BD-NP/healthy controls (HC) written in English from 1994 to 2015 were included.Results: BD-P patients presented higher kynurenic acid levels in the cerebrospinal fluid, elevated antiSaccharomyces cerevisiae antibodies levels, and lower serum levels of dehydroepiandrosterone sulfate and progesterone than BD-NP/HC. Event-related potentials abnormalities have been identified in BD-P with respect to BD-NP. BD-P patients also presented bigger ventricles but similar hippocampal volumes compared to BD-NP/HC. Although the results are contrasting, some cognitive deficits seemed to be related to the psychotic dimension of bipolar affective disorder, such as impairment in verbal/logical memory, working memory, verbal and semantic fluency and executive functioning. Finally, polymorphisms of genes, such as NRG1, 5HTTLPR (s), COMT, DAOA and some chromosome regions (16p12 and 13q), were positively associated with BD-P. Conclusion:Data about the identification of specific biomarkers for BD-P are promising, but most of them have not yet been replicated. They could lead the clinicians to an early diagnosis and proper treatment, thus ameliorating outcome of BD-P and reducing the biological changes associated with a long duration of illness. Further studies with bigger samples are needed to detect more specific biological markers of the psychotic dimension of bipolar affective disorder.Key words: biomarkers, bipolar disorder, psychoneurobiology, psychopathology, psychotic symptoms. B IOLOGICAL MARKERS, AS indicators of a biological or a pathological state and as parameters that can be measured objectively, could provide a valuable support to the clinical decision-making process in many branches of medicine, including psychiatry. Several findings in the field of mood disorders could provide the background for the identification of potential specific and objective biomarkers, which could be an important aid to better understand the course of illness, the mechanisms of vulnerability and of disease expression.A recent paper describing the work of the Biomarkers Network from the International Society for Bipolar Disorders (ISBD-BIONET) cited neuroimaging and genetic findings in bipolar affective disorder (BPAD) (e.g. the loss of gray matter, the altered activation of anterior temporal, ventral prefrontal and subcortical regions in response to emotional stimuli, the identification of several potential candidate genes associated with increased risk for developing *Correspondence: Alice Caldiroli, MD, Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, via Francesco Sforza ...

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“…Of note, more than half of the bipolar patients have hallucinations and delusions at least once during a mood episode [2], and patients with major depressive disorder (MDD) may present psychotic symptoms in 19-25% of cases [3] with worse outcomes than patients without psychotic symptoms [4]. The identification of biological markers (e.g.…”

Section: Introductionmentioning

confidence: 99%

Sex Steroids and Major Psychoses: Which Role for DHEA-S and Progesterone?

et al. 2016

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Objective: Endocrine pathways seem to play a role in the etiology of major psychoses. The identification of biomarkers associated with psychotic symptoms in schizophrenia (SKZ) and mood disorders would allow the identification of high-risk subjects for delusions and hallucinations. The aim of this study was to evaluate dehydroepiandrosterone sulfate (DHEA-S) and progesterone plasma levels in drug-free patients with major psychoses and their relation with the diagnosis and history of psychotic symptoms. Methods: Eighty-nine consecutive drug-free male inpatients with SKZ or mood disorders were recruited, and DHEA-S and progesterone plasma levels were measured. The groups, divided according to pathological/normal-range hormone levels, were compared in terms of clinical variables using χ² tests with Bonferroni's corrections or multivariate analyses of variance. The same analyses were performed for groups divided according to the presence/absence of lifetime psychotic symptoms. Binary logistic regression analysis was performed using hormone levels as independent variables and history of lifetime psychotic symptoms as a dependent one. Results: A higher number of patients with abnormal DHEA-S levels was found to have a family history of major depressive disorder (p < 0.05). Higher DHEA-S levels (F = 8.31; p = 0.005) were found in patients with a history of psychotic symptoms. In addition, binary logistic regression confirmed that DHEA-S levels were associated with a higher probability of lifetime psychotic symptoms (p = 0.037). Conclusions: Our results confirm previous data about the role of endocrine factors in the etiology of major psychoses. A high DHEA-S level might be a risk factor for psychotic symptoms. Studies with larger samples are needed to confirm these data.

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Psychotic versus non-psychotic major depressive disorder: A comparative naturalistic study

Cited by 34 publications

References 27 publications

Psychotic (delusional) depression and suicidal attempts: a systematic review and meta‐analysis

Psychotic (delusional) depression and suicidal attempts: a systematic review and meta‐analysis

Biological aspects and candidate biomarkers for psychotic bipolar disorder: A systematic review

Sex Steroids and Major Psychoses: Which Role for DHEA-S and Progesterone?

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