TY - JOUR PY - 2011// TI - Phenomenology of psychotic mood disorders: lifetime and major depressive episode features JO - Journal of affective disorders A1 - Souery, Daniel A1 - Zaninotto, Leonardo A1 - Calati, Raffaella A1 - Linotte, Sylvie A1 - Sentissi, Othman A1 - Amital, Daniela A1 - Moser, Ulrike A1 - Kasper, Siegfried A1 - Zohar, Joseph A1 - Mendlewicz, Julien A1 - Serretti, Alessandro SP - 241 EP - 250 VL - 135 IS - 1-3 N2 - BACKGROUND: The nosological and clinical implications of psychotic features in the course of mood disorders have been widely debated. Currently, no specification exists for defining a subgroup of lifetime Psychotic Mood Disorder (PMD) patients. METHODS: A total of 2178 patients were examined, including subjects with Bipolar Disorder (BP) type I (n=519) and II (n=207) and Major Depressive Disorder (n=1452). Patients were divided between PMD (n=645) and non-psychotic Mood Disorders (MD) (n=1533) by the lifetime presence of at least one mood episode with psychotic features. Subjects having a depressive episode at the time of assessment were also examined: HAM-D and YMRS scores were compared between MD and PMD subjects, both with and without current psychotic features. RESULTS: A diagnosis of BP-I, a higher familial load for BP, a higher number of mood episodes lifetime, and a higher prevalence of OCD and somatic comorbidities were all associated to PMD. A diagnosis of BP (OR=4.48) was the only significant predictor for psychosis. PMD with non-psychotic depression were apparently less severe than MD patients and had a lower rate of "non-responders" to AD treatment. Sub-threshold manic symptoms and suicidal risk were also more pronounced among PMD. LIMITATIONS: The lack of information about number and polarity of previous psychotic mood episodes may be the major limitations of our study. CONCLUSIONS: BP diagnosis is the most significant predictor for psychosis in mood disorders. Non-psychotic mood episodes in PMD patients may be characterized by a distinctive symptom profile and, possibly, a different response to treatment.
Language: en
LA - en SN - 0165-0327 UR - http://dx.doi.org/10.1016/j.jad.2011.07.027 ID - ref1 ER -