Sub-threshold depression and antidepressants use in a community sample: searching anxiety and finding bipolar disorder.

Abstract

BACKGROUND:

To determine the use of antidepressants (ADs) in people with sub-threshold depression (SD); the lifetime prevalence of mania and hypomania in SD and the link between ADs use, bipolarity and anxiety disorders in SD.

METHODS:

STUDY DESIGN:

community survey.

STUDY POPULATION:

samples randomly drawn, after stratification from the adult population of municipal records.

SAMPLE SIZE:

4999 people from seven areas within six Italian regions. Tools: Questionnaire on psychotropic drug consumption, prescription; Structured Clinical Interview NP for DSM-IV modified (ANTAS); Hamilton Depression Rating Scale (HAM-D); Mood Disorder Questionnaire (MDQ); Short Form Health Survey (SF-12). SD definition: HAM-D > 10 without lifetime diagnosis of Depressive Episode (DE).

RESULTS:

SD point prevalence is 5.0%. The lifetime prevalence of mania and hypomania episodes in SD is 7.3%. Benzodiazepines (BDZ) consumption in SD is 24.1%, followed by ADs (19.7%). In SD, positive for MDQ and comorbidity with Panic Disorder (PD) or Generalized Anxiety Disorders (GAD) are associated with ADs use, whereas the association between a positive MDQ and ADs use, without a diagnosis of PD or GAD, is not significant. Only in people with DE the well-being (SF-12) is higher among those using first-line antidepressants compared to those not using any medication. In people with SD no significant differences were found in terms of SF-12 score according to drug use.

CONCLUSIONS:

This study suggests caution in prescribing ADs to people with SD. In people with concomitant anxiety disorders and SD, it should be mandatory to perform a well-designed assessment and evaluate the presence of previous manic or hypomanic symptoms prior to prescribing ADs.

• Authors: Mauro G Carta, Leonardo Tondo, Matteo Balestrieri, Filippo Caraci, Liliana Dell'osso, Guido Di Sciascio, Carlo Faravelli, Maria Carolina Hardoy, Maria E Lecca, Maria Francesca Moro, Krishna M Bhat, Massimo Casacchia, Filippo Drago
• Journal: BMC psychiatry (BMC Psychiatry) Vol. 11 Pg. 164 (Oct 10 2011) ISSN: 1471-244X [Electronic] England
• PMID: 21985128 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antidepressive Agents
• Benzodiazepines

Topics

• Adolescent
• Adult
• Aged
• Antidepressive Agents (therapeutic use)
• Anxiety Disorders (complications, drug therapy, epidemiology)
• Benzodiazepines (therapeutic use)
• Bipolar Disorder (complications, epidemiology)
• Depression (complications, diagnosis, drug therapy, epidemiology)
• Female
• Health Surveys (statistics & numerical data)
• Humans
• Italy (epidemiology)
• Male
• Middle Aged
• Prevalence
• Psychiatric Status Rating Scales (statistics & numerical data)
• Residence Characteristics (statistics & numerical data)