Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2019 Dec;21(8):785-793.
doi: 10.1111/bdi.12816. Epub 2019 Aug 28.

The role of different patterns of psychomotor symptoms in major depressive episode: Pooled analysis of the BRIDGE and BRIDGE-II-MIX cohorts

Margherita Barbuti  1 , Cecilia Mainardi  1   2 , Isabella Pacchiarotti  2 , Norma Verdolini  2   3   4   5 , Giuseppe Maccariello  1 , Jules Angst  6 , Jean-Michel Azorin  7 , Charles L Bowden  8 , Sergey Mosolov  9 , Allan H Young  10 , Eduard Vieta  2 , Giulio Perugi  1
Affiliations
Multicenter Study

The role of different patterns of psychomotor symptoms in major depressive episode: Pooled analysis of the BRIDGE and BRIDGE-II-MIX cohorts

Margherita Barbuti et al. Bipolar Disord. 2019 Dec.

Abstract

Background: Psychomotor agitation (PA) or retardation (PR) during major depressive episodes (MDEs) have been associated with depression severity in terms of treatment-resistance and course of illness.

Objectives: We investigated the possible association of psychomotor symptoms (PMSs) during a MDE with clinical features belonging to the bipolar spectrum.

Methods: The initial sample of 7689 MDE patients was divided into three subgroups based on the presence of PR, PA and non-psychomotor symptom (NPS). Univariate comparisons and multivariate logistic regression models were performed between subgroups.

Results: A total of 3720 patients presented PR (48%), 1971 showed PA (26%) and 1998 had NPS (26%). In the PR and PA subgroups, the clinical characteristics related to bipolarity, along with the diagnosis of bipolar disorder (BD), were significantly more frequent than in the NPS subgroup. When comparing PA and PR patients, the former presented higher rates of bipolar spectrum features, such as family history of BD (OR = 1.39, CI = 1.20-1.61), manic/hypomanic switches with antidepressants (OR = 1.28, CI = 1.11-1.48), early onset of first MDE (OR = 1.40, CI = 1.26-1.57), atypical (OR = 1.23, CI = 1.07-1.42) and psychotic features (OR = 2.08, CI = 1.78-2.44), treatment with mood-stabilizers (OR = 1.39, CI = 1.24-1.55), as well as a BD diagnosis according to both the DSM-IV criteria and the bipolar specifier criteria. When logistic regression model was performed, the clinical features that significantly differentiated PA from PR were early onset of first MDE, atypical and psychotic features, treatment with mood-stabilizers and a BD diagnosis according to the bipolar specifier criteria.

Conclusions: Psychomotor symptoms could be considered as markers of bipolarity, illness severity, and treatment complexity, particularly if PA is present.

Keywords: bipolar disorder; major depressive episode; psychomotor agitation; psychomotor retardation.

PubMed Disclaimer

References

REFERENCES

    1. Schrijvers D, Hulstijn W, Sabbe B. Psychomotor symptoms in depression: a diagnostic, pathophysiological and therapeutic tool. J Affect Disord. 2008;109(1-2):1-20.
    1. Parker G, Roy K, Wilhelm K, Mitchell P, Hadzi-Pavlovic D. The nature of bipolar depression: implications for the definition of melancholia. J Affect Disord. 2000;59(3):217-224.
    1. Parker G, Fink M, Shorter E, et al. Issues for DSM-5: whither melancholia? The case for its classification as a distinct mood disorder. Am J Psychiatry. 2010;167(7):745-747.
    1. Leonpacher AK, Liebers D, Pirooznia M, et al. Distinguishing bipolar from unipolar depression: the importance of clinical symptoms and illness features. Psychol Med. 2015;45(11):2437-2446.
    1. Hantouche EG, Akiskal HS. Bipolar II vs. unipolar depression: psychopathologic differentiation by dimensional measures. J Affect Disord. 2005;84(2-3):127-132.

Publication types

LinkOut - more resources