Tesi di laurea specialistica LC6
Depression with anxious distress specifier: a prospective study on a 241 patients
RICERCA TRASLAZIONALE E DELLE NUOVE TECNOLOGIE IN MEDICINA E CHIRURGIA
Corso di studi
MEDICINA E CHIRURGIA
relatore Dell'Osso, Liliana
Data inizio appello
Data di rilascio
DSM-5 describes different specifiers relating to major depressive disorder. Many studies indicate anxious distress specifier as a negative prognostic factor: patients have greater severity of depression, chronicity, greater functional impairment, more suicidal ideation, self harm and complete suicide, poor treatment outcome, and greater frequency of side effects during antidepressant treatment.<br>The aim of this study was to assess the presence of anxious distress specifier in a sample of 241 patients with major depressive episode with Mdd, BP-I or Bp-II, and to evaluate a longitudinal predictive validity of the specifier.<br>Diagnostic assessment was performed with SCID-5, SIMD, HAM-D, YMRS, CGI, Brief TEMPS-M, and GAF.<br>In the sample, the anxious distress specifier was present in 58,9%, and compared with the group without this specifier had a correlation with BD-II diagnosis, previous hypomanic episodes, mixed features, seasonal pattern, family history of bipolar disorder and significant higher scores of YMRS, HDRS and CGI-S.<br>The two groups differed significantly in use of SSRIs, antipsychotics (both typical and atypical), which was higher in the group with anxious distress.<br>The patients were followed for 12 weeks and the response from baseline to the end of the study was a significant reduction of HDRS and an increase for the YMRS score. <br>These results indicate a worse outcome for patients with anxious distress specifier, and a possible relationship with bipolar spectrum.
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