Sub-threshold depression and antidepressants use in a community sample: searching anxiety and finding bipolar disorder
Carta, Mauro G.
Di Sciascio, Guido
Hardoy, Maria Carolina
Lecca, Maria E.
Moro, Maria Francesca
Bhat, Krishna M.
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CitationCarta, Mauro G, Leonardo Tondo, Matteo Balestrieri, Filippo Caraci, Liliana dell’Osso, Guido Di Sciascio, Carlo Faravelli, et al. 2011. “Sub-Threshold Depression and Antidepressants Use in a Community Sample: Searching Anxiety and Finding Bipolar Disorder.” BMC Psychiatry 11 (1). Springer Nature. doi:10.1186/1471-244x-11-164.
AbstractBackground: 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.
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