Sub-threshold depression and antidepressants use in a community sample searching anxiety and finding bipolar disorder 英文参考文献.docVIP

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Sub-threshold depression and antidepressants use in a community sample searching anxiety and finding bipolar disorder 英文参考文献.doc

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Sub-threshold depression and antidepressants use in a community sample searching anxiety and finding bipolar disorder 英文参考文献

Cartaetal.BMCPsychiatry2011,11:164 /1471-244X/11/164 RESEARCH ARTICLE OpenAccess Sub-thresholddepressionandantidepressants useinacommunitysample:searchinganxiety andfindingbipolardisorder MauroGCarta1*,LeonardoTondo2,MatteoBalestrieri3,FilippoCaraci4,Lilianadell’Osso5,GuidoDiSciascio6, CarloFaravelli7,MariaCarolinaHardoy1,8,MariaELecca1,MariaFrancescaMoro1,KrishnaMBhat9, MassimoCasacchia10andFilippoDrago4 Abstract Background:Todeterminetheuseofantidepressants(ADs)inpeoplewithsub-thresholddepression(SD);the lifetimeprevalenceofmaniaandhypomaniainSDandthelinkbetweenADsuse,bipolarityandanxietydisorders inSD. Methods:Studydesign:communitysurvey.Studypopulation:samplesrandomlydrawn,afterstratificationfromthe adultpopulationofmunicipalrecords.Samplesize:4999peoplefromsevenareaswithinsixItalianregions.Tools: Questionnaireonpsychotropicdrugconsumption,prescription;StructuredClinicalInterviewNPforDSM-IV modified(ANTAS);HamiltonDepressionRatingScale(HAM-D);MoodDisorderQuestionnaire(MDQ);ShortForm HealthSurvey(SF-12).SDdefinition:HAM-D10withoutlifetimediagnosisofDepressiveEpisode(DE). Results:SDpointprevalenceis5.0%.ThelifetimeprevalenceofmaniaandhypomaniaepisodesinSDis7.3%. Benzodiazepines(BDZ)consumptioninSDis24.1%,followedbyADs(19.7%).InSD,positiveforMDQandcomorbidity withPanicDisorder(PD)orGeneralizedAnxietyDisorders(GAD)areassociatedwithADsuse,whereastheassociation betweenapositiveMDQandADsuse,withoutadiagnosisofPDorGAD,isnotsignificant.OnlyinpeoplewithDEthe well-being(SF-12)ishigheramongthoseusingfirst-lineantidepressantscomparedtothosenotusinganymedication. InpeoplewithSDnosignificantdifferenceswerefoundintermsofSF-12scoreaccordingtodruguse. Conclusions:ThisstudysuggestscautioninprescribingADstopeoplewithSD.Inpeoplewithconcomitant anxietydisordersandSD,itshouldbemandatorytoperformawell-designedassessmentandevaluatethe presenceofpreviousmanicorhypomanicsymptomspriortoprescribingADs. Background subtyping of depression is based on the DSM-IV-TR Patientswithmild-to-moder