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Title: The implications of hypersomnia in the context of major depression: Results from a large, international, observational study
Author: Murru, Andrea
Guiso, Giovanni
Barbuti, Margherita
Anmella, Gerard
Verdolini, Norma
Samalin, Ludovic
Azorin, Jean-Michel
Angst, Jules
Bowden, Charles L.
Mosolov, Sergey
Young, Allan H.
Popovic, Dina
Valdes, M.
Perugi, Giulio
Vieta i Pascual, Eduard, 1963-
Pacchiarotti, Isabella
BRIDGE-II-Mix Study Group
Keywords: Depressió psíquica
Trastorn bipolar
Trastorns del son
Mental depression
Manic-depressive illness
Sleep disorders
Issue Date: Apr-2019
Publisher: Elsevier B.V.
Abstract: According to the DSM-5, 'reduction in the need for sleep' is the only sleep-related criteria for mixed features in depressive episodes. We aimed at studying the prevalence, clinical correlates and the role of hypersomnia in a sample of acutely depressed patients. Secondarily, we factors significantly increasing the odds of hypersomnia were studied. We conducted a post-hoc analysis of the BRIDGE-II-Mix study. Variables were compared between patients with hypersomnia (SLEEP+) and with insomnia (SLEEP-) with standard bivariate tests. A stepwise backward logistic regression model was performed with SLEEP+ as dependent variable. A total of 2514 subjects were dichotomized into SLEEP+ (n = 423, 16.8%) and SLEEP- (n = 2091, 83.2%). SLEEP+ had significant higher rates of obese BMI (p < 0.001), BD diagnosis (p = 0.027), severe BD (p < 0.001), lifetime suicide attempts (p < 0.001), lower age at first depression (p = 0.004) than SLEEP-. Also, SLEEP+ had significantly poorer response to antidepressants (AD) such as (hypo)manic switches, AD resistance, affective lability, or irritability (all 0<0.005). Moreover, SLEEP+ had significantly higher rates of mixed-state specifiers than SLEEP- (all 0 < 0.006). A significant contribution to hypersomnia in our regression model was driven by metabolic-related features, such as 'current bulimia' (OR = 4.21) and 'overweight/obese BMI (OR = 1.42)'. Globally, hypersomnia is associated with poor outcome in acute depression. Hypersomnia is strongly associated with mixed features and bipolarity. Metabolic aspects could influence the expression of hypersomnia, worsening the overall clinical outcome. Along with commonly used screening tools, detection of hypersomnia has potential, costless discriminative validity in the differential diagnosis unipolar and bipolar depression.
Note: Versió postprint del document publicat a:
It is part of: European Neuropsychopharmacology, 2019, vol. 29, num. 4, p. 471-481
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ISSN: 0924-977X
Appears in Collections:Articles publicats en revistes (Medicina)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

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