Date: Fri, 14 May 1999 13:41:14 +0200
From: "Gatherer, D. (Derek)" <D.Gatherer@organon.nhe.akzonobel.nl>
Subject: genetic susceptibility to depression
To: "'memetics@mmu.ac.uk'" <memetics@mmu.ac.uk>
The only recent article in Am J Psychiatry from University of Texas is this
one:
Phenomenology of mania: evidence for distinct depressed, dysphoric, and
euphoric
presentations.
Dilsaver SC, Chen YR, Shoaib AM, Swann AC
Harris County Psychiatric Center and the Department of Psychiatry and
Behavioral Sciences, University of Texas Health Science Center,
Houston, USA.
OBJECTIVE: A substantial number of manic episodes include conspicuous
depressive symptoms. Manic episodes have been clinically
classified a posteriori using preset criteria. The aim of this study was to
investigate the possibility that there might be a natural division of
manic episodes into clinical types. METHOD: One hundred and five inpatients
met Research Diagnostic Criteria and DSM-III-R criteria for
manic episodes and were rated before institution of pharmacological
treatment. The authors conducted a factor analysis of 37 behavior
rating items from the Schedule for Affective Disorders and Schizophrenia.
The resulting factors were used as independent variables in a
cluster analysis of the patients. RESULTS: This analysis revealed four
factors corresponding to manic activation, depressed state, sleep
disturbance, and irritability/paranoia. Cluster analysis separated the
patients into two groups. One included patients with major depressive
disorder and mania. Blind, a priori clinical classification into classic and
mixed mania (mania plus depression) showed that all of the patients
in the depressed cluster, and about 40% of those in the nondepressed
cluster, were in a mixed state according to clinical criteria.
Comparison of the clinically mixed and nonmixed patients in the nondepressed
cluster revealed that the mixed patients in that cluster had
higher scores for items related to anger, worry, dysphoria, and
irritability. CONCLUSIONS: These data suggest that manic episodes can be
naturalistically classified as classic (predominately euphoric), dysphoric,
or depressed.
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