Major Depressive Disorder With Subthreshold Bipolarity in the National Comorbidity Survey Replication
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OBJECTIVE: There is growing clinical and epidemiologic evidence that major mood disorders form a spectrum from major depressive disorder to pure mania. The authors examined the prevalence and clinical correlates of major depressive disorder with subthreshold bipolarity compared with pure major depressive disorder in the National Comorbidity Survey Replication (NCS-R). METHOD: The NCS-R is a nationally representative face-to-face household survey of the U.S. population conducted between February 2001, and April 2003. Lifetime history of mood disorders, symptoms, and clinical indicators of severity were collected using version 3.0 of the World Health Organization's Composite International Diagnostic Interview. RESULTS: Nearly 40% of study participants with a history of major depressive disorder had a history of subthreshold hypo-mania. This subgroup had a younger age at onset, more episodes of depression, and higher rates of comorbidity than those without a history of hypomania and lower levels of clinical severity than those with bipolar II disorder. CONCLUSIONS: These findings demonstrate heterogeneity in major depressive disorder and support the validity of inclusion of subthreshold mania in the diagnostic classification. The broadening of criteria for bipolar disorder would have important implications for research and clinical practice.
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Between 33 and 66% of patients suffering from MDD have a psychiatric comorbidity that could potentially exclude them from psychedelic-assisted therapy.
“Between 33 and 66% of patients suffering from MDD have a psychiatric comorbidity that could potentially exclude them from psychedelic-assisted therapy”
From Psychedelics and Other Psychoplastogens for Treating Mental Illness. (2021) · cites this paper as [267]
The Results (page unavailable) report psychiatric comorbidity among people with MDD, particularly higher rates of anxiety, substance-use disorders, and behavioral problems in those with subthreshold hypomania than in those with MDD alone. The cited passages do not establish the 33–66% range or say that these conditions could exclude patients from psychedelic-assisted therapy. (LLM, conf=0.85)
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References 36 · Cited by 305
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- Authors
- Angst, J., Cui, L., Swendsen, J., Rothen, S., Cravchik, A., Kessler, R. C., & Merikangas, K. R.
- Affiliations
- University of Geneva (CH)
- Venue
- American Journal of Psychiatry
- Published
- 2010-10
- Volume
- 167
- Issue
- 10
- Pages
- 1194-1201
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- PMC
- PMC3145248
- OpenAlex
- W2161726793
- Cited by
- 305
- References
- 36
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 6 · 2023: 7 · 2022: 10 · 2021: 8 · 2020: 7 · 2019: 12 · 2018: 21 · 2017: 21 · 2016: 19 · 2015: 22 · 2014: 32 · 2013: 39 · 2012: 48
- FWCI
- 27.55
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Archive ouverte UNIGE (University of Geneva) (acceptedVersion)
- Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by)
- Funders
- National Institutes of Health
- National Institute of Mental Health (U01-MH-60220, U01MH060220)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- major depressive disorder, bipolar II disorder, mood disorders, diagnostic classification, comorbidities, age of onset, clinical severity, depression heterogeneity, prevalence
- MeSH terms
- Adolescent, Adult, Mental Disorders, Bipolar Disorder, Depressive Disorder, Major, Major Depressive Disorder, Diagnosis, Differential, Female, Health Surveys, Humans, Male, Psychiatric Status Rating Scales, Psychometrics, Severity of Illness Index, Syndrome, United States, Comorbidity, Prevalence, Age of Onset, Diagnostic and Statistical Manual of Mental Disorders
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