ANTIDEPRESSANT-ASSOCIATED HYPOMANIA IN OUTPATIENT DEPRESSION - A 203-CASE STUDY IN PRIVATE-PRACTICE

The incidence of hypomania/mania was studied in 203 consecutive mood d isorder outpatients, presenting for treatment of depression in private practice, during a follow-up of 3 to 6 months. Of these 50.7% were un ipolar, 45.3% were bipolar II, and 3.9% were bipolar I patients. Compa red to unipolar patients, bipolar II patients had a threefold greater risk of switching (17.3% vs. 5.8%, a significant difference), but a lo wer rate than expected from previous work. In a previous analysis of t he whole sample, bipolar II patients had a lower age al onset and more frequent atypical features than unipolar patients. Both unipolar and bipolar switchers had instead early age at onset and frequent atypical features, suggesting that these factors might increase the risk of sw itching in unipolar depression. (C) 1997 Elsevier Science B.V.