Posted by SLS on November 10, 2001, at 8:50:56
In reply to Re: Refractary depression To Scott !!!, posted by pat c. on November 10, 2001, at 7:47:39
Hi Pat.
> Sounds like atypical depression to me.
That was my initial impression also.
I think it is important for Petters to more thoroughly evaluate whether a true mania ever occurred. I am hoping that my questions will help to determine this.
The phrase "racing thoughts" is often used by people with anxious depression or comorbid anxiety. This might be the case with Petters given the description of "Phobic anxiety, social phobia". By itself, I would not use the phrase "racing thoughts" as being sufficient to diagnose bipolar disorder. Aside from this, I don't see anything else that would be consistent with bipolar disorder and inconsistent with unipolar (atypical) disorder. Since Lamictal and adjunctive lithium are often beneficial in treating atypical depression, Petter's improvement while using these drugs does not exclude unipolar depression.
One of the features that sticks out in my mind is OCD.
Petters - Is your OCD episodic or steady and chronic. What exactly are your OCD symptoms? By the way, I never asked you. Are you male or female? I am not familiar with the name "Petters". I feel silly :-)
- Scott
------------------------------------------------------Eur Arch Psychiatry Clin Neurosci 1998;248(5):240-4 Related Articles, Books, LinkOut
Episodic course in obsessive-compulsive disorder.Perugi G, Akiskal HS, Gemignani A, Pfanner C, Presta S, Milanfranchi A, Lensi P, Ravagli S, Maremmani I, Cassano GB.
Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, Italy.
The course of obsessive-compulsive disorder (OCD) is variable, ranging from episodic to chronic. We hypothesised that the former course is more likely to be related to bipolar mood disorders. With the use of a specially constructed OCD questionnaire, we studied 135 patients fulfilling DSM-III-R criteria for OCD with an illness duration of at least 10 years and divided by course: 27.4% were episodic and 72.6% chronic. We compared clinical and familial characteristics and comorbidity. Univariate analyses showed that episodic OCD had a significantly lower rate of checking rituals and a significantly higher rate of a positive family history for mood disorder. Multivariate stepwise discriminant analysis revealed a positive and significant relationship between episodic course, family history for mood disorders, lifetime comorbidity for panic and bipolar-II disorders, late age at onset and negative correlation with generalized anxiety disorder. These data suggest that the episodic course of OCD has important clinical correlates which are related to cyclic mood disorders. This correlation has implications for treatment and research strategies on the aetiology within a subpopulation of OCD.
PMID: 9840370 [PubMed - indexed for MEDLINE]
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poster:SLS
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