Dimensions of Delusions in Major Depression: Socio-demographic and Clinical Correlates in an Unipolar-Bipolar Sample
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Objective: The present study aims at exploring associations between a continuous measure of distorted thought contents and a set of demographic and clinical features in a sample of unipolar/bipolar depressed patients. Methods: Our sample included 1,833 depressed subjects. Severity of mood symptoms was assessed by the 21 items Hamilton Depression Rating Scale (HAM-D). The continuous outcome measure was represented by a delusion (DEL) factor, extracted from HAM-D items and including items: 2 (“Feelings of guilt”), 15 (“Hypochondriasis”), and 20 (“Paranoid symptoms”). Each socio-demographic and clinical variable was tested by a generalized linear model test, having depressive severity (HAM-D score−DEL score) as the covariate. Results: A family history of major depressive disorder (MDD; p=0.0006), a diagnosis of bipolar disorder, type I ( p=0.0003), a comorbid general anxiety disorder (p＜0.0001), and a higher number of manic episodes during lifetime (p＜0.0001), were all associated to higher DEL scores. Conversely, an older age at onset (p＜0.0001) and a longer duration of hospitalization for depression over lifetime (p=0.0003) had a negative impact over DEL scores. On secondary analyses, only the presence of psychotic features (p＜0.0001) and depressive severity (p＜0.0001) were found to be independently associated to higher DEL scores. Conclusion: The retrospective design and a non validated continuous measure for distorted thought contents were the main limitations of our study. Excluding the presence of psychotic features and depressive severity, no socio-demographic or clinical variable was found to be associated to our continuous measure of distorted thinking in depression.
Abstract
Objective: The present study aims at exploring associations between a continuous measure of distorted thought contents and a set of demographic and clinical features in a sample of unipolar/bipolar depressed patients. Methods: Our sample included 1,833 depressed subjects. Severity of mood symptoms was assessed by the 21 items Hamilton Depression Rating Scale (HAM-D). The continuous outcome measure was represented by a delusion (DEL) factor, extracted from HAM-D items and including items: 2 (“Feelings of guilt”), 15 (“Hypochondriasis”), and 20 (“Paranoid symptoms”). Each socio-demographic and clinical variable was tested by a generalized linear model test, having depressive severity (HAM-D score−DEL score) as the covariate. Results: A family history of major depressive disorder (MDD; p=0.0006), a diagnosis of bipolar disorder, type I ( p=0.0003), a comorbid general anxiety disorder (p＜0.0001), and a higher number of manic episodes during lifetime (p＜0.0001), were all associated to higher DEL scores. Conversely, an older age at onset (p＜0.0001) and a longer duration of hospitalization for depression over lifetime (p=0.0003) had a negative impact over DEL scores. On secondary analyses, only the presence of psychotic features (p＜0.0001) and depressive severity (p＜0.0001) were found to be independently associated to higher DEL scores. Conclusion: The retrospective design and a non validated continuous measure for distorted thought contents were the main limitations of our study. Excluding the presence of psychotic features and depressive severity, no socio-demographic or clinical variable was found to be associated to our continuous measure of distorted thinking in depression.
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