Subsyndromal Depression Is Associated With Functional Impairment in Patients With Bipolar Disorder
J Clin Psychiatry 2002;63(9):807-811
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: The purpose of this study was
to assess whether a relationship exists between
mild depressive symptoms and overall functioning
in subjects with bipolar disorder.
Method: Twenty-five male subjects with
bipolar I disorder (DSM-III-R criteria), who had
not experienced a DSM-III-R episode of mania, hypomania, or major depression for 3 months
as determined using the Structured Clinical Interview for DSM-III-R, were evaluated for degree
of depressive symptoms using the Hamilton Rating Scale for Depression (HAM-D) and for
overall functional status using the Global Assessment
of Functioning (GAF, DSM-IV Axis V).
Results: GAF scores were significantly
negatively correlated with HAM-D scores (r=-0.61, df=23, p=.001), despite the fact that no
patient had a HAM-D score high enough to be considered clinically depressed.
Conclusion: The results of this study
support a relationship between subsyndromal
depressive symptoms and functional impairment in
bipolar subjects, despite their not meeting threshold
criteria for a major depressive episode. These
findings raise the possibility that in some patients
with bipolar disorder subsyndromal depressive symptoms might contribute to ongoing functional