Athanasios Koukopoulos

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OBJECTIVE The risk-benefit profile of antidepressant medications in bipolar disorder is controversial. When conclusive evidence is lacking, expert consensus can guide treatment decisions. The International Society for Bipolar Disorders (ISBD) convened a task force to seek consensus recommendations on the use of antidepressants in bipolar disorders. METHOD(More)
The DSM system has never acknowledged a central position for mixed states; thus, mixed depressions have been almost completely neglected for decades. Now, DSM-5 is proposing diagnostic criteria for depression with mixed features that will lead to more misdiagnosis and inadequate treatment of this syndrome. Different criteria, based on empirically stronger(More)
OBJECTIVE The authors compared the efficacy of olanzapine and lithium in the prevention of mood episode relapse/recurrence. METHOD Patients with a diagnosis of bipolar disorder (manic/mixed), a history of two or more manic or mixed episodes within 6 years, and a Young Mania Rating Scale total score > or =20 entered the study and received open-label(More)
AIMS The aim of this study was to identify predictors of completed suicide in a wide sample of psychiatric inpatients receiving retrospective and prospective DSM-IV diagnoses. METHODS We followed up 4441 severe psychiatric patients who were hospitalized for some time during a 35-year period in a private hospital setting. We collected sociodemographic,(More)
BACKGROUND Gender is known to modulate the clinical course and severity of bipolar disorder (BD). Although cognitive abnormalities are an established feature of BD, there is limited information regarding whether gender also influences the pattern and severity of cognitive impairment. METHOD We evaluated the performance of 86 remitted patients with BD,(More)
OBJECTIVE The nature of mixed mood episodes is still a matter of controversy amongst experts. Currently, the approach to this syndrome is mainly categorical and very restrictive. The factor-structure of bipolar mood episodes has not been studied yet. We performed a dimensional analysis of the structure of bipolar episodes aimed at identifying a factor(More)
BACKGROUND Bipolar disorder (BD) is associated with brain structural and cognitive abnormalities. There is a paucity of evidence regarding the evolution of these deficits over time. This study examined the relationship between age and brain morphology and cognition in patients with BD type I. METHODS Brain structural magnetic resonance imaging data were(More)
BACKGROUND Sub-syndromal symptoms in bipolar disorder impair functioning and diminish quality of life. AIMS To examine factors associated with time spent with sub-syndromal symptoms and to characterise how these symptoms influence outcomes. METHOD In a double-blind randomised maintenance trial, patients received either olanzapine or lithium monotherapy(More)
This paper focuses on the clinical importance of affective mixed states with special attention given to agitated depression, which has lost its status as a mixed state in the DSM and ICD systems. Following a historical review of the topic, the psychopathological elements are examined. Psychic and motor agitation are considered equally important for the(More)