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Individuals with bipolar disorder experience twice the cardiovascular mortality expected from general population estimates. The metabolic syndrome is more common in those with bipolar disorder, with a prevalence ratio of 1.6, and includes many traditional cardiovascular risk factors, which may explain much of the elevated risk. Manic symptom burden also(More)
OBJECTIVE The authors assessed whether subthreshold hypomanic symptoms in patients with major depression predicted new-onset mania or hypomania. METHOD The authors identified 550 individuals followed for at least 1 year in the National Institute of Mental Health Collaborative Depression Study with a diagnosis of major depression at intake. All(More)
Depression causes significant morbidity and mortality, and this also occurs in Huntington Disease (HD), an inherited neurodegenerative illness with motor, cognitive, and psychiatric symptoms. The presentation of depression in this population remains poorly understood, particularly in the prodromal period before development of significant motor symptoms. In(More)
BACKGROUND Several studies have suggested a greater risk of suicide in Huntington disease (HD); however, unique risk factors for suicide in HD are not established. OBJECTIVE We sought to determine risk factors for suicidal behavior, defined as suicide or attempted suicide, in prodromal HD. METHODS From the prospective PREDICT-HD cohort, we identified(More)
IMPORTANCE Although symptoms of irritability or anger are not central to the diagnosis of unipolar major depressive episodes (MDEs), these symptoms have been found, in cross-sectional studies, to be highly prevalent and associated with increased comorbidity and depressive illness burden. OBJECTIVE To determine the prevalence of overtly expressed(More)
BACKGROUND There has been considerable interest in the elevated risk of cardiovascular disease associated with serious mental illness. Although the contemporary literature has paid much attention to major depression and schizophrenia, focus on the risk of cardiovascular mortality for patients with bipolar disorder has been more limited, despite some(More)
OBJECTIVE The 2007 revision of the black box warning for suicidality with antidepressants states that patients of all ages who initiate antidepressants should be monitored for clinical worsening or suicidality. The objective of this study was to examine the association of antidepressants with suicide attempts and with suicide deaths. METHOD A(More)
CONTEXT The phenomenology of bipolar I disorder affects treatment and prognosis. OBJECTIVE To describe the duration of bipolar I mood episodes and factors associated with recovery from these episodes. DESIGN Subjects with Research Diagnostic Criteria bipolar I disorder were prospectively followed up for as long as 25 years. The probability of recovery(More)
OBJECTIVES To compare the risk for cardiovascular mortality between bipolar I and bipolar II subtypes and determine correlates of cardiovascular mortality. Bipolar disorder conveys an increased risk of cardiovascular mortality. METHODS Participants with major affective disorders were recruited for the National Institute of Mental Health Collaborative(More)
BACKGROUND It is well established that the presence of prominent anxiety within depressive episodes portends poorer outcomes. Important questions remain as to which anxiety features are important to outcome and how sustained their prognostic effects are over time. AIMS To examine the relative prognostic importance of specific anxiety features and to(More)