Preditores de conversão diagnóstica do transtorno depressivo maior para transtorno bipolar

Abstract

Background: Subjects previously diagnosed with major depressive disorder (MDD) may present diagnostic conversion to bipolar disorder (BD), and identify risk factors is important. Our objective is to investigate the risk factors associated with diagnostic conversion from MDD) to BD as well as childhood trauma as potential distinguishing factors between MDD and BD. Methods: A prospective cohort study conducted in two phases, in the city of Pelotas, RS, with aged 18 and 60 years old with MDD in the first phase. All participants were re-evaluated three years after. Sociodemographic and clinical data were collected in both phases. Substance abuse was assessed using the Alcohol, Smoking and Substance Involvement Screening Test. The diagnosis of MDD and BD was conducted through the Mini International Neuropsychiatric Interview-Plus. The Childhood Trauma Questionnaire was used to evaluate traumatic events in childhood. Results: 565 subjects with MDD and 127 with BD were evaluated in the first phase of the study. In this phase subjects with BD showed higher medians than those with MDD in the total CTQ score. In the second phase, conversion rate from MDD to BD was 12.4%. Demographic risk factors for a change from MDD to BD included female, younger age, low schooling level and use of illicit substances. Childhood trauma is not considered risk factor for conversion. Limitations: The results of the convenience sampling could not be generalized. Conclusion: Our findings can contribute to the prevention, identification, and prognosis of subjects at risk of diagnostic conversion to BD.