{"doi":"10.1016/j.jad.2024.10.104","title":"Hypomanic symptoms in major depressive disorder: Prognostic impact and treatment issues","abstract":null,"journal":"Journal of Affective Disorders","year":2025,"id":610262,"datarank":0.24141568686511508,"base_score":1.6094379124341003,"endowment":1.6094379124341003,"self_citation_contribution":0.24141568686511508,"citation_network_contribution":0.0,"self_endowment_contribution":0.24141568686511508,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":4,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":615225,"name":"Siegfried Kasper","orcid":"0000-0001-8278-191X","position":1,"is_corresponding":false},{"id":351436,"name":"Joseph Zohar","orcid":"0000-0002-6925-9104","position":2,"is_corresponding":false},{"id":351437,"name":"Daniel Souery","orcid":"0000-0003-3434-5958","position":3,"is_corresponding":false},{"id":98627,"name":"Stuart Montgomery","orcid":"0000-0002-5983-0063","position":4,"is_corresponding":false},{"id":1455167,"name":"Panagiotis Ferentinos","orcid":null,"position":5,"is_corresponding":false},{"id":256441,"name":"Dan Rujescu","orcid":"0000-0002-1432-313X","position":6,"is_corresponding":false},{"id":1546092,"name":"Raffaella Zanardi","orcid":null,"position":7,"is_corresponding":false},{"id":1569000,"name":"Gernot Fugger","orcid":null,"position":8,"is_corresponding":false},{"id":198272,"name":"Raffaele Ferri","orcid":null,"position":9,"is_corresponding":false},{"id":1569002,"name":"Mariangela Tripodi","orcid":null,"position":10,"is_corresponding":false},{"id":5320,"name":"Bernhard T. Baune","orcid":"0000-0001-6548-426X","position":11,"is_corresponding":false},{"id":351433,"name":"Chiara Fabbri","orcid":"0000-0003-0276-7865","position":12,"is_corresponding":false},{"id":351440,"name":"Julien Mendlewicz","orcid":"0000-0002-6131-2732","position":13,"is_corresponding":false},{"id":184617,"name":"Alessandro Serretti","orcid":null,"position":14,"is_corresponding":false},{"id":752776,"name":"Paolo Olgiati","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Hypomanic symptoms in major depressive disorder: Prognostic impact and treatment issues","abstract":"<h4>Background</h4>Mixed depression (MXD), defined as (hypo)manic symptoms occurring within major depressive episodes, is common in both bipolar and unipolar disorders, but its prognostic and treatment implications remain unclear. This study aimed to examine the relationship between hypomanic symptoms, treatment response and remission of suicidal thoughts.<h4>Methods</h4>We analyzed 1243 adults with major depressive disorder (MDD), recruited for a naturalistic study on treatment-resistant depression. Data were gathered cross-sectionally and retrospectively through structured interviews and clinical rating scales including the Young Mania Rating Scale (YMRS) and Montgomery-Asberg Depression Rating Scale (MADRS); statistical analyses were performed using univariate and multivariate methods.<h4>Results</h4>Hypomanic symptoms were present in 651 patients (45 %), while 307 patients (25 %) responded to treatment. Both treatment responders (p < 0.0001) and those who achieved remission from suicide ideation (p = 0.0085) showed lower hypomanic (YMRS) scores. Multivariate analysis showed that hypomanic symptoms were negatively linked to treatment response (O.R. 0.71-0.87), while bipolar spectrum markers such as age at illness onset (O.R. 1.00-1.03) and MDD recurrence (O.R. 0.47-0.89) predicted remission from suicidal thoughts. Medications commonly used to treat bipolar disorder showed some benefits, with dopamine/serotonin antagonists improving suicide ideation (p < 0.0001) and mood stabilizers being associated with reduced hypomanic symptoms (p = 0.0003).<h4>Limitations</h4>The study lacked prospective clinical assessments and treatment randomization.<h4>Conclusion</h4>Hypomanic symptoms are common in unipolar depression; their assessment is essential to identify challenging-to-treat cases and select the best pharmacological options.","is_dataset_classified":null,"base_score":1.6094379124341003,"endowment":1.6094379124341003,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"39447979","pmcid":null,"openalex_id":"https://openalex.org/W4403633275","authors":[],"funders":[],"total_grants":0,"fwci":1.1366,"citation_percentile":0.79169465,"influential_citations":0,"citation_trend":[{"year":2024,"count":1},{"year":2025,"count":1},{"year":2026,"count":2}],"oa_status":"green","license":"cc-by-nc-nd","oa_locations":[{"url":"https://www.sciencedirect.com/science/article/pii/S0165032724018019/pdf","host_type":"repository"},{"url":"https://www.sciencedirect.com/science/article/pii/S0165032724018019/pdf","host_type":"repository"},{"url":"https://api.elsevier.com/content/article/PII:S0165032724018019?httpAccept=text/xml","host_type":"publisher"},{"url":"https://api.elsevier.com/content/article/PII:S0165032724018019?httpAccept=text/plain","host_type":"publisher"},{"url":"https://doi.org/10.1016/j.jad.2024.10.104","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/39447979","host_type":"repository"},{"url":"https://hdl.handle.net/11389/81140","host_type":"repository"}],"fields_of_study":["Bipolar Disorder and Treatment","Electroconvulsive Therapy Studies","Tryptophan and brain disorders"],"mesh_terms":["Mania","Adult","Antidepressive Agents","Bipolar Disorder","Cross-Sectional Studies","Major Depressive Disorder","Depressive Disorder, Major","Female","Humans","Male","Middle Aged","Prognosis","Psychiatric Status Rating Scales","Retrospective Studies","Treatment Outcome","Suicidal Ideation","Depressive Disorder, Treatment-Resistant"],"keywords":["Major depressive disorder","Psychiatry","Depressive symptoms","Bipolar disorder","Psychology","Clinical psychology","Medicine","Mood","Anxiety","Unipolar Depression","Treatment-resistant Depression","Mood Stabilizers","Antidepressant Response","Hypomanic Symptoms"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-07-31T20:56:25.208892Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}