P.1.097 Pindolol augmentation of paroxetine in depressive patients: Sub-group analyses show benefits for bipolar and first-episode patients

Abstract

To estimate the conversion rate from unipolar depression (ICD10 codes F32–F33) to bipolar disorder (BP) (ICD10 codes F31) in an English national cohort. It was hypothesised that early-onset BP (age <18 years) is a more severe form of the disorder, with a more rapid, and higher rate of conversion from depression to BP.This record linkage study used English national Hospital Episode Statistics (HES) covering all NHS inpatient and day case admissions between 1999 and 2011.The overall rate of conversion from depression to BP for all ages was 5.65% (95% CI: 5.48–5.83) over a minimum 4-year follow-up period. The conversion rate from depression to BP increased in a linear manner with age from 10–14 years – 2.21% (95% C: 1.16–4.22) to 30–34 years – 7.06% (95% CI: 6.44–7.55) (F1,23=77.6, p=0.001, R2=0.77). The time to conversion was constant across the age range. The rate of conversion was higher in females (6.77%; 95% CI: 6.53–7.02) compared to males, (4.17%; 95% CI: 3.95–4.40) (χ2=194, p<0.0001), and in those with psychotic depression 8.12% (95% CI: 7.65–8.62) compared to non-psychotic depression 5.65% (95% CI: 5.48–5.83) (χ2=97.0, p<0.0001).The study was limited to hospital discharges and diagnoses were not standardised.Increasing conversion rate from depression to bipolar disorder with age, and constant time for conversion across the age range does not support the notion that early-onset BP is a more severe form of the disorder.