Sensitivity and specificity of the Italian version of the bipolar spectrum diagnostic scale. Different scores in distinct populations with unipolar depression

2017 ◽  
Vol 41 (S1) ◽  
pp. S333-S333
Author(s):  
D. Piacentino ◽  
P. Girardi ◽  
K.G.D. Md ◽  
L. Sanna ◽  
I. Pacchiarotti ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Unipolar Depression ◽  
Type I ◽  
Bipolar Spectrum ◽  
Italian Version ◽  
Major Depressive ◽  
Specificity And Sensitivity ◽  
Competing Interest ◽  
Major Depressive Episodes ◽  
Depressive Episodes

IntroductionTo date, the proposition of recurrence as a subclinical bipolar disorder feature has not received adequate testing.Objectives/AimsWe used the Italian version of the bipolar spectrum diagnostic scale (BSDS), a self-rated questionnaire of bipolar risk, in a sample of patients with mood disorders to test its specificity and sensitivity in identifying cases and discriminating between high risk for bipolar disorder major depressive patients (HRU) and low risk (LRU) adopting as a high recurrence cut-off five or more lifetime major depressive episodes.MethodsWe included 115 patients with DSM-5 bipolar disorder (69 type I, 41 type II, and 5 NOS) and 58 with major depressive disorder (29 HRU and 29 LRU, based on the recurrence criterion). Patients filled-out the Italian version of the BSDS, which is currently undergoing a validation process.ResultsThe BSDS, adopting a threshold of 14, had 84% sensitivity and 76% specificity. HRU, as predicted, scored on the BSDS intermediate between LRU and bipolar disorder. Clinical characteristics of HRU were more similar to bipolar disorder than to LRU; HRU, like bipolar disorder patients, had more lifetime hospitalizations, higher suicidal ideation and attempt numbers, and higher rates of family history of suicide.ConclusionsThe BSDS showed satisfactory sensitivity and sensitivity. Splitting the unipolar sample into HRU and LRU, on the basis of the at least 5 lifetime major depressive episodes criterion, yielded distinct unipolar subpopulations that differ on outcome measures and BSDS scores.Disclosure of interestThe authors have not supplied their declaration of competing interest.

What is the role of conventional antidepressants in the treatment of major depressive episodes with Mixed Features Specifier?

CNS Spectrums ◽  
2016 ◽  
Vol 22 (2) ◽  
pp. 120-125 ◽  
Author(s):  
Gianni L. Faedda ◽  
Ciro Marangoni
Keyword(s):  
Clinical Trials ◽  
Unipolar Depression ◽  
Preliminary Evidence ◽  
Major Depressive ◽  
Pharmacological Management ◽  
Diagnostic And Statistical Manual ◽  
Mixed Features ◽  
Effective Use ◽  
Major Depressive Episodes ◽  
Depressive Episodes

The newly introduced Mixed Features Specifier of Major Depressive Episode and Disorder (MDE/MDD) is especially challenging in terms of pharmacological management. Prior to the publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, the symptoms of the mixed features specifier were intradepressive hypomanic symptoms, always and only associated with bipolar disorder (BD).Intradepressive hypomanic symptoms, mostly referred to as depressive mixed states (DMX), have been poorly characterized, and their treatment offers significant challenges. To understand the diagnostic context of DMX, we trace the nosological changes and collocation of intradepressive hypomanic symptoms, and examine diagnostic and prognostic implications of such mixed features.One of the reasons so little is known about the treatment of DMX is that depressed patients with rapid cycling, substance abuse disorder, and suicidal ideation/attempts are routinely excluded from clinical trials of antidepressants. The exclusion of DMX patients from clinical trials has prevented an assessment of the safety and tolerability of short- and long-term use of antidepressants. Therefore, the generalization of data obtained in clinical trials for unipolar depression to patients with intradepressive hypomanic features is inappropriate and methodologically flawed.A selective review of the literature shows that antidepressants alone have limited efficacy in DMX, but they have the potential to induce, maintain, or worsen mixed features during depressive episodes in BD. On the other hand, preliminary evidence supports the effective use of some atypical antipsychotics in the treatment of DMX.

scholarly journals Aggression Protects Against the Onset of Major Depressive Episodes in Individuals With Bipolar Spectrum Disorder

2017 ◽  
Vol 48 (3) ◽  
pp. 311-321 ◽  
Author(s):  
Tommy H. Ng ◽  
Rachel D. Freed ◽  
Madison K. Titone ◽  
Jonathan P. Stange ◽  
Rachel B. Weiss ◽  
...  
Keyword(s):  
Spectrum Disorder ◽  
Bipolar Spectrum ◽  
Major Depressive ◽  
Bipolar Spectrum Disorder ◽  
Major Depressive Episodes ◽  
Depressive Episodes

scholarly journals A systematic review on neuropsychological function in bipolar disorders type I and II and subthreshold bipolar disorders—something to think about

CNS Spectrums ◽  
2019 ◽  
Vol 24 (1) ◽  
pp. 127-143 ◽  
Author(s):  
Sinead King ◽  
James M Stone ◽  
Anthony Cleare ◽  
Allan H Young
Keyword(s):  
Bipolar Disorder ◽  
Bipolar Disorders ◽  
Cochrane Library ◽  
Type I ◽  
Neuropsychological Dysfunction ◽  
Visual Spatial ◽  
Significant Difference ◽  
Major Depressive Episodes ◽  
Depressive Episodes ◽  
Disorder Type

Neuropsychological dysfunction is a well-established finding in individuals with bipolar disorder type I (BP-I), even during euthymic periods; however, it is less clear whether this also pertains to bipolar disorder type II (BP-II) or those with subthreshold states (SBP; subthreshold bipolar disorder), such as bipolar not otherwise specified (BP-NOS). Herein, we compare the literature regarding neuropsychological performance in BP-II vs BP-I to determine the extent of relative impairment, and we present and review all related studies on cognition in SBP. After systematically searching PubMed, Medline, PsycINFO, and The Cochrane Library, we found 17 papers that comprise all the published studies relevant for this review. The areas that are consistently found to be impaired in BP are executive function, verbal memory, visual spatial working memory, and attention. More studies than not show no significant difference between BP-I and BP-II, particularly in euthymic samples. Preliminary evidence suggests that patients experiencing major depressive episodes who also meet criteria for SBP show similar profiles to BP-II; however, these results pertain only to a depressed sample. SBP were found to perform significantly better than both MDD and healthy controls in a euthymic sample. A consensus on mood state, patient selection, and neuropsychological testing needs to be agreed on for future research. Furthermore, no studies have used the most recent DSM-5 criteria for SBP; future studies should address this. Finally, the underlying bases of cognitive dysfunction in these diagnostic groups need to be further investigated. We suggest recommendations on all of the above current research challenges.

scholarly journals Reduced visual contrast suppression during major depressive episodes

2021 ◽  
Vol 46 (2) ◽  
Author(s):  
Viljami Salmela ◽  
Lumikukka Socada ◽  
John Söderholm ◽  
Roope Heikkilä ◽  
Jari Lahti ◽  
...  
Keyword(s):  
Bayes Factor ◽  
Unipolar Depression ◽  
Cortical Processing ◽  
Major Depressive ◽  
Visual Contrast ◽  
Contrast Information ◽  
Behavioural Tests ◽  
Contrast Perception ◽  
Major Depressive Episodes ◽  
Depressive Episodes

Background: Previous studies have suggested that processing of visual contrast information could be altered in major depressive disorder. To clarify the changes at different levels of the visual hierarchy, we behaviourally measured contrast perception in 2 centre-surround conditions, assessing retinal and cortical processing. Methods: As part of a prospective cohort study, our sample consisted of controls (n = 29; 21 female) and patients with unipolar depression, bipolar disorder and borderline personality disorder who had baseline major depressive episodes (n = 111; 74 female). In a brightness induction test that assessed retinal processing, participants compared the perceived luminance of uniform patches (presented on a computer screen) as the luminance of the backgrounds was varied. In a contrast suppression test that assessed cortical processing, participants compared the perceived contrast of gratings, which were presented with collinearly or orthogonally oriented backgrounds. Results: Brightness induction was similar for patients with major depressive episodes and controls (p = 0.60, d = 0.115, Bayes factor = 3.9), but contrast suppression was significantly lower for patients than for controls (p < 0.006, d = 0.663, Bayes factor = 35.2). We observed no statistically significant associations between contrast suppression and age, sex, or medication or diagnostic subgroup. At follow-up (n = 74), we observed some normalization of contrast perception. Limitations: We assessed contrast perception using behavioural tests instead of electrophysiology. Conclusion: The reduced contrast suppression we observed may have been caused by decreased retinal feedforward or cortical feedback signals. Because we observed intact brightness induction, our results suggest normal retinal but altered cortical processing of visual contrast during a major depressive episode. This alteration is likely to be present in multiple types of depression and to partially normalize upon remission.

From Obsessivity to Bipolarity and Vice Versa. A Literature Review

2016 ◽  
Vol 33 (S1) ◽  
pp. S494-S494
Author(s):  
P. Cano Ruiz ◽  
S. Cañas Fraile ◽  
A. Gómez Peinado ◽  
P. Sanmartin Salinas
Keyword(s):  
Bipolar Disorder ◽  
Depressive Illness ◽  
Bipolar Spectrum ◽  
Manic Depressive Illness ◽  
Bipolar Spectrum Disorders ◽  
Increased Risk ◽  
Spectrum Disorders ◽  
Competing Interest ◽  
Bipolar Patients ◽  
Depressive Episodes

IntroductionThe prevalence of obsessive symptoms in bipolar patients is currently under discussion. Last years, different cases of antidepressant-induced mania and hypomania in patients with OCD have been described.Several authors have reported that patients with OCD and bipolar disorder have more depressive episodes than patients with only OCD.ObjectiveTo know the relationship between OCD and other bipolar spectrum disorders.MethodBibliographical review on comorbidity between obsessive symptoms and bipolarity.ResultsSome longitudinal analysis have shown that patients firstly diagnosed with OCD have an increased risk for subsequent diagnosis of all other conditions, especially for bipolar and schizoaffective disorder, for those whose risk is of up to 13 times higher. The handling of a patient with bipolar disorder and OCD implies some difficulty, because of the main treatment of anxiety disorders, the antidepressants, alters the course of manic-depressive illness, accelerating cycles.ConclusionsOCD is etiologically related to bipolar spectrum disorders and schizophrenia. Therefore, it is necessary to continue the investigation of possible involved genes and approaches for clinical practice.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Do bipolar II and bipolar I disorder have different genotypes and why do we observe unipolar depression converting to bipolar II and then bipolar I?

2016 ◽  
Vol 33 (S1) ◽  
pp. S328-S328
Author(s):  
M. Agius ◽  
M. Fawcett ◽  
R. Zaman
Keyword(s):  
Bipolar Disorder ◽  
Mood Disorder ◽  
Recent Literature ◽  
Bipolar Affective Disorder ◽  
Unipolar Depression ◽  
Bipolar Spectrum ◽  
Clinical Genetic ◽  
Bipolar Ii ◽  
Competing Interest ◽  
Staging Model

We review the recent literature in order to establish the importance of a spectrum for bipolar affective disorder, and that unipolar depression, bipolar II and bipolar I are discrete entities that may however evolve in sequence. We discuss clinical, genetic and neurobiological data which illustrate the differences between bipolar I and bipolar II. To fit the data we suggest a series of multiple mood disorder genotypes, some of which evolve into other conditions on the bipolar spectrum. Thence, we discuss the nature of the bipolar spectrum and demonstrate how this concept can be used as the basis of a staging model for bipolar disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Stability of symptoms across major depressive episodes in bipolar disorder

2009 ◽  
Vol 11 (8) ◽  
pp. 867-875 ◽  
Author(s):  
Roy H Perlis ◽  
Michael J Ostacher ◽  
Rudolf Uher ◽  
Andrew A Nierenberg ◽  
Francesco Casamassima ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive ◽  
Major Depressive Episodes ◽  
Depressive Episodes

scholarly journals Detection of bipolar disorder

2011 ◽  
Vol 199 (1) ◽  
pp. 3-4 ◽  
Author(s):  
Allan H. Young ◽  
Holly MacPherson
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Accurate Diagnosis ◽  
Major Depressive ◽  
History Of ◽  
Major Depressive Episodes ◽  
Depressive Episodes

SummaryMajor depressive episodes are common in bipolar disorder, which consequently may be misdiagnosed as major depressive disorder. Improved detection of bipolar disorder rests upon better ascertainment of a history of hypomania. Antidepressants are of dubious benefit in bipolar disorder and more accurate diagnosis of depression would promote better treatment.

Determining the cut-off for recurrent depressive episode to predict diagnostic conversion from unipolar depression to bipolar disorder: 5-year retrospective study in one university hospital

2016 ◽  
Vol 33 (S1) ◽  
pp. S120-S120
Author(s):  
W.M. Bahk ◽  
Y.S. Woo ◽  
H.R. Wang ◽  
B.H. Yoon ◽  
D.I. Jon ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Depressive Episode ◽  
Predictive Value ◽  
Medical Records ◽  
Characteristic Curve ◽  
Clinical Information ◽  
Unipolar Depression ◽  
University Hospital ◽  
Competing Interest ◽  
Depressive Episodes

ObjectivesThe aim of this study was to determining the cut-off for recurrent depressive episode to predict diagnostic conversion from unipolar depression to bipolar disorder by means of retrospective reviews of medical records.MethodsThe medical records of 250 patients with a diagnosis of major depressive disorder for at least 5 years were retrospectively reviewed for this study. We reviewed DSM-IV diagnosis and detailed clinical information at the index admission with assessments made every year after discharge to determining the cut-off for recurrent depressive episode to predict diagnostic conversion from unipolar depression to bipolar disorder.ResultsReceiver operating characteristic curve analysis indicated cut-off scores for recurrent depressive episode of more than three times (area under curve = 0.647, sensitivity = 0.435, specificity = 0.819, positive predictive value = 0.351, negative predictive value = 0.865).ConclusionsThese findings suggest that it could predict the best diagnostic conversion from unipolar depression to bipolar disorder when depressive episodes are recurrent more than three times. Based on these findings, it will be able to promote the accuracy of diagnosis and the efficiency of treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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