C.08.03 Major depressive disorder (MOD) and bipolar depression: different diagnoses, same treatment?

Cariprazine is a new therapeutic agent recently approved for the treatment of both schizophrenia and manic or mixed episodes associated with bipolar disorder, and is under investigation for the treatment of both bipolar depression and major depressive disorder.

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Ketamine for the treatment of major depressive disorder and bipolar depression: A review of the literature

Mental Health Clinician ◽

10.9740/mhc.2017.01.016 ◽

2017 ◽

Vol 7 (1) ◽

pp. 16-23 ◽

Cited By ~ 19

Author(s):

Sarah E. Grady ◽

Travis A. Marsh ◽

Allison Tenhouse ◽

Kelsey Klein

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Bipolar Depression ◽

Treatment Resistant Depression ◽

Treatment Resistant ◽

Major Depressive ◽

Randomized Controlled ◽

The Past ◽

Aspartate Receptor ◽

Resistant Depression

Abstract Introduction: Over the past decade, ketamine has been studied for major depressive disorder and bipolar depression. Ketamine is believed to exert its antidepressant properties through N-methyl-D-aspartate receptor antagonism. Methods: Study authors completed a literature review of seven randomized controlled trials of ketamine usage in major depressive disorder and bipolar depression. Results: Ketamine demonstrated a statistically significant improvement over placebo or midazolam in major depressive disorder. Ketamine also exhibited a statistically significant improvement over placebo in bipolar depression. Discussion: Ketamine has shown promise in quickly reducing symptoms in patients with treatment resistant depression and bipolar depression. Using ketamine may be helpful for patients that have exhausted other therapeutic options.

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Clinical differences between bipolar and unipolar depression

The British Journal of Psychiatry ◽

10.1192/bjp.bp.107.045294 ◽

2008 ◽

Vol 192 (5) ◽

pp. 388-389 ◽

Cited By ~ 78

Author(s):

Liz Forty ◽

Daniel Smith ◽

Lisa Jones ◽

Ian Jones ◽

Sian Caesar ◽

...

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Clinical Course ◽

Bipolar Depression ◽

Unipolar Depression ◽

Major Depressive ◽

Symptom Profiles ◽

Clinical Presentations ◽

Course Variables ◽

Depressive Episodes

SummaryIt is commonly – but wrongly – assumed that there are no important differences between the clinical presentations of major depressive disorder and bipolar depression. Here we compare clinical course variables and depressive symptom profiles in a large sample of individuals with major depressive disorder (n=593) and bipolar disorder (n=443). Clinical characteristics associated with a bipolar course included the presence of psychosis, diurnal mood variation and hypersomnia during depressive episodes, and a greater number of shorter depressive episodes. Such features should alert a clinician to a possible bipolar course. This is important because optimal management is not the same for bipolar and unipolar depression.

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Identification of plasma biomarkers for distinguishing bipolar depression from major depressive disorder by iTRAQ-coupled LC–MS/MS and bioinformatics analysis

Psychoneuroendocrinology ◽

10.1016/j.psyneuen.2017.09.005 ◽

2017 ◽

Vol 86 ◽

pp. 17-24 ◽

Cited By ~ 21

Author(s):

Juanjuan Ren ◽

Guoqing Zhao ◽

Xiujia Sun ◽

Hongmei Liu ◽

Ping Jiang ◽

...

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Bioinformatics Analysis ◽

Bipolar Depression ◽

Major Depressive ◽

Plasma Biomarkers

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Place of electroconvulsive therapy in the treatment of depression in France: A comparative study between clinical practice and international recommendations

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1446 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S767-S768

Author(s):

T. Charpeaud ◽

A. Tremey ◽

P. Courtet ◽

B. Aouizerate ◽

P.M. Llorca

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Electroconvulsive Therapy ◽

Bipolar Depression ◽

Psychotic Symptoms ◽

Diagnosis Delay ◽

Recurrent Depression ◽

University Hospitals ◽

Major Depressive ◽

Competing Interest

ObjectivesTo study the place of electroconvulsive therapy (ECT) in the treatment of major depressive disorder in France and compare it with international recommendations and algorithms.MethodMulticenter, retrospective study in 12 French university hospitals. Diagnosis, delay between the onset of the episode and the first day of ECT, previous treatments have been identified. Only patients treated for major depressive disorder between 1 January 2009 and 1 January 2014 were included.ResultsA total of 754 patients were included (middle age 61.07 years, sex ratio 0.53). The diagnoses listed were: first major depressive episode (14.95%), bipolar depression (38.85%) and unipolar recurrent depression (46.19%). The delay before ECT, was 11.01 months (13,98), and was significantly longer for first episodes (16.45 months, P < 0.001) and shorter in case of psychotic symptoms (8.76 months, P < 0.03) and catatonic symptoms (6.70, P < 0.01).ConclusionsThe delay before ECT appears on average, four times longer than recommended by treatment algorithms for the management of major depressive disorder. This long delay could be explained by a very heterogeneous access to this treatment in French territory.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Discriminating bipolar depression from major depressive disorder with polygenic risk scores

Psychological Medicine ◽

10.1017/s003329172000015x ◽

2020 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

David T. Liebers ◽

Mehdi Pirooznia ◽

Andrea Ganna ◽

Fernando S. Goes ◽

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Clinical Features ◽

Clinical Symptoms ◽

Bipolar Depression ◽

Risk Scores ◽

Characteristic Analysis ◽

Major Depressive ◽

Polygenic Risk ◽

Increased Risk

Abstract Background Although accurate differentiation between bipolar disorder (BD) and unipolar major depressive disorder (MDD) has important prognostic and therapeutic implications, the distinction is often challenging based on clinical grounds alone. In this study, we tested whether psychiatric polygenic risk scores (PRSs) improve clinically based classification models of BD v. MDD diagnosis. Methods Our sample included 843 BD and 930 MDD subjects similarly genotyped and phenotyped using the same standardized interview. We performed multivariate modeling and receiver operating characteristic analysis, testing the incremental effect of PRSs on a baseline model with clinical symptoms and features known to associate with BD compared with MDD status. Results We found a strong association between a BD diagnosis and PRSs drawn from BD (R2 = 3.5%, p = 4.94 × 10−12) and schizophrenia (R2 = 3.2%, p = 5.71 × 10−11) genome-wide association meta-analyses. Individuals with top decile BD PRS had a significantly increased risk for BD v. MDD compared with those in the lowest decile (odds ratio 3.39, confidence interval 2.19–5.25). PRSs discriminated BD v. MDD to a degree comparable with many individual symptoms and clinical features previously shown to associate with BD. When compared with the full composite model with all symptoms and clinical features PRSs provided modestly improved discriminatory ability (ΔC = 0.011, p = 6.48 × 10−4). Conclusions Our study demonstrates that psychiatric PRSs provide modest independent discrimination between BD and MDD cases, suggesting that PRSs could ultimately have utility in subjects at the extremes of the distribution and/or subjects for whom clinical symptoms are poorly measured or yet to manifest.

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