scholarly journals Clinical differences between bipolar and unipolar depression

2008 ◽  
Vol 192 (5) ◽  
pp. 388-389 ◽  
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.

May duration of untreated illness influence the long-term course of major depressive disorder?

2008 ◽  
Vol 23 (2) ◽  
pp. 92-96 ◽  
Author(s):  
A. Carlo Altamura ◽  
Bernardo Dell'Osso ◽  
Serena Vismara ◽  
Emanuela Mundo
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Antidepressant Treatment ◽  
Age At Onset ◽  
Major Depressive ◽  
Chi Square ◽  
Duration Of Untreated Illness ◽  
Course Variables ◽  
Depressive Episodes

AbstractThe aim of this naturalistic study was to investigate the possible influence of the duration of untreated illness (DUI) on the long-term course of Major Depressive Disorder (MDD). One hundred and thirteen patients with recurrent MDD, according to DSM-IV-TR criteria, followed up for 5 years, were selected, interviewed and their clinical charts were reviewed. The DUI was defined as the interval between the onset of the first depressive episode and the first adequate antidepressant treatment. The sample was divided into two groups according to the DUI: one group with a DUI ≤ 12 months (n = 75), and the other with a DUI > 12 months (n = 38). The main demographic and clinical course variables were compared between the two groups using Student's t-tests or chi-square tests. Patients with a longer DUI showed an earlier age at onset (t = 2.82, p = 0.006) and a longer duration of illness (t = 3.20, p = 0.002) compared to patients with a shorter DUI. In addition, the total number of depressive episodes occurring before the first antidepressant treatment was higher in the group with a longer DUI (t = −2.223, p < 0.03). Even though limited by the retrospective nature of the study, these preliminary findings would suggest that a longer DUI may negatively influence the course of MDD. Larger prospective studies are warranted to further investigate the role of the DUI within MDD.

scholarly journals Comparison of depressive episodes in bipolar disorder and in major depressive disorder within bipolar disorder pedigrees

2011 ◽  
Vol 199 (4) ◽  
pp. 303-309 ◽  
Author(s):  
Philip B. Mitchell ◽  
Andrew Frankland ◽  
Dusan Hadzi-Pavlovic ◽  
Gloria Roberts ◽  
Justine Corry ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Clinical Features ◽  
Bipolar Depression ◽  
Bipolar Affective Disorder ◽  
Probabilistic Approach ◽  
Psychomotor Retardation ◽  
Major Depressive ◽  
Depressive Episodes

BackgroundAlthough genetic epidemiological studies have confirmed increased rates of major depressive disorder among the relatives of people with bipolar affective disorder, no report has compared the clinical characteristics of depression between these two groups.AimsTo compare clinical features of depressive episodes across participants with major depressive disorder and bipolar disorder from within bipolar disorder pedigrees, and assess the utility of a recently proposed probabilistic approach to distinguishing bipolar from unipolar depression. A secondary aim was to identify subgroups within the relatives with major depression potentially indicative of ‘genetic’ and ‘sporadic’ subgroups.MethodPatients with bipolar disorder types 1 and 2 (n = 246) and patients with major depressive disorder from bipolar pedigrees (n = 120) were assessed using the Diagnostic Interview for Genetic Studies. Logistic regression was used to identify distinguishing clinical features and assess the utility of the probabilistic approach. Hierarchical cluster analysis was used to identify subgroups within the major depressive disorder sample.ResultsBipolar depression was characterised by significantly higher rates of psychomotor retardation, difficulty thinking, early morning awakening, morning worsening and psychotic features. Depending on the threshold employed, the probabilistic approach yielded a positive predictive value ranging from 74% to 82%. Two clusters within the major depressive disorder sample were found, one of which demonstrated features characteristic of bipolar depression, suggesting a possible ‘genetic’ subgroup.ConclusionsA number of previously identified clinical differences between unipolar and bipolar depression were confirmed among participants from within bipolar disorder pedigrees. Preliminary validation of the probabilistic approach in differentiating between unipolar and bipolar depression is consistent with dimensional distinctions between the two disorders and offers clinical utility in identifying patients who may warrant further assessment for bipolarity. The major depressive disorder clusters potentially reflect genetic and sporadic subgroups which, if replicated independently, might enable an improved phenotypic definition of underlying bipolarity in genetic analyses.

scholarly journals Individuals with bipolar disorder have a higher level of peripheral uric acid than major depressive disorder: a case-control study

2021 ◽  
Author(s):  
Zhe Lu ◽  
Yingtan Wang ◽  
Guanglei Xun
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Case Control Study ◽  
Bipolar Depression ◽  
Unipolar Depression ◽  
Acute Stage ◽  
Major Depressive ◽  
Drug Free ◽  
Control Study

Abstract Background: At present, no well-established biomarkers were ever found to distinguish unipolar depression (UD) and bipolar disorder (BD). This study aimed to provide a clearer comparison of UA levels between BD and major depressive disorder. Methods: Peripheral UA of 119 patients with BD in acute stage (AS) and 77 in remission stage (RS), and 95 patients with UD in AS and 61 in RS were measured, so were 180 healthy controls. Results: UA levels in BD group were higher than UD and HC groups regardless of the AS or RS, while differences in UA levels between UD group and HC group were not significant. Differences in UA levels of BD-M (bipolar mania/hypomania) were higher than BD-D (bipolar depression) subgroups, and UA levels of BD-M and BD-D subgroups were higher than UD and HC groups. The comparison of number of participants with hyperuricemia among groups confirmed the above results. There were no significant differences in UA levels of between drug-use and drug-free/naïve subgroups. Conclusion: The study suggests patients with BD had a higher level of UA than UD, especially in mania episode.

Cognitive characteristics of unipolar (major depressive disorder) and bipolar depression

2016 ◽  
Vol 33 (S1) ◽  
pp. S374-S374 ◽  
Author(s):  
B. Suciu ◽  
R. Paunescu ◽  
I. Miclutia
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Cognitive Deficits ◽  
Bipolar Depression ◽  
Cognitive Domain ◽  
Global Functioning ◽  
Major Depressive ◽  
Cognitive Domains ◽  
Depressive Episodes

IntroductionImpairment in cognitive performance is an important characteristic in many psychiatric illnesses, such as Bipolar Disorder and Major Depressive Disorder. Initially, cognitive dysfunctions were considered to be present only in acute depressive episodes and to improve after symptoms recovered. Reports have described persistent cognitive deficits even after significant improvement of depressive symptoms.Aims/ObjectivesWe wanted to understand the dimension of cognitive impairment in unipolar and bipolar depression and also to underline the differences between cognitive profiles of patients diagnosed within the two mentioned disorders.MethodThis review examined recent literature about unipolar and bipolar depression.ResultsBoth depressed patients presented cognitive deficits in several cognitive domains. Different aspects of attention were altered in both patients but impairment in shifting attention appeared specific to unipolar disorder while impaired sustained attention was particular for bipolar disorder. Both types of patients showed memory deficits that were associated with poor global functioning. Two recent studies described that bipolar depressed subjects were more impaired across all cognitive domains than unipolar depressed subjects on tests assessing verbal memory, verbal fluency, attention and executive functions. The most consistently deficits were displayed on measures of executive functioning – such as tasks requiring problem solving, planning, decision making – suggesting that this cognitive domain is a trait-marker for depression.ConclusionsCognitive deficits are present in both disorders during a depressive episode but they display slightly different patterns of impairment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Individuals with bipolar disorder have a higher level of uric acid than major depressive disorder: a case–control study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Zhe Lu ◽  
Yingtan Wang ◽  
Guanglei Xun
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Bipolar Depression ◽  
Unipolar Depression ◽  
Acute Stage ◽  
Major Depressive ◽  
Potential Biomarker ◽  
Drug Free ◽  
Control Study

AbstractAt present, no well-established biomarkers were ever found to distinguish unipolar depression and bipolar disorder (BD). This study aimed to provide a clearer comparison of UA levels between BD and major depressive disorder. Peripheral UA of 119 patients with BD in acute stage (AS) and 77 in remission stage (RS), and 95 patients with UD in AS and 61 in RS were measured, so were 180 healthy controls. UA levels in BD group were higher than UD and HC groups regardless of the AS or RS, while differences in UA levels between UD group and HC group were not significant. Differences in UA levels of BD-M (bipolar mania/hypomania) were higher than BD-D (bipolar depression) subgroups, and UA levels of BD-M and BD-D subgroups were higher than UD and HC groups. The comparison of number of participants with hyperuricemia among groups confirmed the above results. There were no significant differences in UA levels of between drug-use and drug-free/naïve subgroups. UA could distinguish BD and UD significantly both in acute and remission stage. The study suggests patients with BD had a higher level of UA than UD, especially in mania episode. UA may be a potential biomarker to distinguish BD from UD.

scholarly journals A Comparative Study of Depressive Episode in Major Depressive Disorder and Bipolar Disorder

2016 ◽  
pp. 1-7
Author(s):  
Arijit Mondal ◽  
Sumit Mukherjee ◽  
Sayanti Ghosh ◽  
Divya Gopal Mukherjee
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Family History ◽  
Depressive Disorder ◽  
Depressive Episode ◽  
Bipolar Depression ◽  
Unipolar Depression ◽  
Major Depressive ◽  
Demographic Profile ◽  
Suicidal Ideas

Distinguishing between major depressive disorder (MDD) and bipolar disorder is important because there are differences in the optimal management of these conditions. Antidepressant treatment of bipolar depression (BPD) can adversely affect long-term prognosis by causingdestabilisation of mood and more frequent depressive episodes, and can lead to the development of treatment resistance. Most people with bipolar disorder experience depression rather than mania as their first episode of illness. It is clinically desirable to recognise, or at least to suspect,bipolar depression at an early stage of a bipolar illness.  OBJECTIVE : Comparison of depressive episode in major depressive disorder and bipolar affective disorder in a tertiary care general hospital, psychiatry unit.  METHOD : 80 cases of unipolar depression and 54 cases of bipolar depression were compared on the basis of socio-demographic profile, family history of mood disorder and clinical features using Semi structured questionnaire for socio-demographic profile and validated Bengaliversion of Beck Depression Inventory (BDI).  RESULTS : Bipolar depression is characterized by early age of onset, more number of previous episodes, positive family history, more severe in nature associated with prominent features of guilt feeling, self dislike, self accusation, suicidal ideas, irritability, social withdrawal, fatigability and loss of libido. Major depressive disorder shows female preponderance, more number of stressful life events before episodes. Body image change, insomnia, anorexia, weight loss, somatic pre-occupation are more in unipolar depression.

scholarly journals Validity and reliability of the Structured Clinical Interview for Mood Spectrum: Brazilian version (SCIMOODS-VB)

2011 ◽  
Vol 33 (1) ◽  
pp. 64-67 ◽  
Author(s):  
Roberto Ratzke ◽  
Doris Hupfeld Moreno ◽  
Clarice Gorenstein ◽  
Ricardo Alberto Moreno
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Intraclass Correlation ◽  
Unipolar Depression ◽  
Brazilian Portuguese ◽  
Clinical Interview ◽  
Stepwise Discriminant Analysis ◽  
Cutoff Score ◽  
Major Depressive

OBJECTIVE: The aim of this study was to translate the Structured Clinical Interview for Mood Spectrum into Brazilian Portuguese, measuring its reliability, validity, and defining scores for bipolar disorders. METHOD: Questionnaire was translated (into Brazilian Portuguese) and back-translated into English. Sample consisted of 47 subjects with bipolar disorder, 47 with major depressive disorder, 18 with schizophrenia and 22 controls. Inter-rater reliability was tested in 20 subjects with bipolar disorder and MDD. Internal consistency was measured using the Kuder Richardson formula. Forward stepwise discriminant analysis was performed. Scores were compared between groups; manic (M), depressive (D) and total (T) threshold scores were calculated through receiver operating characteristic (ROC) curves. RESULTS: Kuder Richardson coefficients were between 0.86 and 0.94. Intraclass correlation coefficient was 0.96 (CI 95 % 0.93-0.97). Subjects with bipolar disorder had higher M and T, and similar D scores, when compared to major depressive disorder (ANOVA, p < 0.001). The sub-domains that best discriminated unipolar and bipolar subjects were manic energy and manic mood. M had the best area under the curve (0.909), and values of M equal to or greater than 30 yielded 91.5% sensitivity and 74.5% specificity. CONCLUSION: Structured Clinical Interview for Mood Spectrum has good reliability and validity. Cut-off of 30 best differentiates subjects with bipolar disorder vs. unipolar depression. A cutoff score of 30 or higher in the mania sub-domain is appropriate to help make a distinction between subjects with bipolar disorder and those with unipolar depression.

scholarly journals Psychotherapy for subclinical depression: meta-analysis

2014 ◽  
Vol 205 (4) ◽  
pp. 268-274 ◽  
Author(s):  
Pim Cuijpers ◽  
Sander L. Koole ◽  
Annemiek van Dijke ◽  
Miquel Roca ◽  
Juan Li ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Major Depression ◽  
Depressive Disorder ◽  
Psychological Treatment ◽  
Meta Analysis ◽  
Major Depressive ◽  
Major Depressive Episodes ◽  
Depressive Episodes ◽  
Subclinical Depression

BackgroundThere is controversy about whether psychotherapies are effective in the treatment of subclinical depression, defined by clinically relevant depressive symptoms in the absence of a major depressive disorder.AimsTo examine whether psychotherapies are effective in reducing depressive symptoms, reduce the risk of developing major depressive disorder and have comparable effects to psychological treatment of major depression.MethodWe conducted a meta-analysis of 18 studies comparing a psychological treatment of subclinical depression with a control group.ResultsThe target groups, therapies and characteristics of the included studies differed considerably from each other, and the quality of many studies was not optimal. Psychotherapies did have a small to moderate effect on depressive symptoms against care as usual at the post-test assessment (g = 0.35, 95% CI 0.23–0.47; NNT = 5, 95% CI 4–8) and significantly reduced the incidence of major depressive episodes at 6 months (RR = 0.61) and possibly at 12 months (RR = 0.74). The effects were significantly smaller than those of psychotherapy for major depressive disorder and could be accounted for by non-specific effects of treatment.ConclusionsPsychotherapy may be effective in the treatment of subclinical depression and reduce the incidence of major depression, but more high-quality research is needed.

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