scholarly journals Unrecognised bipolar disorder in primary care patients with depression

2011 ◽  
Vol 199 (1) ◽  
pp. 49-56 ◽  
Author(s):  
Daniel J. Smith ◽  
Emily Griffiths ◽  
Mark Kelly ◽  
Kerry Hood ◽  
Nick Craddock ◽  
...  
Keyword(s):  
Primary Care ◽  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Psychosocial Functioning ◽  
Unipolar Depression ◽  
Major Depressive ◽  
Manic Symptoms ◽  
History Of ◽  
Primary Care Patients

BackgroundBipolar disorder is complex and can be difficult to diagnose. It is often misdiagnosed as recurrent major depressive disorder.AimsWe had three main aims. To estimate the proportion of primary care patients with a working diagnosis of unipolar depression who satisfy DSM–IV criteria for bipolar disorder. To test two screening instruments for bipolar disorder (the Hypomania Checklist (HCL–32) and Bipolar Spectrum Diagnostic Scale (BSDS)) within a primary care sample. To assess whether individuals with major depressive disorder with subthreshold manic symptoms differ from those individuals with major depressive disorder but with no or little history of manic symptoms in terms of clinical course, psychosocial functioning and quality of life.MethodTwo-phase screening study in primary care.ResultsThree estimates of the prevalence of undiagnosed bipolar disorder were obtained: 21.6%, 9.6% and 3.3%. The HCL–32 and BSDS questionnaires had quite low positive predictive values (50.0 and 30.1% respectively). Participants with major depressive disorder and with a history of subthreshold manic symptoms differed from those participants with no or little history of manic symptoms on several clinical features and on measures of both psychosocial functioning and quality of life.ConclusionsBetween 3.3 and 21.6% of primary care patients with unipolar depression may have an undiagnosed bipolar disorder. The HCL–32 and BSDS screening questionnaires may be more useful for detecting broader definitions of bipolar disorder than DSM–IV-defined bipolar disorder. Subdiagnostic features of bipolar disorder are relatively common in primary care patients with unipolar depression and are associated with a more morbid course of illness. Future classifications of recurrent depression should include dimensional measures of bipolar symptoms.

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 Disruptive mood dysregulation disorder in offspring of parents with depression and bipolar disorder

2017 ◽  
Vol 210 (6) ◽  
pp. 408-412 ◽  
Author(s):  
Lukas Propper ◽  
Jill Cumby ◽  
Victoria C. Patterson ◽  
Vladislav Drobinin ◽  
Jacqueline M. Glover ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Family History ◽  
Depressive Disorder ◽  
Control Group ◽  
Major Depressive ◽  
Disruptive Mood Dysregulation Disorder ◽  
Increased Risk ◽  
History Of ◽  
Mood Dysregulation

BackgroundIt has been suggested that offspring of parents with bipolar disorder are at increased risk for disruptive mood dysregulation disorder (DMDD), but the specificity of this association has not been established.AimsWe examined the specificity of DMDD to family history by comparing offspring of parents with (a) bipolar disorder, (b) major depressive disorder and (c) a control group with no mood disorders.MethodWe established lifetime diagnosis of DMDD using the Schedule for Affective Disorders and Schizophrenia for School Aged Children for DSM-5 in 180 youth aged 6–18 years, including 58 offspring of parents with bipolar disorder, 82 offspring of parents with major depressive disorder and 40 control offspring.ResultsDiagnostic criteria for DMDD were met in none of the offspring of parents with bipolar disorder, 6 of the offspring of parents with major depressive disorder and none of the control offspring. DMDD diagnosis was significantly associated with family history of major depressive disorder.ConclusionsOur results suggest that DMDD is not specifically associated with a family history of bipolar disorder and may be associated with parental depression.

DATA-DRIVEN COURSE TRAJECTORIES IN PRIMARY CARE PATIENTS WITH MAJOR DEPRESSIVE DISORDER

2014 ◽  
Vol 31 (9) ◽  
pp. 778-786 ◽  
Author(s):  
Klaas J. Wardenaar ◽  
Henk-Jan Conradi ◽  
Peter de Jonge
Keyword(s):  
Primary Care ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Data Driven ◽  
Major Depressive ◽  
Primary Care Patients

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.

scholarly journals Association between antidepressant resistance in unipolar depression and subsequent bipolar disorder: cohort study

2012 ◽  
Vol 200 (1) ◽  
pp. 45-51 ◽  
Author(s):  
Cheng-Ta Li ◽  
Ya-Mei Bai ◽  
Yu-Lin Huang ◽  
Ying-Sheue Chen ◽  
Tzeng-Ji Chen ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Large Scale ◽  
Antidepressant Treatment ◽  
Poor Response ◽  
Unipolar Depression ◽  
Major Depressive ◽  
Antidepressant Use ◽  
Nationally Representative

BackgroundPeople with major depressive disorder who fail to respond to adequate trials of antidepressant treatment may harbour hidden bipolar disorder.AimsWe aimed to compare the rates of a change in diagnosis to bipolar disorder among people with major depressive disorder with stratified responses to antidepressants during an 8-year follow-up period.MethodInformation on individuals with major depressive disorder identified during 2000 (cohort 2000, n = 1485) and 2003 (cohort 2003, n = 2459) were collected from a nationally representative cohort of 1 000 000 health service users in Taiwan. Participants responding well to antidepressants were compared with those showing poor responses to adequate trials of antidepressants.ResultsIn 7.6–12.1% of those with a diagnosis of unipolar major depressive disorder this diagnosis was subsequently changed to bipolar disorder, with a mean time to change of 1.89–2.98 years. Difficult-to-treat participants presented higher rates of change to a bipolar diagnosis (25.6% in cohort 2000; 26.6% in cohort 2003) than easy-to-treat participants (8.8–8.9% in cohort 2000; 6.8–8.6% in cohort 2003; P<0.0001). Regression analysis showed that the variable most strongly associated with the change in diagnosis was antidepressant use history. The difficult-to-treat participants were associated most with diagnostic changing (cohort 2000: odds ratio (OR) = 1.88 (95% CI 1.12–3.16); cohort 2003: OR = 4.94 (95% CI 2.81–8.68)).ConclusionsThis is the first large-scale study to report an association between antidepressant response history and subsequent change in diagnosis from major depressive disorder to bipolar disorder. Our findings support the view that a history of poor response to antidepressants in unipolar depression could be a useful predictor for bipolar diathesis.

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