scholarly journals Clinical Features of Patients With Major Depressive Disorder and Bipolar Disorder Depressive Episodes With Mixed Features 

Author(s):  
Hong Wang ◽  
Yan-Xia Xiao ◽  
Jing-Ge Du ◽  
Xia Du ◽  
Lin Chen

Abstract Background: To investigate the clinical phenomenology and clinical features of the new concept of major depressive disorder and bipolar disorder depressive episodes with mixed features.Methods: A total of 357 patients with major depressive disorder or bipolar disorder depressive episodes were assessed, we compared the differences of clinical features with or without mixed features.Results: According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria, the overall prevalence of mixed features was 9.52% (34/357) in major depressive disorder and bipolar disorder depressive episodes; specifically, the prevalence was 6.0% in major depressive disorder and 23.3% in bipolar disorder depressive episodes. Compared with the non-mixed features group, the mixed features group had more single individuals (P=0.002), earlier onset age (P=0.003), more patients with an onset age <25 years (P=0.001), and more previous incidences and prior hospitalizations (P<0.001, P=0.004, respectively), and fewer melancholic features (P=0.013).Logistic regression analysis showed that marital status (OR=0.237) and previous incidence (OR=1.478) was associated with mixed features.Conclusion: It indicates that previous incidence may be a risk factor of in patients with major depressive disorder and bipolar disorder depressive episodes with mixed features, and marital status may be a protective factor.

2011 ◽  
Vol 199 (4) ◽  
pp. 303-309 ◽  
Author(s):  
Philip B. Mitchell ◽  
Andrew Frankland ◽  
Dusan Hadzi-Pavlovic ◽  
Gloria Roberts ◽  
Justine Corry ◽  
...  

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.


Author(s):  
Raymond W. Lam

• Depression is associated with a number of physical, emotional, and cognitive symptoms.• Sub-typing of major depressive disorder has implications for treatment choice and selection.• The differential diagnosis of depression includes bereavement, bipolar disorder, and other medical or substance-induced conditions.Depression is associated with many different types of symptoms which can result to a variable presentation in any given person. The features of depression can be physical (sleep, energy, appetite, libido), emotional (low mood, anxiety, crying) or cognitive (guilt, pessimism, suicidal thoughts). ...


2015 ◽  
Vol 76 (01) ◽  
pp. 32-39 ◽  
Author(s):  
Andrew Frankland ◽  
Ester Cerrillo ◽  
Dusan Hadzi-Pavlovic ◽  
Gloria Roberts ◽  
Adam Wright ◽  
...  

2016 ◽  
Vol 33 (S1) ◽  
pp. S374-S374 ◽  
Author(s):  
B. Suciu ◽  
R. Paunescu ◽  
I. Miclutia

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.


2013 ◽  
Vol 15 (2) ◽  
pp. 199-205 ◽  
Author(s):  
Yu-Tao Xiang ◽  
Ling Zhang ◽  
Gang Wang ◽  
Chen Hu ◽  
Gabor S Ungvari ◽  
...  

2017 ◽  
Vol 39 ◽  
pp. 17-26 ◽  
Author(s):  
C. Samamé ◽  
A.G. Szmulewicz ◽  
M.P. Valerio ◽  
D.J. Martino ◽  
S.A. Strejilevich

AbstractBackgroundNeuropsychological deficits are present in both major depression and bipolar disorder. So far, however, reports directly comparing these mood disorders with regard to cognitive outcomes have been scant and yielded inconsistent results. This work aims to combine the findings of comparative studies of cognition in major depression and bipolar disorder in order to explore whether these neuropsychiatric conditions present with distinct cognitive features.MethodsThe main online databases were extensively searched to retrieve reports assessing neurocognitive functioning in two groups of mood disorder patients, one with major depressive disorder and another with bipolar disorder, both in the same phase of illness. Between-group effect sizes for cognitive variables were obtained from selected studies and pooled by means of meta-analytic procedures.ResultsDuring euthymia, a significant overall effect size (Hedges’g = 0.64, P < 0.001) favoring major depressive disorder was found for verbal memory as assessed with list learning tests, whereas no significant between-group differences were found for the remaining variables analyzed. During depressive episodes, similar cognitive outcomes were observed between groups.ConclusionAt present, it is not possible to postulate specific neuropsychological profiles for major depression and bipolar disorder in light of available evidence. It remains to be ascertained whether the differences found for verbal memory constitute an expression of distinct underlying mechanisms or whether they are best explained by sample characteristics or differential exposure to variables with a negative impact on cognition.


2011 ◽  
Vol 134 (1-3) ◽  
pp. 133-137 ◽  
Author(s):  
A. Carlo Altamura ◽  
Massimiliano Buoli ◽  
Bernardo Dell'Osso ◽  
Alessandra Albano ◽  
Marta Serati ◽  
...  

Author(s):  
Licínia Ganança ◽  
David A. Kahn ◽  
Maria A. Oquendo

This chapter discusses the mood disorders. Major depressive disorder is characterized by neurovegetative changes, anhedonia, and suicidal ideation. Persistent depressive disorder is a milder form of depression, lasting for at least 2 years, with little or no remission during that time... Psychotic features can occur in both depressive and manic episodes. Premenstrual dysphoric disorder is diagnosed through use of a prospective daily symptom ratings log showing a cyclical pattern over at least 2 consecutive months. Patients with mood episodes with mixed features have a high risk of suicide. Some patients with bipolar disorder and major depressive disorder may develop catatonic features characterized by marked psychomotor disturbance. Selective serotonin reuptake inhibitors (SSRIs) are the usual first-line medication treatment for patients with major depressive disorder. For patients with bipolar disorder the mainstays of somatic therapy are lithium and the anticonvulsants valproate and carbamazepine.


2011 ◽  
Vol 199 (1) ◽  
pp. 3-4 ◽  
Author(s):  
Allan H. Young ◽  
Holly MacPherson

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.


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