Are Depressive Episodes Different in Bipolar Disorder type I, type II and Unipolar Depression?

2014 ◽  
Vol 4 (4) ◽  
pp. 143
Author(s):  
Arzu Aksoy ◽  
Sermin Kesebir
CNS Spectrums ◽  
2019 ◽  
Vol 24 (1) ◽  
pp. 127-143 ◽  
Author(s):  
Sinead King ◽  
James M Stone ◽  
Anthony Cleare ◽  
Allan H Young

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.


2012 ◽  
Vol 53 (7) ◽  
pp. 775-781 ◽  
Author(s):  
Lindsay S. Schenkel ◽  
Amy E. West ◽  
Rachel Jacobs ◽  
John A. Sweeney ◽  
Mani N. Pavuluri

2017 ◽  
Vol 41 (S1) ◽  
pp. S333-S333
Author(s):  
D. Piacentino ◽  
P. Girardi ◽  
K.G.D. Md ◽  
L. Sanna ◽  
I. Pacchiarotti ◽  
...  

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.


2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
M. Mazza ◽  
D. Harnic ◽  
G. Marano ◽  
V. Catalano ◽  
L. Janiri ◽  
...  

Introdution:Our study represents a pilot evaluation about how the MOOD-SR recognizes subthreshold manifestations that may be associated with clinical symptomatology in a group of bipolar patients.Methods:At Day Hospital of Psychiatry, Policlinico “A. Gemelli”, Bipolar Disorders Unit, it has been conducted an experimental study on a heterogeneous sample of 24 patients with a diagnosis of Bipolar Disorder type I. Patients have been assessed with the MOOD-SR, a clinical self-reported interview, that is specific for the spectrum of subthreshold pathology, and with the Quality of Life (QoL), that investigates the patient's quality of life.Results:We have found that 16 patients on 24 report a score higher than 60 (68,4%). Among these, 10 female patients on 15 have a total score higer than 61 (68.75%) while 6 male patients on 9 obtain a total score higher than 60 (62,5%). However, these results have only preliminary value, further studies are needed in order to obtain a deeper evaluation.Conclusion:Spectrum manifestations are both indicator of course and response to treatment and predictive for relapse. This finding may represent an important preventive instrument for maniacal relapse in patients with Bipolar Disorder, that is often underdiagnosed or confused for Unipolar Depression. By adequately recognizing the problem we will be able to refine diagnosis and individualize therapy.


2010 ◽  
Vol 22 (6) ◽  
pp. 280-283 ◽  
Author(s):  
Marcia B De Macedo-Soares ◽  
Elisa Brietzke ◽  
Rodrigo Da Silva Dias ◽  
Tiago Mendonça ◽  
Camila Moreira ◽  
...  

de Macedo-Soares MB, Brietzke E, da Silva Dias R, Mendonca T, Moreira C, Lafer B. A comparison of the symptomatic profile between two consecutive depressive episodes in patients with bipolar disorder type I.Objective:To compare the variability of patterns of depressive symptoms between two consecutive depressive episodes in patients with bipolar disorder type I.Methods:Review of prospectively collected data from 136 subjects of an out-patient bipolar unit from 1997 to 2007. Binomial statistics was used for the analysis of Hamilton Depression Rating Scale (HDRS)-31 items of the first and second episodes, and the correlation of the HDRS-31 item scores of both episodes was determined using the Spearman coefficient.Results:Ten depressive symptoms showed a significant correlation between index and subsequent episodes: psychological anxiety, somatic anxiety, somatic symptoms, diurnal variation, paranoid symptoms, obsessive and compulsive symptoms, hypersomnia, loss of appetite and helplessness. Only four symptoms were stable in both statistical tests: paranoid symptoms, obsessive–compulsive symptoms, loss of appetite and hypersomnia.Conclusions:Paranoid and obsessive–compulsive symptoms, loss of appetite and hypersomnia tended to be found in successive episodes. However, the moderate correlations of the symptoms across two depressive recurrences suggested that clinical presentations in bipolar depression may not be predicted by symptom profiles presented in previous episodes.


2015 ◽  
Vol 175 ◽  
pp. 92-97 ◽  
Author(s):  
Delfina Janiri ◽  
Gabriele Sani ◽  
Emanuela Danese ◽  
Alessio Simonetti ◽  
Elisa Ambrosi ◽  
...  

2017 ◽  
Vol 41 (S1) ◽  
pp. S75-S75
Author(s):  
D. Janiri ◽  
G. Giuseppin ◽  
E. Spinazzola ◽  
M. Maggiora ◽  
G. Sani

IntroductionImpulsivity is a key feature of both bipolar disorder (BD) type I (BDI) and type II (BDII).ObjectiveStructural neuroimaging studies help clarifying brain mechanisms underpinning the regulation of impulsivity in BDI and BDII.AimsTo address the question whether grey matter (GM) alterations relate differently with impulsivity in BDI and BDII.MethodsWe assessed 54 euthymic outpatients, diagnosed with BDI (n = 28) or BDII (n = 26) according to DSM-IV-TR criteria. They underwent a 3 T magnetic resonance imaging (MRI) investigation. GM brain volumes were analyzed on a voxel-by-voxel basis using Statistical Parametric Mapping 8. The Barratt Impulsiveness Scale (BIS), version 11A, was used to assess trait impulsivity.ResultsBDI and BDII patients present an inverse relationship between impulsivity and GM volume in two cerebral areas: the right cerebellum (right crus I) and the interface between the left angular gyrus and the left inferior parietal cortex (Brodmann Area 39, 7, 40). More specifically, a negative relationship for BPI and a positive relationship for BPII were found in both areas.ConclusionsResults suggest that the different diagnosis between BDI and BDII could have a significant effect on GM changes according to impulsivity severity and point up the importance of considering the BP subtype distinction in neuroimaging studies on this topic.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2018 ◽  
Vol 213 (3) ◽  
pp. 548-554 ◽  
Author(s):  
Sonya F. Foley ◽  
Matthew Bracher-Smith ◽  
Katherine E. Tansey ◽  
Judith R. Harrison ◽  
Greg D. Parker ◽  
...  

BackgroundFractional anisotropy in the uncinate fasciculus and the cingulum may be biomarkers for bipolar disorder and may even be distinctly affected in different subtypes of bipolar disorder, an area in need of further research.AimsThis study aims to establish if fractional anisotropy in the uncinate fasciculus and cingulum shows differences between healthy controls, patients with bipolar disorder type I (BD-I) and type II (BD-II), and their unaffected siblings.MethodFractional anisotropy measures from the uncinate fasciculus, cingulum body and parahippocampal cingulum were compared with tractography methods in 40 healthy controls, 32 patients with BD-I, 34 patients with BD-II, 17 siblings of patients with BD-I and 14 siblings of patients with BD-II.ResultsThe main effects were found in both the right and left uncinate fasciculus, with patients with BD-I showing significantly lower fractional anisotropy than both patients with BD-II and healthy controls. Participants with BD-II did not differ from healthy controls. Siblings showed similar effects in the left uncinate fasciculus. In a subsequent complementary analysis, we investigated the association between fractional anisotropy in the uncinate fasciculus and polygenic risk for bipolar disorder and psychosis in a large cohort (n= 570) of healthy participants. However, we found no significant association.ConclusionsFractional anisotropy in the uncinate fasciculus differs significantly between patients with BD-I and patients with BD-II and healthy controls. This supports the hypothesis of differences in the physiological sub-tract between bipolar disorder subtypes. Similar results were found in unaffected siblings, suggesting the potential for this biomarker to represent an endophenotype for BD-I. However, fractional anisotropy in the uncinate fasciculus seems unrelated to polygenic risk for bipolar disorder or psychosis.Declaration of interestNone.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Anna Manelis ◽  
Adriane Soehner ◽  
Yaroslav O. Halchenko ◽  
Skye Satz ◽  
Rachel Ragozzino ◽  
...  

AbstractDiscerning distinct neurobiological characteristics of related mood disorders such as bipolar disorder type-II (BD-II) and unipolar depression (UD) is challenging due to overlapping symptoms and patterns of disruption in brain regions. More than 60% of individuals with UD experience subthreshold hypomanic symptoms such as elevated mood, irritability, and increased activity. Previous studies linked bipolar disorder to widespread white matter abnormalities. However, no published work has compared white matter microstructure in individuals with BD-II vs. UD vs. healthy controls (HC), or examined the relationship between spectrum (dimensional) measures of hypomania and white matter microstructure across those individuals. This study aimed to examine fractional anisotropy (FA), radial diffusivity (RD), axial diffusivity (AD), and mean diffusivity (MD) across BD-II, UD, and HC groups in the white matter tracts identified by the XTRACT tool in FSL. Individuals with BD-II (n = 18), UD (n = 23), and HC (n = 24) underwent Diffusion Weighted Imaging. The categorical approach revealed decreased FA and increased RD in BD-II and UD vs. HC across multiple tracts. While BD-II had significantly lower FA and higher RD values than UD in the anterior part of the left arcuate fasciculus, UD had significantly lower FA and higher RD values than BD-II in the area of intersections between the right arcuate, inferior fronto-occipital and uncinate fasciculi and forceps minor. The dimensional approach revealed the depression-by-spectrum mania interaction effect on the FA, RD, and AD values in the area of intersection between the right posterior arcuate and middle longitudinal fasciculi. We propose that the white matter microstructure in these tracts reflects a unique pathophysiologic signature and compensatory mechanisms distinguishing BD-II from UD.


2010 ◽  
Vol 32 (1) ◽  
pp. 62-65 ◽  
Author(s):  
Arthur Kummer ◽  
Fernando M. V. Dias ◽  
Francisco Cardoso ◽  
Antonio L. Teixeira

OBJECTIVE: To investigate the frequency of bipolar disorder, dopamine dysregulation syndrome and punding in Parkinson's disease patients from a Brazilian movement disorders clinic. METHOD: One hundred patients underwent a comprehensive psychiatric examination composed of MINI-plus and specific questionnaires to investigate dopamine dysregulation syndrome and punding. RESULTS: We identified, respectively, one and five Parkinson's disease patients with bipolar disorder type I and type II. All manic/hypomanic episodes occurred before Parkinson's disease onset. No patient was identified with dopamine dysregulation syndrome or punding. CONCLUSION: The frequency of manic/hypomanic episodes seems to decrease with Parkinson's disease onset, and local environmental factors (e.g. drug availability) may be responsible for the low frequency of dopamine dysregulation syndrome and punding in Brazilian Parkinson's disease patients.


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