Skip to main content

Unipolar depression versus bipolar disorder; an overview

Author/s
Gursharan Kashyap, Lucy Pauli
Citation
Issue 3 Summer 2013
CEPiP.2013;1:49-53
Abstract

The case is made for the importance of diagnosing unipolar depression and bipolar disorder as two separate conditions. Differences in the natural history and course of the disorders, their symptomatology and response to treatment are described. The correct diagnosis and treatment of these conditions is of great importance in determining outcome.

Keywords: mania, bipolar illness, unipolar depression

Cite as: Cutting Edge Psychiatry in Practice 2013, 3(1):49-53; https://doi.org/10.65031/welg5268

References

  1. McGuffin P, Rijsdijk F, Andrew M, Sham P, Katz R, Cardno, A. The heritability of bipolar affective disorder and the genetic relationship to unipolar depression. Arch Gen Psychiatry 2003;60:497-502 https://doi.org/10.1001/archpsyc.60.5.497
  2. Kendler KS, Neale MC, Kessler RC, et al. The lifetime history of major depression in women. Reliability of diagnosis and heritability. Arch Gen Psychiatry 1993;50 (11):863–87017 https://doi.org/10.1001/archpsyc.1993.01820230054003
  3. Judd LL, Akiskal HS, Schettler PJ, Endicott J, Leon AC, Solomon DA, Coryell W, Maser JD, Keller MB. Psychosocial Disability in the Course of Bipolar I and II Disorders: A Prospective, Comparative, Longitudinal Study. Archives of General Psychiatry 2005;62 (12):1322–1330 https://doi.org/10.1001/archpsyc.62.12.1322
  4. Osby, U Brandt, L Correia, N Ekbom, A Sparén, P. (2001). Excess mortality in bipolar and unipolar disorder in Sweden. Archives of General Psychiatry 2001;58 (9): 844–850. https://doi.org/10.1001/archpsyc.58.9.844
  5. Goodwin FK, Jamison KR (1990). Manic-Depressive Illness. Oxford University press. 2nd Edition. New York. NY; 2006.          
  6. Valtonen HM, Suominen K, Haukka J et al. Differences in incidence of suicide attempts during phases of bipolar I and II disorders. Bipolar Disorders 2008;vol. 10, no. 5:pp. 588–596, https://doi.org/10.1111/j.1399-5618.2007.00553.x
  7. Yazici O, Kora K, Uçok A, Saylan M, Ozdemir O, Kiziltan E, Ozpulat TJ. Unipolar mania: a distinct disorder? Affect Disord. 2002 Sep;71 (1-3):97-103. https://doi.org/10.1016/s0165-0327(01)00416-5
  8. Solomon DA, Leon AC, Coryell W, Mueller TI, Posternak MA. Unipolar mania: A 20-year follow-up study. American Journal of Psychiatry 2003;160:2049–2050. https://doi.org/10.1176/appi.ajp.160.11.2049
  9. Hirschfeld RM. Psychiatric management. In: American Psychiatric Association, ed. Guidelines Watch: Practice Guideline for the Treatment of Patients With Bipolar Disorder. 2006. http://www. psychiatryonline.com/content.aspx?aID=148440. Accessed on 09/12/12). https://doi.org/10.1176/appi.books.9780890423363.148430
  10. Benazzi F. Is there a link between atypical and early-onset unipolar depression and bipolar II disorder? Compr Psychiatry 2003 Mar-Apr;44 (2):102-9. https://doi.org/10.1053/comp.2003.50015
  11. Akiskal HS. Searching for behavioral indicators of bipolar II in patients with major depressive episodes: the “red sign”, the “rule of three” and other biographic signs of temperamental extravagance, activation and hypomania. J Affect Disord. 2005;84:279–290 https://doi.org/10.1016/j.jad.2004.06.002
  12. Forty L et al. Clinical differences between bipolar and unipolar depression. The British Journal of Psychiatry 2008;192:388-389            
  13. Roy PH. Misdiagnosis of bipolar disorder. Am J Manag Care 2005;11:S271–S274.              
  14. Hirschfeld RM, Holzer C, Calabrese JR, et al. Validity of the mood disorder questionnaire: A general population study. Am J Psychiatry 2003;160:178–80.
  15. Perlis RH, Eileen Brown MD, Baker RW,Nierenberg AA. Clinical Features of Bipolar Depression Versus Major Depressive Disorder in Large Multicenter Trials. Am J Psychiatry 2006;163:225-231 https://doi.org/10.1176/appi.ajp.163.2.225
  16. Benazzi F. Depressive mixed states: unipolar and bipolar II. Eur Arch Psychiatry 2000;ClinNeurosci. 250:249-253. https://doi.org/10.1007/s004060070014
  17. Akiskal HS et al. The evolving bipolar spectrum. Prototypes I, II, III, and IV. Psychiatr Clin North Am. 1999           
  18. Perugi G, Micheli C, Akiskal HS, et al. Polarity of first episode, clinical characteristics, and course of manic depressive illness: A systemic retrospective investigation of 320 bipolar I patients. 2000;41:13–18. https://doi.org/10.1016/s0010-440x(00)90125-1
  19. Bowden CL. Strategies to reduce misdiagnosis of bipolar depression. Psychiatric services (Washington, D.C.) 2001;52 (1): 51–55. https://doi.org/10.1176/appi.ps.52.1.51
  20. Judd LL, Akiskal HS, Schettler PJ et al. The long-term natural history of the weekly symptomatic status of bipolar I disorder. Archives of General Psychiatry 2002;vol. 59, no. 6:pp. 530–537. https://doi.org/10.1001/archpsyc.59.6.530
  21. Bauer MS, Calabrese JR, Dunner DL, et al. Multisite data reanalysis of the validity of rapid cycling as a course modifier for bipolar disorder in DSM-IV. Am J Psychiatry 1994;151:506-515 https://doi.org/10.1176/ajp.151.4.506
  22. Lee S, Tsang A, Kessler RC, Jin R, Sampson N, Andrade L, Karam EG, Mora ME, Merikangas K, Nakane Y, Popovici DG, Posada-Villa J, Sagar R, Wells JE, Zarkov Z, Petukhova M: Rapid-cycling bipolar disorder: cross-national community study. Br J Psychiatry 2010 Mar;196 (3):217-25 https://doi.org/10.1192/bjp.bp.109.067843
  23. Schneck CD, Miklowit DJ, Miyahara S, Araga M, Wisniewski S, Gyulai L, Allen MH,Thase ME, Sachs GS. The Prospective Course of Rapid-Cycling Bipolar Disorder: Findings From the STEP-BD. The American Journal of Psychiatry;VOL. 165, No. 3 https://doi.org/10.1176/appi.ajp.2007.05081484
  24. Altshuler LL, Gitlin MJ, Mintz J, Leight KL, Frye MA. Subsyndromal depression is associated with functional impairment in patients with bipolar disorder. Journal of Clinical Psychiatry 2002;vol. 63, no. 9:pp. 807–811, https://doi.org/10.4088/jcp.v63n0910
  25. Perlis RH, OstacherMJ, Patel JK et al. Predictors of recurrence in bipolar disorder: primary outcomes from the systematic treatment enhancement program for bipolar disorder (STEP-BD). American Journal of Psychiatry 2006;vol. 163, no. 2:pp. 217–224. https://doi.org/10.1176/appi.ajp.163.2.217
  26. Hirschfeld RM, Lewis L, Vornik LA. Perceptions and impact of bipolar disorder: how far have we really come? Results of the national depressive and manic-depressive association 2000 survey of individuals with bipolar disorder. J Clin Psychiatry 2003 Feb;64 (2):161-74). https://doi.org/10.4088/jcp.v64n0209
  27. Muzina DJ, Elhaj O, Gajwani P, Gao K, Shelton MD, Calabrese JR. Advances in treatment of rapid cycling bipolar disorders. Oldham JM, Riba MB, Ketter TA, eds. Review of Psychiatry, Volume 24. Arlington, Va: American Psychiatric Publishing Inc; 2005:147-178 https://doi.org/10.1176/appi.books.9781615377664.lg05
  28. Wehr TA, Sack DA, Rosenthal NE et al. Rapid cycling affective disorder: contributing factors and treatment responses in 51 patients. Am J Psychiatry 1988;145:179-184. https://doi.org/10.1176/ajp.145.2.179
  29. Angst J. The bipolar spectrum. Br J Psychiatry 2007;190:189–9.      
  30. Bipolar II disorder: epidemiology, diagnosis and management. CNS Drugs. 2007;21 (9):727-40 https://doi.org/10.2165/00023210-200721090-00003