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Journal Article

Citation

Patella AM, Jansen K, Cardoso TA, Souza LDM, Silva RAD, Coelho FMDC. J. Affect. Disord. 2018; 243: 103-107.

Affiliation

Federal University of Pelotas, RS, Brazil.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.jad.2018.09.007

PMID

30241024

Abstract

INTRODUCTION: Subjects with bipolar disorder suffering of a depressive episode are frequently misdiagnosed as unipolar depression, being important studies assessing the differential diagnosis between bipolar and unipolar depression.

OBJECTIVE: To assess the sociodemographic and clinical features of drug-free young adults in a depressive episode of bipolar or unipolar disorder in order to identify factors that may differentiate these psychiatric conditions.

METHODS: This is a cross-sectional study with 241 young adults aged between 18 and 29 years who were evaluated using the Structured Clinical Interview for DSM-IV (SCID). The sample comprised patients with BD (n = 89) and major depressive disorder (n = 152), experiencing a depressive episode and not using psychoactive drugs or illicit psychoactive substances.

RESULTS: The characteristics associated with bipolar depression were being male (p < 0.001), with a family history of BD (p = 0.013), a higher frequency of childhood traumatic experiences (p = 0.001), younger age of onset of mood disorder (p = 0.004), many previous depressive episodes (p = 0.027), greater severity of depressive symptoms (p < 0.001) and day/night reversal (p = 0.013). Those with unipolar depression showed a higher frequency of biological rhythm disturbances (p < 0.001), and diurnal preference (p = 0.028). LIMITATIONS: The sample has not included subjects with severe suicide risk, a possible important marker in differentiate unipolar from bipolar depression.

CONCLUSION: Some clinical aspects may contribute to an early differential diagnosis of both bipolar and unipolar depression even in the initial stages of the disease.

Copyright © 2018. Published by Elsevier B.V.


Language: en

Keywords

Bipolar depression; Bipolar disorder; Differential diagnosis; Major depressive disorder; Mood disorders; Unipolar depression

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