+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Comparison of depressive episodes in bipolar disorder and in major depressive disorder within bipolar disorder pedigrees



Comparison of depressive episodes in bipolar disorder and in major depressive disorder within bipolar disorder pedigrees



British Journal of Psychiatry 199(4): 303-309



Although 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. To 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. Patients 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. Bipolar 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. A 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.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 052232054

Download citation: RISBibTeXText

PMID: 21508436

DOI: 10.1192/bjp.bp.110.088823


Related references

Comparing the phenomenology of depressive episodes in bipolar I and II disorder and major depressive disorder within bipolar disorder pedigrees. Journal of Clinical Psychiatry 76(1): 32-8; Quiz 39, 2015

Add-on high frequency deep transcranial magnetic stimulation (dTMS) to bilateral prefrontal cortex in depressive episodes of patients with major depressive disorder, bipolar disorder I, and major depressive with alcohol use disorders. Neuroscience Letters 671: 128-132, 2018

Circadian Rhythm Characteristics in Mood Disorders: Comparison among Bipolar I Disorder, Bipolar II Disorder and Recurrent Major Depressive Disorder. Clinical Psychopharmacology and Neuroscience 10(2): 110-116, 2013

Decreased Functional Connectivity in Insular Subregions in Depressive Episodes of Bipolar Disorder and Major Depressive Disorder. Frontiers in Neuroscience 12: 842, 2018

The impact of brief depressive episodes on the outcome of bipolar disorder and major depressive disorder: a 1-year prospective study. Journal of Affective Disorders 134(1-3): 133-137, 2011

Antidepressant-associated mood elevations in bipolar II disorder compared with bipolar I disorder and major depressive disorder: a systematic review and meta-analysis. Journal of Clinical Psychiatry 69(10): 1589-1601, 2009

Resting-state alpha and gamma activity in affective disorder with Adhd symptoms: Comparison between bipolar disorder and major depressive disorder. International Journal of Psychophysiology 143: 57-63, 2019

P.2.d.031 Predictors for manic switch at depressive episodes in bipolar disorder: the Systematic Treatment Enhancement Program for Bipolar Disorder. European Neuropsychopharmacology 24: S431-S432, 2014

Relationship of alcohol and cocaine on mood episodes among HIV-infected adults with bipolar disorder and major depressive disorder. Drug and Alcohol Dependence 146: E158-E159, 2015

Comparison of the validity of the Chinese versions of the Hypomania Symptom Checklist-32 (HCL-32) and Mood Disorder Questionnaire (MDQ) for the detection of bipolar disorder in medicated patients with major depressive disorder. International Journal of Psychiatry in Clinical Practice 16(2): 132-137, 2012

Subcortical volumes differentiate Major Depressive Disorder, Bipolar Disorder, and remitted Major Depressive Disorder. Journal of Psychiatric Research 68: 91-98, 2016

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. Journal of Clinical Psychiatry 64(2): 161-174, 2003

Prospective study of clinical predictors of suicidal acts after a major depressive episode in patients with major depressive disorder or bipolar disorder. American Journal of Psychiatry 161(8): 1433-1441, 2004

Psychosocial Functioning in Depressive Patients: A Comparative Study between Major Depressive Disorder and Bipolar Affective Disorder. Depression Research and Treatment 2014: 302741, 2014

The Impact of a Single Nucleotide Polymorphism in SIGMAR1 on Depressive Symptoms in Major Depressive Disorder and Bipolar Disorder. Advances in Therapy 34(3): 713-724, 2017