Tags

Type your tag names separated by a space and hit enter

A continuity between bipolar II depression and major depressive disorder?
Prog Neuropsychopharmacol Biol Psychiatry. 2006 Aug 30; 30(6):1043-50.PN

Abstract

BACKGROUND

A recent series of studies has questioned the current categorical split of mood disorders into bipolar and depressive disorders. Mixed states, especially mixed depression (i.e., depression plus co-occurring, noneuphoric, hypomanic symptoms) might support a continuity between bipolar II (BP-II) depression and major depressive disorder (MDD). The aim of the study was to assess the distribution of intradepressive hypomanic symptoms rating between BP-II and MDD depressions. A bi-modal distribution would support a categorical distinction, and no bi-modality would support continuity.

METHODS

Consecutive 389 BP-II and 261 MDD major depressive episode (MDE) outpatients were interviewed (off psychoactive drugs) with the Structured Clinical Interview for DSM-IV, the Hypomania Interview Guide (HIG, to assess intradepressive hypomanic symptoms), and the Family History Screen, by a mood specialist psychiatrist in a private practice. Mixed depression was defined as MDE plus 3 or more intradepressive, noneuphoric hypomanic symptoms, a definition validated by Akiskal and Benazzi. The distribution of intradepressive hypomanic symptoms rating was studied by Kernel density estimate and by histogram.

RESULTS

BP-II depression, versus MDD depression, had significantly lower age at onset, was significantly more likely to be atypical and mixed, had more depression recurrences, and a higher bipolar family history loading. BP-II depression, versus MDD depression, had significantly more irritability, racing/crowded thoughts, distractibility, psychomotor agitation, talkativeness, increased goal-directed activity, and excessive risky activities. HIG scores were significantly higher in BP-II. The distribution of intradepressive hypomanic symptoms rating showed no bi-modality in the entire depression sample.

CONCLUSIONS

Interpretation of study findings relies on the method used to define a categorical disorder. By using classic diagnostic validators (such as family history and age at onset), BP-II and MDD depressions would seem to be distinct disorders. Instead, by using the 'bi-modality' approach, a continuity would seem to be supported. Which of these methods for classification is the best has yet to be shown.

Authors+Show Affiliations

Hecker Psychiatry Research Center, Forli, Italy. FrancoBenazzi@FBenazzi.it

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16682104

Citation

Benazzi, Franco. "A Continuity Between Bipolar II Depression and Major Depressive Disorder?" Progress in Neuro-psychopharmacology & Biological Psychiatry, vol. 30, no. 6, 2006, pp. 1043-50.
Benazzi F. A continuity between bipolar II depression and major depressive disorder? Prog Neuropsychopharmacol Biol Psychiatry. 2006;30(6):1043-50.
Benazzi, F. (2006). A continuity between bipolar II depression and major depressive disorder? Progress in Neuro-psychopharmacology & Biological Psychiatry, 30(6), 1043-50.
Benazzi F. A Continuity Between Bipolar II Depression and Major Depressive Disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2006 Aug 30;30(6):1043-50. PubMed PMID: 16682104.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A continuity between bipolar II depression and major depressive disorder? A1 - Benazzi,Franco, Y1 - 2006/05/08/ PY - 2006/5/10/pubmed PY - 2006/8/24/medline PY - 2006/5/10/entrez SP - 1043 EP - 50 JF - Progress in neuro-psychopharmacology & biological psychiatry JO - Prog Neuropsychopharmacol Biol Psychiatry VL - 30 IS - 6 N2 - BACKGROUND: A recent series of studies has questioned the current categorical split of mood disorders into bipolar and depressive disorders. Mixed states, especially mixed depression (i.e., depression plus co-occurring, noneuphoric, hypomanic symptoms) might support a continuity between bipolar II (BP-II) depression and major depressive disorder (MDD). The aim of the study was to assess the distribution of intradepressive hypomanic symptoms rating between BP-II and MDD depressions. A bi-modal distribution would support a categorical distinction, and no bi-modality would support continuity. METHODS: Consecutive 389 BP-II and 261 MDD major depressive episode (MDE) outpatients were interviewed (off psychoactive drugs) with the Structured Clinical Interview for DSM-IV, the Hypomania Interview Guide (HIG, to assess intradepressive hypomanic symptoms), and the Family History Screen, by a mood specialist psychiatrist in a private practice. Mixed depression was defined as MDE plus 3 or more intradepressive, noneuphoric hypomanic symptoms, a definition validated by Akiskal and Benazzi. The distribution of intradepressive hypomanic symptoms rating was studied by Kernel density estimate and by histogram. RESULTS: BP-II depression, versus MDD depression, had significantly lower age at onset, was significantly more likely to be atypical and mixed, had more depression recurrences, and a higher bipolar family history loading. BP-II depression, versus MDD depression, had significantly more irritability, racing/crowded thoughts, distractibility, psychomotor agitation, talkativeness, increased goal-directed activity, and excessive risky activities. HIG scores were significantly higher in BP-II. The distribution of intradepressive hypomanic symptoms rating showed no bi-modality in the entire depression sample. CONCLUSIONS: Interpretation of study findings relies on the method used to define a categorical disorder. By using classic diagnostic validators (such as family history and age at onset), BP-II and MDD depressions would seem to be distinct disorders. Instead, by using the 'bi-modality' approach, a continuity would seem to be supported. Which of these methods for classification is the best has yet to be shown. SN - 0278-5846 UR - https://www.unboundmedicine.com/medline/citation/16682104/A_continuity_between_bipolar_II_depression_and_major_depressive_disorder L2 - https://linkinghub.elsevier.com/retrieve/pii/S0278-5846(06)00130-8 DB - PRIME DP - Unbound Medicine ER -