Rasim Somer Diler1, Tina R Goldstein1, Danella Hafeman1, John Merranko1, Fangzi Liao1, Benjamin I Goldstein2, Heather Hower3, Mary Kay Gill1, Jeffrey Hunt3, Shirley Yen3, Martin B Keller3, David Axelson4, Michael Strober5, Satish Iyengar6, Neal D Ryan1, Boris Birmaher1. 1. 1 Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania. 2. 2 Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto Faculty of Medicine , Toronto, Canada . 3. 3 Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University , Providence, Rhode Island. 4. 4 Department of Psychiatry, Nationwide Children's Hospital , The Ohio State College of Medicine, Columbus, Ohio. 5. 5 Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California , Los Angeles, Los Angeles, California. 6. 6 Department of Statistics, University of Pittsburgh , Pittsburgh, Pennsylvania.
Abstract
OBJECTIVES: To identify mood symptoms that distinguishes bipolar disorder (BP) depression versus unipolar depression in youth during an acute depressive episode. METHODS: Youth with BP (N = 30) were compared with youth with unipolar depression (N = 59) during an acute depressive episode using the depression and mania items derived from the Schedule for Affective Disorders and Schizophrenia for Children (K-SADS)-Present Version. The results were adjusted for multiple comparisons, and any significant between-group differences in demographic, nonmood comorbid disorders, and psychiatric family history. RESULTS: In comparison with unipolar depressed youth, BP depressed youth had significantly higher scores in several depressive symptoms and all subsyndromal manic symptoms, with the exception of increased goal-directed activity. Among the depressive symptoms, higher ratings of nonsuicidal physical self-injurious acts and mood reactivity, and lower ratings of aches/pains, were the symptoms that best discriminated BP from unipolar depressed youth. Subsyndromal manic symptoms, particularly motor hyperactivity, distractibility, and pressured speech, were higher in BP depressed youth and discriminated BP depressed from unipolar depressed youth. CONCLUSIONS: The results of this study suggest that it is possible to differentiate BP depression from unipolar depression based on depressive symptoms, and in particular subsyndromal manic symptoms. If replicated, these results have important clinical and research implications.
OBJECTIVES: To identify mood symptoms that distinguishes bipolar disorder (BP) depression versus unipolar depression in youth during an acute depressive episode. METHODS: Youth with BP (N = 30) were compared with youth with unipolar depression (N = 59) during an acute depressive episode using the depression and mania items derived from the Schedule for Affective Disorders and Schizophrenia for Children (K-SADS)-Present Version. The results were adjusted for multiple comparisons, and any significant between-group differences in demographic, nonmood comorbid disorders, and psychiatric family history. RESULTS: In comparison with unipolar depressed youth, BP depressed youth had significantly higher scores in several depressive symptoms and all subsyndromal manic symptoms, with the exception of increased goal-directed activity. Among the depressive symptoms, higher ratings of nonsuicidal physical self-injurious acts and mood reactivity, and lower ratings of aches/pains, were the symptoms that best discriminated BP from unipolar depressed youth. Subsyndromal manic symptoms, particularly motor hyperactivity, distractibility, and pressured speech, were higher in BP depressed youth and discriminated BP depressed from unipolar depressed youth. CONCLUSIONS: The results of this study suggest that it is possible to differentiate BP depression from unipolar depression based on depressive symptoms, and in particular subsyndromal manic symptoms. If replicated, these results have important clinical and research implications.
Entities:
Keywords:
atypical depressive symptoms; bipolar; depression; manic symptoms; mixed features
Authors: David A Axelson; Boris Birmaher; Michael A Strober; Benjamin I Goldstein; Wonho Ha; Mary Kay Gill; Tina R Goldstein; Shirley Yen; Heather Hower; Jeffrey I Hunt; Fangzi Liao; Satish Iyengar; Daniel Dickstein; Eunice Kim; Neal D Ryan; Erica Frankel; Martin B Keller Journal: J Am Acad Child Adolesc Psychiatry Date: 2011-09-08 Impact factor: 8.829
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