Symptom characteristics of depressive episodes prior to the onset of mania or hypomania

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

Abstract

Objective: Depressive episodes are typically the initial presentation of bipolar disorder. The evidence as to whether depressive episodes occurring in persons who later convert to bipolar disorder are symptomatically distinct from episodes of unipolar depression remains controversial. As there are crucial differences in the therapeutic management, symptom profiles indicating subsequent bipolar conversion may aid in appropriate treatment. Method: A representative community sample of originally N = 3021 adolescents and young adults aged 14-24 years at baseline was assessed up to four times over 10 years. Assessment of symptoms was conducted by clinically trained interviewers using the standardized M-CIDI. Symptom profiles of depressive episodes were compared via logistic regression between subjects that subsequently developed (hypo-)manic episodes (n = 35) or remained unipolar depressive (n = 659). Results: Initial depression amongst prospective converters was characterized by significantly increased suicidality (odds ratio, OR = 2.31), higher rates of feelings of worthlessness and excessive guilt (OR = 2.52), complete loss of pleasure (OR = 2.53) and diurnal variation (OR = 4.30). No differences were found for hyperphagia, hypersomnia and psychomotor alterations. Conclusion: Findings suggest that the symptom profile of initial depressive episodes may be useful in the identification of subjects with an elevated risk for the subsequent conversion to bipolar disorder.

Details

Original languageEnglish
Pages (from-to)196-204
Number of pages9
JournalActa psychiatrica Scandinavica
Volume133
Issue number3
Publication statusPublished - 1 Mar 2016
Peer-reviewedYes

External IDs

PubMed 26252885
ORCID /0000-0001-7646-8265/work/142232696
ORCID /0000-0002-9687-5527/work/142235326
ORCID /0000-0002-2666-859X/work/146643974
ORCID /0000-0003-4286-5830/work/148143966
ORCID /0000-0002-3415-5583/work/150329691

Keywords

Sustainable Development Goals

ASJC Scopus subject areas

Keywords

  • Bipolar disorder, Early manifestation, Early recognition, Unipolar depression