Bipolar spectrum in major depressive disorders

Abstract

Growing evidence for the spectrum concept of most mental disorders, particularly mood disorders, has challenged the arbitrary distinctions inherent in the contemporary categorical diagnostic classification system. Detection of manic symptoms in the context of episodes of depression is particularly important because of the implications for differential treatment of bipolar vs unipolar depression. The purpose of this study is to characterize the magnitude and clinical correlates of subthreshold manic syndromes or symptoms among people with major depressive disorder (MDD) compared to those without a history of manic symptoms. We defined two subthreshold manifestations-manic syndrome or symptoms-that did not include a criterion for duration. In the context of MDD, we found that the clinical correlates of those with the subthreshold manic syndrome were more similar to those with bipolar-II disorder than to MDD alone, whereas those with manic symptoms only were intermediate between those with subthreshold manic syndrome and MDD alone. These results confirm the spectrum concept of mania and suggest that a manic syndrome should be considered when evaluating people with MDD.

Pharmacotherapeutic interventions for bipolar disorder type II: addressing multiple symptoms and approaches with a particular emphasis on strategies in lower and middle-income countries

“…A number of reviews and guidelines have been published in this area, including burden of illness studies and studies of attitudes toward antipsychotic treatment [43,[66][67][68][69]78,82,90,96,97,107,[124][125][126]. Consequently, we did not undertake a formal systematic review.…”

“…However, there is an ongoing debate about the definition of hypomania [70] and concerns whether different rating scales for diagnosing (hypo)mania are interchangeable [76]. In practice, it can be difficult to differentiate between different BD disorders and other similar conditions, exacerbated by the presence of mixed states of BD, including depressive symptoms coexisting with manic symptoms [70,74,[77][78][79][80][81]. BD patients are typically sensitive to depressive symptoms but may not recognize their hypomanic or manic symptoms [69].…”

The Co-Morbidity between Bipolar and Panic Disorder in Fibromyalgia Syndrome

“…A growing body of evidence highlights both the epidemiologic and clinical relevance of the milder form of BD and PD. The application of the subthreshold bipolarity diagnostic criteria in a growing number of population surveys has shown that as many as 11.2% of adults presented bipolar spectrum disorders [58]. In addition to the epidemiological consistency of subthreshold BD, it is well known that this population is prone to experiencing severe role impairment and negative outcomes (including co-morbidity with Ads, high risks of physical illnesses, and suicidal attempts), which are virtually equivalent to those occurring in BD-I and BD-II [59,60].…”

The place of comorbidity and of subtle psychopathological evaluation

“…This can be seen in the current literature where results on comorbidity and co-symptomatology seem sometimes to predominate studies on disorders without comorbid conditions [2][3][4][5][6][7]. However, depending on the design of the studies, it is not always clear whether e.g.…”