Onset of Depressive Episodes Is Faster in Patients With Bipolar Versus Unipolar Depressive Disorder

Hegerl, Ulrich; Bottner, Anja-Christine; Holtschmidt-Täschner, Bettina; Born, Christoph; Seemüller, Florian; Scheunemann, W.; Schütze, Michael; Grunze, Heinz; Henkel, Verena; Mergl, Roland; Angst, J.

doi:10.4088/jcp.v69n0705

Cited by 32 publications

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“…Conclusion: In patients with bipolar disorder the full development of depressive episode lasts shorter time which is in accordance with published findings (Hegerl et al, 2008). Morning worsening occurs with similar frequency in bipolar and unipolar patients, but when counting all mood variations together, frequency is slightly more in bipolar then unipolar MDE.…”

Section: Motovsky Branislav and Dagmar Breznoscakovasupporting

confidence: 91%

Difference of symptomatology of unipolar and bipolar depression - pilot findings

Motovsky¹,

Breznoscakova²

2011

International Clinical Psychopharmacology

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antidepressant-like effect. In addition the actual immobility time and the latency to the first immobility episode (i.e. the time that elapses since placing the animals into the water cylinders up to the first immobility episode) were measured. Statistics: The results were analyzed by analysis of variance (ANOVA) followed by Newman-Keuls test. The analysis of the data involves a between group factor, treatment. The diving scores were not subjected to statistical analysis since only very few animals occasionally displayed this behaviour. Results:The results show that both HU210 and SR14171A increase the swimming scores and reduce immobility time. However, HU210, but not SR141716A, increased the latency to the first immobility episode. Moreover, the antidepressant-like effect of the CB1 agonist, HU-210, was antagonised by haloperidol.Conclusion: These results, taken together with the clinical data on rimonabant, suggest that the latency to the first immobility episode might reveal 'false positives' in this test. This interpretation would also resolve the discrepancy between the pre-clinical and the clinical evidence. Morever we found that the antidepressant-like effect of the CB1 receptor stimulation is antagonized by blockade of dopamene receptors, suggesting that this effect might be mediated by the activation of dopamine transmission.

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Section: Motovsky Branislav and Dagmar Breznoscakovasupporting

confidence: 91%

Difference of symptomatology of unipolar and bipolar depression - pilot findings

Motovsky¹,

Breznoscakova²

2011

International Clinical Psychopharmacology

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“…For instance, ultra-rapid cycling with four or more episodes/month occurs in some 40% of patients and ultradian cycling in some 19%. It has also been shown that the onset of depressive episodes is faster in patients with bipolar versus unipolar depressive disorder [29]. Capturing depressive (or manic) symptoms early will enhance the chance of timely and successful intervention.…”

Section: Discussionmentioning

confidence: 99%

Saving time and money: a validation of the self ratings on the prospective NIMH life-chart method (NIMH-LCM)

et al. 2014

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BackgroundCareful observation of the longitudinal course of bipolar disorders is pivotal to finding optimal treatments and improving outcome. A useful tool is the daily prospective Life-Chart Method, developed by the National Institute of Mental Health. However, it remains unclear whether the patient version is as valid as the clinician version.MethodsWe compared the patient-rated version of the Lifechart (LC-self) with the Young-Mania-Rating Scale (YMRS), Inventory of Depressive Symptoms–Clinician version (IDS-C), and Clinical Global Impression–Bipolar version (CGI-BP) in 108 bipolar I and II patients who participated in the Naturalistic Follow-up Study (NFS) of the German centres of the Bipolar Collaborative Network (BCN; formerly Stanley Foundation Bipolar Network). For statistical evaluation, levels of severity of mood states on the Lifechart were transformed numerically and comparison with affective scales was performed using chi-square and t tests. For testing correlations Pearson´s coefficient was calculated.ResultsRatings for depression of LC-self and total scores of IDS-C were found to be highly correlated (Pearson coefficient r = −.718; p < .001), whilst the correlation of ratings for mania with YMRS compared to LC-self were slightly less robust (Pearson coefficient r = .491; p = .001). These results were confirmed by good correlations between the CGI-BP IA (mania), IB (depression) and IC (overall mood state) and the LC-self ratings (Pearson coefficient r = .488, r = .721 and r = .65, respectively; all p < .001).ConclusionsThe LC-self shows a significant correlation and good concordance with standard cross sectional affective rating scales, suggesting that the LC-self is a valid and time and money saving alternative to the clinician-rated version which should be incorporated in future clinical research in bipolar disorder. Generalizability of the results is limited by the selection of highly motivated patients in specialized bipolar centres and by the open design of the study.

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“…Additional predictive symptoms were depressed mood, self-reproach or self-pity, suicidal tendencies, weight gain, somatic preoccupations, diminished concentration, irritability, and demandingness. Precipitous MDD onset was also predictive of bipolar depression vs. MDD in a study of adults 63 . Moreover, another study of depressed youth also found that psychotic features and psychomotor retardation, as well as treatment-induced (hypo-) mania and/or a BP-I family history predicted BP-I 64 .…”

Section: Evidence For a Presence Of A Bipolar–i Disorder Prodrome In mentioning

confidence: 95%

The Significance of At-Risk or Prodromal Symptoms for Bipolar I Disorder in Children and Adolescents

Hauser

Correll

2013

Can J Psychiatry

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Background While in the early identification and intervention of psychosis, specific instruments and risk criteria have been generated and validated, research into preventive strategies for bipolar-I disorder (BP-I) has only recently gained momentum. Since first signs of BP-I often start before adulthood, such efforts are especially important in the vulnerable pediatric population. Methods Narrative review of data regarding the presence and nature of potentially prodromal, i.e., sub-syndromal, symptoms prior to BP-I, defined by first-episode mania, focusing on pediatric patients. Results The possibility of early identification of youth at high-risk for BP is supported by retrospective studies of BP-I patients, and prospective studies of community samples, offspring of BP-I subjects, youth with depressive disorders, and patients at high-risk for psychosis or with BP-spectrum disorders without lifetime history of mania. These data provide essential insight into potential signs and symptoms that may enable pre-syndromal identification of BP-I in youth. However, except for offspring studies, broader prospective approaches that focus on youth at risk for BP-I and on developing specific interviews/rating scales and risk criteria are mostly missing, or in their early stage. Conclusions More work is needed to determine valid clinical high-risk criteria, to distinguish risk factors, endophenotypes and comorbidities from specific prodromal symptomatology, and to develop phase-specific interventions that titrate the risk of intervention to the risk of transition to mania and to functional impairment or distress. Moreover, studies are needed that determine potential differences in prodromal symptoms and trajectories between children, adolescents and adults, and the best phase-specific interventions.

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Onset of Depressive Episodes Is Faster in Patients With Bipolar Versus Unipolar Depressive Disorder

Cited by 32 publications

References 0 publications

Difference of symptomatology of unipolar and bipolar depression - pilot findings

Difference of symptomatology of unipolar and bipolar depression - pilot findings

Saving time and money: a validation of the self ratings on the prospective NIMH life-chart method (NIMH-LCM)

The Significance of At-Risk or Prodromal Symptoms for Bipolar I Disorder in Children and Adolescents

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