Diagnostic guidelines for bipolar depression: a probabilistic approach

Bipolar Disorders
Philip B MitchellRobert M A Hirschfeld

Abstract

There are currently no accepted diagnostic criteria for bipolar depression for either research or clinical purposes. This paper aimed to develop recommendations for diagnostic criteria for bipolar I depression. Studies on the clinical characteristics of bipolar and unipolar depression were reviewed. To identify relevant papers, literature searches using PubMed and Medline were undertaken. There are no pathognomonic characteristics of bipolar I depression compared to unipolar depressive disorder. There are, however, replicated findings of clinical characteristics that are more common in both bipolar I depression and unipolar depressive disorder, respectively, or which are observed in unipolar-depressed patients who 'convert' (i.e., who later develop hypo/manic symptoms) to bipolar disorder over time. The following features are more common in bipolar I depression (or in unipolar 'converters' to bipolar disorder): 'atypical' depressive features such as hypersomnia, hyperphagia, and leaden paralysis; psychomotor retardation; psychotic features, and/or pathological guilt; and lability of mood. Furthermore, bipolar-depressed patients are more likely to have an earlier age of onset of their first depressive episode, to have more prior...Continue Reading

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Bipolar Disorder

Bipolar disorder is characterized by manic and/or depressive episodes and associated with uncommon shifts in mood, activity levels, and energy. Discover the latest research this illness here.