title: The clinical characteristics of unipolar vs. bipolar major depression in ADHD youth.
abstract: OBJECTIVE
  To investigate the characteristics of unipolar vs. bipolar depression in youth using a sample of children referred for a study on attention deficit hyperactivity disorder (ADHD).
  
  
  METHODS
  We compared children with unipolar depression (N=109) to those with bipolar depression (N=43) using boys and girls (N=280) referred for a study on ADHD. Comparisons were made in characteristics of depression, comorbidity and family history. All diagnoses were made using the KSADS-E.
  
  
  RESULTS
  In comparison to children with unipolar depression, children with bipolar depression were more likely to have met criteria for depression due to both "sad" and "mad" mood states as stated in the KSADS-E, have severe depression with suicidality, anhedonia and hopelessness. Children with bipolar depression were more likely to have comorbid conduct disorder, severe oppositional defiant disorder, agoraphobia, obsessive compulsive disorder and alcohol abuse, compared to children with unipolar depression. Bipolar depressed children had lower GAF scores and higher rates of hospitalization. Bipolar depression is associated with higher levels of psychiatric disorders in first-degree relatives.
  
  
  CONCLUSIONS
  In youth, bipolar depression is distinct from unipolar depression in quality and severity of symptoms, comorbidity and family history. This presentation can aid clinicians in identifying children and adolescents with bipolar disorder.
authors.affiliation: Pediatric Psychopharmacology Research Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. jwozniak@partners.org
authors.forename: Janet
authors.initials: J
authors.lastname: Wozniak
authors.forename: Thomas
authors.initials: T
authors.lastname: Spencer
authors.forename: Joseph
authors.initials: J
authors.lastname: Biederman
authors.forename: Anne
authors.initials: A
authors.lastname: Kwon
authors.forename: Michael
authors.initials: M
authors.lastname: Monuteaux
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Rettew
authors.forename: Kathryn
authors.initials: K
authors.lastname: Lail
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications* / Q000523:psychology*; D001714:Bipolar Disorder / Q000175:diagnosis / Q000523:psychology*; D016022:Case-Control Studies; D002648:Child; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology*; D003937:Diagnosis, Differential; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000150:complications / Q000523:psychology; D010375:Pedigree; D012720:Severity of Illness Index