Differentiating bipolar disorders from major depressive disorders: treatment implications.
BACKGROUND
Bipolar disorder is a highly prevalent mood disorder, frequently misdiagnosed as unipolar major depressive disorder.


METHODS
In order to summarize the historical and clinical features that may distinguish bipolar disorder and major depressive disorder, a MedLine search was conducted of all English-language articles published between 1996 and 2006 using the key search terms bipolar disorder and manic-depression cross-referenced with major depressive disorder.


RESULTS
Better methods for arriving at the correct diagnosis of bipolar disorder include a clinical history that evaluates symptoms beyond narrow DSM-IV criteria and the use of self-reported screening tools. Twenty-six separate features were identified that are believed to aid in the differentiation of bipolar disorder from unipolar major depressive disorder.


CONCLUSIONS
It is estimated that as many as 1 in 5 depressed outpatients may have undeclared bipolar disorder. Recognition of bipolar disorder can be improved by increasing the clinical acumen of diagnosticians and through the use of screening tools.
Muzina
David J
DJ
Cleveland Clinic Neurological Institute, Psychiatry & Psychology, Cleveland, OH 44195, USA. muzinad@ccf.org
Kemp
David E
DE
McIntyre
Roger S
RS
D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D015995:Prevalence
D000928:Antidepressive Agents