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.
Cleveland Clinic Neurological Institute, Psychiatry & Psychology, Cleveland, OH 44195, USA. muzinad@ccf.org
David J
DJ
Muzina
David E
DE
Kemp
Roger S
RS
McIntyre
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