[Major depression: features indicative of bipolarity?].
Several recent studies have shown that bipolar disorder is underdiagnosed in patients with major depression. Missing the diagnosis of a bipolar disorder may have serious and even occasionally fatal consequences for a patient with the disease. Moreover misdiagnosis may lead to inappropriate treatment and therefore contribute to worsening medical and functional prognosis. Although there are no pathognomonic characteristics of bipolar depression compared to unipolar depression, evidence-based findings suggest that some features may be indicative of bipolarity, in patients with depression. These features are related to clinical picture of depressive state, course of episode and illness, response to treatment, family history, comorbid conditions, as well as demographic and temperamental characteristics. Based on such features, some authors have proposed operationalized criteria or a diagnostic specific for bipolarity, to identify bipolar depression. Screening instruments may also be used, to facilitate early recognition. Validation studies of these diagnostic features and instruments are underway.
Pôle universitaire de psychiatrie hôpital Ste Marguerite, 270 bd Sainte-Marguerite, 13274 Marseille cedex 09, France. jazorin@ap-hm.fr
J-M
JM
Azorin
D001714:Bipolar Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics / Q000523:psychology; D003937:Diagnosis, Differential; D019317:Evidence-Based Medicine; D020022:Genetic Predisposition to Disease; D006801:Humans; D008403:Mass Screening; D010552:Personality Assessment; D013694:Temperament; D016896:Treatment Outcome