title: Undiagnosed Bipolar Disorders in Patients with Major Depressive Episode: Iran's part of a Multicenter Cross-Sectional Study.
abstract: OBJECTIVE
  Bipolar spectrum disorders may often go undiagnosed or unrecognized. The aim of this study was to determine the proportion of bipolar disorder symptoms in Iranian patients with a major depressive episode.
  
  
  METHODS
  313 patients with a current DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders 4th ed. Text rev.) diagnosed with a major depressive episode entered this cross-sectional study. Thirty two items revised Hypomania/ mania Symptoms Checklist (HCL-32) was used to determine the frequency of bipolar episodes.
  
  
  RESULTS
  Considerable proportion of patients (53.9%) previously diagnosed as major depressive disorder fulfilled the criteria for bipolar disorder by Bipolarity Specifier. The Bipolarity Specifier additionally identified significant association for manic / hypomanic states during antidepressants therapy (p<0.0003) and current mixed mood symptoms (p<0.0001).
  
  
  CONCLUSIONS
  Bipolar symptoms meeting the criteria for bipolar disorders in depressed patients who have not been previously diagnosed with bipolar disorder are frequent. Current DSM criteria may not be sufficient to diagnose more subtle or atypical forms of bipolar disorders.
authors.affiliation: Department of Psychiatry and Psychiatry Research Center, Tehran University of Medical Sciences.
authors.forename: Seyed Ali Ahmadi
authors.initials: SA
authors.lastname: Abhari
authors.forename: Majid
authors.initials: M
authors.lastname: Sadeghi
authors.forename: Seyed Mehdi Samimi
authors.initials: SM
authors.lastname: Ardestani
authors.forename: Yousef
authors.initials: Y
authors.lastname: Semnani
authors.forename: Gholamreza
authors.initials: G
authors.lastname: Mirsepassi
authors.forename: Seyed Saeed
authors.initials: SS
authors.lastname: Sadr
authors.forename: Atefe
authors.initials: A
authors.lastname: Kamaloo
authors.forename: Morvarid
authors.initials: M
authors.lastname: Ahadi
authors.forename: Behin
authors.initials: B
authors.lastname: Pourmirza
authors.forename: Elham
authors.initials: E
authors.lastname: Mir
keywords: Bipolar Spectrum; Bipolar disorder; Bipolarity Specifier; Hypomania; Major depressive disorder; Mania