title: Bipolar I and II versus unipolar depression: clinical differences and impulsivity/aggression traits.
abstract: OBJECTIVE
  To investigate distinguishing features between bipolar I, II and unipolar depression, and impulsivity/aggression traits in particular.
  
  
  METHODS
  Six hundred and eighty-five (n=685) patients in a major depressive episode with lifetime Unipolar (UP) depression (n=455), Bipolar I (BP-I) disorder (n=151), and Bipolar II (BP-II) (n=79) disorder were compared in terms of their socio-demographic and clinical characteristics.
  
  
  RESULTS
  Compared to unipolar patients, BP-I and BP-II depressed patients were significantly younger at onset of their first depressive episode, and were more likely to experience their first depressive episode before/at age of 15. They also had more previous affective episodes, more first- and second-degree relatives with history of mania, more current psychotic and subsyndromal manic symptoms, and received psychopharmacological and psychotherapy treatment at an earlier age. Furthermore, BP-I and BP-II depressed patients had higher lifetime impulsivity, aggression, and hostility scores. With regard to bipolar subtypes, BP-I patients had more trait-impulsivity and lifetime aggression than BP-II patients whereas the latter had more hostility than BP-I patients. As for co-morbid disorders, Cluster A and B Personality Disorders, alcohol and substance abuse/dependence and anxiety disorders were more prevalent in BP-I and BP-II than in unipolar patients. Whereas the three groups did not differ on other socio-demographic variables, BP-I patients were significantly more often unemployed that UP patients.
  
  
  CONCLUSIONS
  Our findings comport with major previous findings on differences between bipolar and unipolar depression. As for trait characteristics, bipolar I and II depressed patients had more life-time impulsivity and aggression/hostility than unipolar patients. In addition, bipolar I and II patients also differed on these trait characteristics.
authors.affiliation: Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute and Columbia University, 1051, Riverside Drive, NY 10032, New York, USA; Department of Psychiatry and Behavioral Science, College of Medicine, United Arab Emirates University, Al Ain, United Arab Emirates.
authors.forename: K
authors.initials: K
authors.lastname: Dervic
authors.affiliation: Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Garcia-Amador
authors.affiliation: Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute and Columbia University, 1051, Riverside Drive, NY 10032, New York, USA.
authors.forename: K
authors.initials: K
authors.lastname: Sudol
authors.affiliation: 286, Madison Ave, New York, NY 10016, USA.
authors.forename: P
authors.initials: P
authors.lastname: Freed
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: D A
authors.initials: DA
authors.lastname: Brent
authors.affiliation: Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute and Columbia University, 1051, Riverside Drive, NY 10032, New York, USA.
authors.forename: J J
authors.initials: JJ
authors.lastname: Mann
authors.affiliation: American Foundation for Suicide Prevention, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Harkavy-Friedman
authors.affiliation: Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute and Columbia University, 1051, Riverside Drive, NY 10032, New York, USA. Electronic address: mao4@columbia.edu.
authors.forename: M A
authors.initials: MA
authors.lastname: Oquendo
mesh_terms: D000328:Adult; D000374:Aggression; D001714:Bipolar Disorder / Q000523:psychology*; D015897:Comorbidity; D003866:Depressive Disorder / Q000523:psychology; D003865:Major Depressive Disorder / Q000523:psychology*; D005260:Female; D006801:Humans; D007175:Impulsive Behavior; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D015995:Prevalence; D019966:Substance-Related Disorders
keywords: Aggression; Impulsivity; Mood; Personality disorder; Substance abuse