title: A diagnosis of bipolar spectrum disorder predicts diagnostic conversion from unipolar depression to bipolar disorder: a 5-year retrospective study.
abstract: BACKGROUND
  The major aims of this study were to identify factors that may predict the diagnostic conversion from major depressive disorder (MDD) to bipolar disorder (BP) and to evaluate the predictive performance of the bipolar spectrum disorder (BPSD) diagnostic criteria.
  
  
  METHODS
  The medical records of 250 patients with a diagnosis of MDD for at least 5 years were retrospectively reviewed for this study.
  
  
  RESULTS
  The diagnostic conversion from MDD to BP was observed in 18.4% of 250 MDD patients, and the diagnostic criteria for BPSD predicted this conversion with high sensitivity (0.870) and specificity (0.917). A family history of BP, antidepressant-induced mania/hypomania, brief major depressive episodes, early age of onset, antidepressant wear-off, and antidepressant resistance were also independent predictors of this conversion.
  
  
  CONCLUSIONS
  This study was conducted using a retrospective design and did not include structured diagnostic interviews.
  
  
  CONCLUSIONS
  The diagnostic criteria for BPSD were highly predictive of the conversion from MDD to BP, and conversion was associated with several clinical features of BPSD. Thus, the BPSD diagnostic criteria may be useful for the prediction of bipolar diathesis in MDD patients.
authors.affiliation: Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Young Sup
authors.initials: YS
authors.lastname: Woo
authors.affiliation: Department of Psychiatry, Cancer Center, Dongnam Institute of Radiological & Medical Sciences, Busan, Republic of Korea.
authors.forename: In Hee
authors.initials: IH
authors.lastname: Shim
authors.affiliation: Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Hee-Ryung
authors.initials: HR
authors.lastname: Wang
authors.affiliation: Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Hoo Rim
authors.initials: HR
authors.lastname: Song
authors.affiliation: Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Tae-Youn
authors.initials: TY
authors.lastname: Jun
authors.affiliation: Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address: wmbahk@catholic.ac.kr.
authors.forename: Won-Myong
authors.initials: WM
authors.lastname: Bahk
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001714:Bipolar Disorder / Q000175:diagnosis*; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity
chemical_list: D000928:Antidepressive Agents
keywords: Bipolar depression; Bipolar spectrum disorder; Diagnostic conversion; Unipolar depression