title: The Bipolar II Depression Questionnaire: A Self-Report Tool for Detecting Bipolar II Depression.
abstract: Bipolar II (BP-II) depression is often misdiagnosed as unipolar (UP) depression, resulting in suboptimal treatment. Tools for differentiating between these two types of depression are lacking. This study aimed to develop a simple, self-report screening instrument to help distinguish BP-II depression from UP depressive disorder. A prototype BP-II depression questionnaire (BPIIDQ-P) was constructed following a literature review, panel discussions and a field trial. Consecutively assessed patients with a diagnosis of depressive disorder or BP with depressive episodes completed the BPIIDQ-P at a psychiatric outpatient clinic in Hong Kong between October and December 2013. Data were analyzed using discriminant analysis and logistic regression. Of the 298 subjects recruited, 65 (21.8%) were males and 233 (78.2%) females. There were 112 (37.6%) subjects with BP depression [BP-I = 42 (14.1%), BP-II = 70 (23.5%)] and 182 (62.4%) with UP depression. Based on family history, age at onset, postpartum depression, episodic course, attacks of anxiety, hypersomnia, social phobia and agoraphobia, the 8-item BPIIDQ-8 was constructed. The BPIIDQ-8 differentiated subjects with BP-II from those with UP depression with a sensitivity/specificity of 0.75/0.63 for the whole sample and 0.77/0.72 for a female subgroup with a history of childbirth. The BPIIDQ-8 can differentiate BP-II from UP depression at the secondary care level with satisfactory to good reliability and validity. It has good potential as a screening tool for BP-II depression in primary care settings. Recall bias, the relatively small sample size, and the high proportion of females in the BP-II sample limit the generalization of the results.
authors.affiliation: Department of Psychiatry, Shatin Hospital, Hong Kong SAR, China.
authors.forename: Chi Ming
authors.initials: CM
authors.lastname: Leung
authors.affiliation: Department of Psychiatry, Shatin Hospital, Hong Kong SAR, China.
authors.forename: Chi Lap
authors.initials: CL
authors.lastname: Yim
authors.affiliation: Department of Psychiatry, Shatin Hospital, Hong Kong SAR, China.
authors.forename: Connie T Y
authors.initials: CT
authors.lastname: Yan
authors.affiliation: Department of Psychiatry, Shatin Hospital, Hong Kong SAR, China.
authors.forename: Cheuk Chi
authors.initials: CC
authors.lastname: Chan
authors.affiliation: Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China.
authors.forename: Yu-Tao
authors.initials: YT
authors.lastname: Xiang
authors.affiliation: Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: Arthur D P
authors.initials: AD
authors.lastname: Mak
authors.affiliation: King's College London, King's Health Partners, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom.
authors.forename: Marcella Lei-Yee
authors.initials: ML
authors.lastname: Fok
authors.affiliation: School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia.|The University of Notre Dame Australia/Marian Centre, Perth, Australia.
authors.forename: Gabor S
authors.initials: GS
authors.lastname: Ungvari
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D057566:Self Report; D011795:Surveys and Questionnaires