title: Distinguishing Bipolar Depression from Unipolar Depression in Youth: Preliminary Findings.
abstract: OBJECTIVE
  To identify mood symptoms that distinguishes bipolar disorder (BP) depression versus unipolar depression in youth during an acute depressive episode.
  
  
  METHODS
  Youth with BP (N = 30) were compared with youth with unipolar depression (N = 59) during an acute depressive episode using the depression and mania items derived from the Schedule for Affective Disorders and Schizophrenia for Children (K-SADS)-Present Version. The results were adjusted for multiple comparisons, and any significant between-group differences in demographic, nonmood comorbid disorders, and psychiatric family history.
  
  
  RESULTS
  In comparison with unipolar depressed youth, BP depressed youth had significantly higher scores in several depressive symptoms and all subsyndromal manic symptoms, with the exception of increased goal-directed activity. Among the depressive symptoms, higher ratings of nonsuicidal physical self-injurious acts and mood reactivity, and lower ratings of aches/pains, were the symptoms that best discriminated BP from unipolar depressed youth. Subsyndromal manic symptoms, particularly motor hyperactivity, distractibility, and pressured speech, were higher in BP depressed youth and discriminated BP depressed from unipolar depressed youth.
  
  
  CONCLUSIONS
  The results of this study suggest that it is possible to differentiate BP depression from unipolar depression based on depressive symptoms, and in particular subsyndromal manic symptoms. If replicated, these results have important clinical and research implications.
authors.affiliation: 1 Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania.
authors.forename: Rasim Somer
authors.initials: RS
authors.lastname: Diler
authors.affiliation: 1 Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania.
authors.forename: Tina R
authors.initials: TR
authors.lastname: Goldstein
authors.affiliation: 1 Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania.
authors.forename: Danella
authors.initials: D
authors.lastname: Hafeman
authors.affiliation: 1 Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania.
authors.forename: John
authors.initials: J
authors.lastname: Merranko
authors.affiliation: 1 Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania.
authors.forename: Fangzi
authors.initials: F
authors.lastname: Liao
authors.affiliation: 2 Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto Faculty of Medicine , Toronto, Canada .
authors.forename: Benjamin I
authors.initials: BI
authors.lastname: Goldstein
authors.affiliation: 3 Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University , Providence, Rhode Island.
authors.forename: Heather
authors.initials: H
authors.lastname: Hower
authors.affiliation: 1 Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania.
authors.forename: Mary Kay
authors.initials: MK
authors.lastname: Gill
authors.affiliation: 3 Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University , Providence, Rhode Island.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Hunt
authors.affiliation: 3 Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University , Providence, Rhode Island.
authors.forename: Shirley
authors.initials: S
authors.lastname: Yen
authors.affiliation: 3 Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University , Providence, Rhode Island.
authors.forename: Martin B
authors.initials: MB
authors.lastname: Keller
authors.affiliation: 4 Department of Psychiatry, Nationwide Children's Hospital , The Ohio State College of Medicine, Columbus, Ohio.
authors.forename: David
authors.initials: D
authors.lastname: Axelson
authors.affiliation: 5 Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California , Los Angeles, Los Angeles, California.
authors.forename: Michael
authors.initials: M
authors.lastname: Strober
authors.affiliation: 6 Department of Statistics, University of Pittsburgh , Pittsburgh, Pennsylvania.
authors.forename: Satish
authors.initials: S
authors.lastname: Iyengar
authors.affiliation: 1 Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania.
authors.forename: Neal D
authors.initials: ND
authors.lastname: Ryan
authors.affiliation: 1 Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania.
authors.forename: Boris
authors.initials: B
authors.lastname: Birmaher
mesh_terms: D000293:Adolescent; D001714:Bipolar Disorder / Q000145:classification / Q000175:diagnosis* / Q000523:psychology; D002648:Child; D003865:Major Depressive Disorder / Q000145:classification / Q000175:diagnosis* / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007175:Impulsive Behavior; D008297:Male; D011595:Psychomotor Agitation; D012720:Severity of Illness Index
keywords: atypical depressive symptoms; bipolar; depression; manic symptoms; mixed features