Is there a continuity between bipolar and depressive disorders?

Full Abstract

BACKGROUND:
Recent studies questioned the current categorical split of mood disorders into bipolar disorders (BP) and depressive disorders (MDD).

METHODS:
Medline database search of papers from the last 10 years on the categorical-dimensional classification of mood disorders. Various combinations of the following key words were used:
mood disorders, bipolar, unipolar, major depressive disorder, spectrum, category/categorical, classification, continuity. Only English language clinical papers were included, review papers were excluded, similar papers selected by quality. The number of papers found was 1,141. The number of papers selected was 109.

RESULTS:
The continuity/spectrum between BP (mainly BP-II) and MDD was supported by the following findings:(1) high frequency of mixed states (mixed mania, mixed hypomania, mixed depression, i.e. co-occurring depression and noneuphoric manic/hypomanic symptoms) because opposite polarity symptoms in the same episode do not support a hypomania/mania-depression splitting; (2) MDD was the most common mood disorder in BP probands' relatives; (3) no bimodal distribution of distinguishing symptoms between BP and MDD; (4) bipolar signs not uncommon in MDD; (5) many MDD shifting to BP; (6) many lifetime manic/hypomanic symptoms in MDD; (7) correlation between lifetime manic/hypomanic symptoms and MDD symptoms; (8) hypomania factors in MDD; (9) MDD often recurrent; (10) similar cognitive style.The categorical distinction between BP (mainly BP-I) and MDD was supported by the following findings:
(1) BP more common in BP probands' relatives; (2) lower age at BP onset; (3) females as common as males in BP-I, more common than males in MDD; (4) BP-I depression more atypical and retarded, MDD depression more sleepless and agitated; (5) BP more recurrent.

CONCLUSIONS:
Focusing on mood spectrum's extremes (BP-I vs. MDD), a categorical distinction seems supported. Focusing on midway disorders (BP-II and MDD plus bipolar signs), a continuity/spectrum seems supported. Results seem to support both a categorical and a dimensional view of mood disorders.Copyright 2007 S. Karger AG, Basel.

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Author information

Author/s: Benazzi, Franco (F);

Affiliation: Hecker Psychiatry Research Center, and Department of Psychiatry, National Health Service, Forli, Italy. FrancoBenazzi(-atsign-)FBenazzi.it

Journal and publication information

Publication Type: Journal Article; Review

Journal: Psychotherapy and psychosomatics (Psychother Psychosom), published in Switzerland. (Language: eng)

Reference: 2007-; vol 76 (issue 2) : pp 70-6

Dates: Created 2007/01/18; Completed 2007/03/30;

PMID: 17230047, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Bipolar Disorder - classification; diagnosis; genetics; psychology
Depressive Disorder, Major - classification; diagnosis; genetics; psychology
Diagnosis, Differential
Follow-Up Studies

Follow-Up Studies
Genetic Predisposition to Disease - genetics
Humans
Recurrence

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