A comparative study on psycho-socio-demographic and clinical profile of patients with bipolar versus unipolar depression

Abstract

Background:Several studies have revealed significant differences between bipolar (BP) and unipolar depression (UP). Misdiagnosing BP depression results in suboptimal symptom resolution, induction of manic switch, mixed state, or accelerated cycling. This study compares various psycho-socio-demographic, longitudinal course, and phenomenological factors associated with BP and UP depression.Materials and Methods:We compared 30 UP and 30 BP depression patients using a specially designed intake proforma, International Classification of Diseases-10 diagnostic criteria for research, Hamilton Rating Scale for Depression-21 (HAMD-21), Hypomania Checklist-32 Questionnaire (HCL-32), Brief psychiatric rating scale (BPRS), and Kuppuswami's socioeconomic status scale.Results:BP depression group consisted of mostly males, with earlier age of onset of illness, longer illness duration, frequent episodes, hospitalizations and psychotic symptoms. The total HAM-D score and 4 HAM-D item scores–psychomotor retardation, insight, diurnal variation of symptoms and its severity, and paranoid symptoms were significantly higher in this group. Binary logistic regression identified the age of onset, the total duration of illness, frequency of affective episodes, and presence of delusions as predictors of bipolarity (odds ratio = 1.327; 1.517; 0.062; 0.137).Conclusions:Identification of clinical markers of bipolarity from large scale prospective studies is needed.

Characterizing the experience of auditory verbal hallucinations and accompanying delusions in individuals with a diagnosis of bipolar disorder: A systematic review

“…These findings support established theories that specify shared cross‐diagnostic mechanisms in the development of delusional thinking . Additional studies confirmed that grandiosity reaching delusional severity was most frequently reported by individuals with manic presentations, whereas persecution and paranoid delusions were most frequently reported in studies examining depressive episodes and general samples of individuals with BD irrespective of current mood episode . These results suggest a potentially direct effect of mood on the content of delusions, such that particular delusional themes may be associated with certain mood states .…”

“…Higher AH rates in mania were confirmed in these studies, but the differences reported were actually quite modest. Further examination of AH phenomena may therefore be required within the depressive phases of BD …”

“…Amongst samples of individuals specifically with mania as opposed to depression, there were twice as many studies that reported on delusions. A total of 48% to 93% of those with current or past experiences of psychotic mania reported at least one type of delusional belief, whereas, within depressive episodes, the proportions of people reporting delusions ranged from 12% to 77% . Two studies directly compared the rates of delusions in BD manic and BD depressed groups.…”

“…Negative mood states and emotions, for example, have already been well recognized for their role in influencing the occurrence and content of persecutory delusions within the SCZ literature . Delusions of reference were also commonly reported across BD samples, including cross‐culturally, and may or may not relate to grandiose beliefs about self‐worth or power. Toh and colleagues further examined the relationships between specific types of AVH and delusions in BD .…”

Thyroid profile in depression: a cross-sectional study from North-East India

“…Comparatively more unipolar cases were female and bipolar were male, which is in concordance with few other clinic-based studies but contradictory to many other studies which were basically population based. [18][19][20][21][22] Majority of the cases were of the productive age group, which might had led to a tremendous loss for the societal development.…”