Determining the Incidence of Bipolar Disorder in Patients Treated for Major Depression: An Observational Study

Description

Abstract (English)

Abstract
Aim: The aim of the present study was to assess the proportion of patients with features of bipolar disorder
amongst those primarily diagnosed and treated as major depressive disorder and compare the symptom profile
of unipolar depression and bipolar depression.
Methods: The present study was conducted in the Department of Psychiatry for one year who were being
treated as Major Depressive Disorder according to DSM-4 TR and were receiving antidepressant medications,
were included in the study. 200 patients were included in the study. All the patients were above age of 18 years
and have informant available. Participants were included in the study after taking informed consent.
Results: 64% were females. Majority of selected patients were married females (78%). 19% patients were
illiterate and 80% were hindus. 52% were staying in nuclear family and 85% belonged to urban area. 85%
patients had no history of suicide and there was no family history of any psychiatric illness in 60%. 170 patients
had bipolar disorder and 30 patients had unipolar disorder. Patients having Bipolar Mood disorder were
significantly younger than unipolar depression. No significant difference was found in sex, marital status,
education, religion, income, family type, occupation or locality between two groups. Number episodes of illness
were significantly higher in bipolar mood disorder than unipolar. Family history of mood disorder was
significantly higher in bipolar disorder group than unipolar. In clinical features, there was no significant
difference in suicide attempt between both groups. Significant difference was found in diurnal variation.
Psychotic features were significantly higher in bipolar mood disorder patients than unipolar depression.
Conclusion: It is clear that with high index of suspicion, bipolarity is patently diagnosable in a substantial
proportion of patients being treated as unipolar major depression. They have difference in clinical features from
unipolar depression in the form early age of onset, positive family history for mood disorder, more number of
mood episodes and presence of psychotic features during the depressive episode and course of illness