Distinguishing Bipolar Depression from Unipolar Depression in Youth: Preliminary Findings

作者：Diler Rasim Somer; Goldstein Tina R; Hafeman Danella; Merranko John; Liao Fangzi; Goldstein Benjamin I; Hower Heather; Gill Mary Kay; Hunt Jeffrey; Yen Shirley; Keller Martin B; Axelson David; Strober Michael; Iyengar Satish; Ryan Neal D; Birmaher Boris

来源：Journal of Child and Adolescent Psychopharmacology, 2017, 27(4): 310-319.

DOI：10.1089/cap.2016.0154

• depression
• bipolar
• atypical depressive symptoms
• manic symptoms
• mixed features

Objectives: 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.

• 出版日期2017-5