Differences in symptom expression between unipolar and bipolar spectrum depression: Results from a nationally representative sample using item response theory (IRT).

Hoertel N(1), Blanco C(2), Peyre H(3), Wall MM(4), McMahon K(2), Gorwood P(5), Lemogne C(6), Limosin F(6).



BACKGROUND: The inclusion of subsyndromal forms of bipolarity in the fifth edition of the DSM has major implications for the way in which we approach the diagnosis of individuals with depressive symptoms. The aim of the present study was to use methods based on item response theory (IRT) to examine whether, when equating for levels of depression severity, there are differences in the likelihood of reporting DSM-IV symptoms of major depressive episode (MDE) between subjects with and without a lifetime history of manic symptoms.

METHODS: We conducted these analyses using a large, nationally representative sample from the USA (n=34,653), the second wave of the National Epidemiologic Survey on Alcohol and Related Conditions.

RESULTS: The items sadness, appetite disturbance and psychomotor symptoms were better indicators of depression severity in participants without a lifetime history of manic symptoms, in a clinically meaningful way. DSM-IV symptoms of MDE
were substantially less informative in participants with a lifetime history of manic symptoms than in those without such history.

LIMITATIONS: Clinical information on DSM-IV depressive and manic symptoms was based on retrospective self-report

CONCLUSIONS: The clinical presentation of depressive symptoms may substantially differ in individuals with and without a lifetime history of manic symptoms. These findings alert to the possibility of atypical symptomatic presentations among individuals with co-occurring symptoms or disorders and highlight the importance of continued research into specific pathophysiology differentiating unipolar and bipolar depression.

Copyright © 2016 Elsevier B.V. All rights reserved.
J Affect Disord. 2016 Nov 1;204:24-31. doi: 10.1016/j.jad.2016.06.042.
Epub 2016 Jun 15.

DOI: 10.1016/j.jad.2016.06.042
PMID: 27318596  [PubMed - in process]




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Application to PET images of children with autistic spectrum disordersFactoring neurotrophins into a neurite-based pathophysiological model of schizophrenia.Association of Inflammation Genes with Alcohol Dependence/Abuse: A Systematic Review and a Meta-Analysis.Brain circuits mediating baroreflex bradycardia inhibition in rats: an anatomical and functional link between the cuneiform nucleus and the periaqueductal grey.Is It Possible to Recognize Cervical Artery Dissection on Stroke Brain MR Imaging? A Matched Case-Control Study.Secreted factors from brain endothelial cells maintain glioblastoma stem-like cell expansion through the mTOR pathway.Infarction of “non-core-non-penumbral” tissue after stroke: Multivariate modelling of clinical impactSecreted amyloid precursor protein β and secreted amyloid precursor protein α induce axon outgrowth in vitro through Egr1 signaling pathwayScheduled feeding results in adipogenesis and increased acylated ghrelin.Restenosis Is More Frequent After Carotid Stenting Than After Endarterectomy: The EVA-3S Study.Clinical Relevance of Tumor Cells with Stem-Like Properties in Pediatric Brain TumorsNeurobiology of attention deficit/hyperactivity disorder.Prevalence of MRI-defined recent silent ischemia and associated bleeding risk with thrombolysis.Charte des publications