Bipolar depression versus unipolar depression: demographic and clinical differences

Abstract

Abstract Background Unipolar depression (UD) and bipolar depression (BD) are both characterized by depressive symptoms. In clinical practice, it is hard to distinguish between BD and UD. This often results in misdiagnosis of BD. Misdiagnosis and consequently incorrect treatment represents a burden on patient, society and family. There is still a need for more detailed differentiation between unipolar and bipolar depression to avoid misdiagnosis. Based on this background, the aim of this study was to draw a map for clear, precise, detailed, and simple differentiation points between bipolar and unipolar depression. Methods This study is a cross-sectional study. It concluded a consecutive sample of 178 patients diagnosed with depression. Depression was diagnosed using DSM-5 criteria and confirmed with the use of the Structured Clinical Interview for DSM-5 Disorders, Clinician Version (SCID-5-CV). Having a history of manic episodes confirms the diagnosis of bipolar depression. All patients were subjected to socio-demographic and clinical data collection form, application of Hamilton depression rating scale, Bipolar Depression Rating Scale (mixed subscale), Beck Hopelessness Scale, Montreal Cognitive Assessment Test (MoCA), and the Sheehan Disability Scale, as differentiation tools. Results There was a statistically considerable increased frequency of divorced patients, previous depression episodes, previous manic episodes, family history of mood disorders, and hospitalization rate among the bipolar depression group. Regarding the unipolar depression group, there was a considerable rise in the number of female patients and precipitating factors of unipolar depression. There was a considerable rise in anxiety psychic and agitation mean scores of Hamilton depression scale among the bipolar depression group, while there was a statistically considerable increase in anxiety somatic mean score among the unipolar depression group. There was a statistically considerable increase in the severity of all parameters and total score of mixed subscale of Bipolar Depression Rating Scale among the bipolar depression group. No statistically significant difference was found between the studied groups in total Beck hopelessness mean score and the total MOCA mean score. There was a considerable rise in social life mean score and days lost mean score in Sheehan Disability Scale among the bipolar depression group. Conclusions The differentiating points between bipolar and unipolar depression include a considerable increase in divorce, family history of mood disorders, previous depressive episodes, previous hospitalization, anxiety psychic agitation, restlessness, irritability, disability in social life, and days lost per week among the bipolar depressive group. On the other hand, there was a considerable increase of unipolar depression among the female gender. Precipitating factors of unipolar depression and anxiety somatic symptoms are significantly higher among the unipolar depression group. Taking these points into account is extremely beneficial in accurately distinguishing between unipolar and bipolar depression and thus providing accurate treatment.

Keywords

• Bipolar depression
• Unipolar depression
• Differences