A study of incidence of bipolar disorder in patients treated for major depression

Abstract

Aim: Recurrent episodes of depression are common in both unipolar and bipolar disorder, but diagnostic and clinical problem with bipolar mood disorder is that hypomanic episodes usually go unnoticed by caretakers and clinicians. Several studies have indicated that if carefully looked for, 25% of patients with major depressive disorder have history of bipolarity. So we aim 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. Methodology: One hundred consecutive patients, in tertiary care hospital in Ahmadabad, who were being treated as major depressive disorder according to DSM-4 TR and assessed using scales, HAM-D, GAF, Hypomania Check List-32(HCL) and Mood Disorder Questionnaire (MDQ). Patients who scored higher in HCL and MDQ were assessed in details by MINI. Results: 100 patients of unipolar depression were taken in study, out of which 16 patients were found to have bipolar mood disorder after assessment. Our incidence of bipolar mood disorder in patients treated as unipolar depression is 16%. Patients of bipolar depression had significantly higher number of prior mood episodes, family history of mood disorder and episodes with psychotic features. Conclusion -Bipolarity is confidently diagnosable in a substantial proportion of patients being treated as unipolar major depression. All the patients of unipolar depression must be screened for bipolarity to give them specific treatment with better results and better quality of life. Keywords: Major depressive disorder, Unipolar depression, Bipolar depression.