Comparative study of prodromal symptoms between bipolar disorder and recurrent major depressive disorder

Abstract

Objective To explore the differences of prodromal symptoms between bipolar disorder (BD) and recurrent major depressive disorder (RMDD). Methods We used the Bipolar Prodrome Symptom Interview and Scale-Retrospective to investigate 74 BD patients and 37 RMDD patients, which included open questions and semi-structured questions about the 39 prodromal symptoms to the first full depressive episode. Results (1) Most of BD patients (91.9%, 68/74) and RMDD patients (97.3%, 36/37) could recognize their prodromal symptoms. (2) BD patients reported more psychotic symptoms than RMDD patients (t=- 3.761, P=0.001). (3) Compared with RMDD patients, more BD patients reported prodromal symptoms, overly cheerful/happy/on top of the world(16 cases (21.6%, 16/74) vs. 2 cases (5.4%, 2/37) , χ2= 5.269, P=0.022), overly talkative (19 cases (25.7%, 19/74) vs. 3 cases (8.1%,3/37), χ2=5.370, P=0.020), racing thoughts or jumping from one thought to another (17 cases (23.0%,17/74) vs. 3 cases (8.1%,3/37 ) , χ2=4.168, P=0.041) , extremely energetic or active (18 cases (24.3%,18/74) vs. 1 cases (2.7%, 1/37) , χ2= 8.777, P=0.003) , overly self confident (14 cases (18.9%, 17/74) vs. 0, χ2=8.514, P=0.002) , and frequent mood swings/lability (38 cases (51.4%, 38/74) vs. 8 cases (24.3%, 8/37), χ2=10.537, P=0.001) , and these symptoms were more likely to be a part of the bipolar prodromal symptoms. Conclusions BD patients and RMDD patients represent different prodromal symptoms, which could promote early identification and early intervention of BD. Key words: Bipolar disorder; Depressive disorder; Prodromal symptoms