Features of Depressive Episode with Onset in Adolescence and the Risk of Developing Bipolar Depression

Abstract

Objectives. To study the clinical features of depressive episode with onset in late adolescence associated with the risk of developing bipolar affective disorder (BAD). Materials and methods. A total of 40 patients with BAD (ICD-10 F31) after manifest depressive state, corresponding to the diagnostic criteria for “depressive episode” (F32), at age 15–18 years were studied. The duration of follow-up was 3–5 years. Psychopathological, follow-up, and statistical methods were used. Results. The duration of manifest depressive episodes in patients with BAD was no greater than six months in 70% of cases. Clinical features included frequent psychomotor inhibition, anergy, anhedonia, melancholy, irritability, affective instability with elevated emotional reactivity, and hypersomnia. Less typical were “atypical” depressive symptoms. Suicidal tendencies accompanying psychopathy-like behavioral abnormalities and abuse of psychoactive substances were seen at signifi cant frequency. In most cases, manifest depressive state was accompanied by deterioration in social functioning and led to school maladaptation. Conclusions. Bipolar depression manifest in late adolescence was characterized by a relatively short duration, a predominance of typical depressive symptoms (melancholy, psychomotor inhibition), irritability, increased emotional reactivity, hypersomnia, and an elevated frequency of suicidal tendencies.