Abstract
Introduction/Aim: Patients with bipolar disorder, unrecognized and with a delayed onset of manic or hypomanic episodes are often mistakenly diagnosed with unipolar depression (UD) due to shared symptomatology. The two disorders, however, have related but not identical etiopathogenesis. Immune system alterations might play a crucial role in both the onset and manifestation of these conditions. This study aimed to compare immune markers between patients with bipolar depression (BD) and unipolar depression (UD) and explore their associations with acute episode characteristics and disease progression. Material and Methods: This retrospective study included patients with BD (n=60) and UD (n=242) who were hospitalized within a two year period and whose sociodemographic information, acute episode and course of illness characteristics, and indicators of inflammation were available. Results: Patients with BD exhibited elevated mean platelet volume (MPV) compared to those with UD. MPV levels correlated with clinical characteristics in both groups; higher MPV was observed in UD patients with an earlier age of onset and a longer duration of illness. In BD patients, elevated MPV was associated with the severity of psychopathology, particularly in individuals with a history of suicide attempts and a prolonged duration of untreated disorder. Conclusion: This study indicates the presence of chronic low-grade inflammation in specific subpopulations of patients with affective disorders. Immune changes are distinct in regard to the polarity of the disorder and could be a potential indicator of the severity of psychopathology and illness chronicity.
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