Bipolar depression: phenomenological overview and clinical characteristics

Bipolar depression: phenomenological overview and clinical characteristics Objectives: There has been increasing interest in the depressed phase of bipolar disorder (bipolar depression). This paper aims to review the clinical characteristics of bipolar depression, focusing upon its prevalence and phenomenology, related neuropsychological dysfunction, suicidal behaviour, disability and treatment responsiveness. Methods: Studies on the prevalence of depression in bipolar disorder, the comparative phenomenology of bipolar and unipolar depression, as well as neuropsychology and brain imaging studies, are reviewed. To identify relevant papers, a literature search using MEDLINE and PubMed was undertaken. Results: Depression is the predominant mood disturbance in bipolar disorder, and most frequently presents as subsyndromal, minor or dysthymic depression. Compared with major depressive disorder (unipolar depression), bipolar depression is more likely to manifest with psychosis, melancholic symptoms, psychomotor retardation (in bipolar I disorder) and ‘atypical’ symptoms. The few neuropsychological studies undertaken indicate greater impairment in bipolar depression. Suicide rates are high in bipolar disorder, with suicidal ideation, suicide attempts and completed suicides all occurring predominantly in the depressed phase of this condition. Furthermore, the depressed phase (even subsyndromal) appears to be the major contributant to the disability related to this condition. Conclusions: The significance of the depressed phase of bipolar disorder has been markedly underestimated. Bipolar depression accounts for most of the morbidity and mortality due to this illness. Current treatments have significant limitations. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Bipolar Disorders Wiley

Bipolar depression: phenomenological overview and clinical characteristics

Bipolar Disorders, Volume 6 (6) – Dec 1, 2004

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Publisher
Wiley
Copyright
Copyright © 2004 Wiley Subscription Services, Inc., A Wiley Company
ISSN
1398-5647
eISSN
1399-5618
D.O.I.
10.1111/j.1399-5618.2004.00137.x
Publisher site
See Article on Publisher Site

Abstract

Objectives: There has been increasing interest in the depressed phase of bipolar disorder (bipolar depression). This paper aims to review the clinical characteristics of bipolar depression, focusing upon its prevalence and phenomenology, related neuropsychological dysfunction, suicidal behaviour, disability and treatment responsiveness. Methods: Studies on the prevalence of depression in bipolar disorder, the comparative phenomenology of bipolar and unipolar depression, as well as neuropsychology and brain imaging studies, are reviewed. To identify relevant papers, a literature search using MEDLINE and PubMed was undertaken. Results: Depression is the predominant mood disturbance in bipolar disorder, and most frequently presents as subsyndromal, minor or dysthymic depression. Compared with major depressive disorder (unipolar depression), bipolar depression is more likely to manifest with psychosis, melancholic symptoms, psychomotor retardation (in bipolar I disorder) and ‘atypical’ symptoms. The few neuropsychological studies undertaken indicate greater impairment in bipolar depression. Suicide rates are high in bipolar disorder, with suicidal ideation, suicide attempts and completed suicides all occurring predominantly in the depressed phase of this condition. Furthermore, the depressed phase (even subsyndromal) appears to be the major contributant to the disability related to this condition. Conclusions: The significance of the depressed phase of bipolar disorder has been markedly underestimated. Bipolar depression accounts for most of the morbidity and mortality due to this illness. Current treatments have significant limitations.

Journal

Bipolar DisordersWiley

Published: Dec 1, 2004

References

  • The expanding pharmacopoeia for bipolar disorder
    Mitchell, Mitchell; Malhi, Malhi
  • Psychomotor changes in melancholic and atypical depression: unipolar and bipolar II subtypes
    Benazzi, Benazzi
  • Neuropsychological frontal lobe tests indicate that bipolar depressed patients are more impaired than unipolar
    Borkowska, Borkowska; Rybakowski, Rybakowski
  • Retrieval from semantic memory using meaningful and meaningless constructs by depressed, stable bipolar and manic patients
    Calev, Calev; Nigal, Nigal; Chazan, Chazan
  • Cognitive generation of affect in bipolar depression: an fMRI study
    Malhi, Malhi; Lagopoulos, Lagopoulos; Ward, Ward
  • Cognitive generation of affect in hypomania: an FMRI study
    Malhi, Malhi; Lagopoulos, Lagopoulos; Sachdev, Sachdev; Mitchell, Mitchell; Ivanovski, Ivanovski; Parker, Parker
  • Suicidality, panic disorder and psychosis in bipolar depression, depressive‐mania and pure‐mania
    Dilsaver, Dilsaver; Chen, Chen; Swann, Swann; Shoaib, Shoaib; Tsai‐Dilsaver, Tsai‐Dilsaver; Krajewski, Krajewski
  • Bipolar disorders and suicide behaviour
    Rihmer, Rihmer; Kiss, Kiss
  • Health care utilization and costs among privately insured patients with bipolar I disorder
    Bryant‐Comstock, Bryant‐Comstock; Stender, Stender; Devercelli, Devercelli
  • Course and outcome of depressive episodes: comparison between bipolar, unipolar and subthreshold depression
    Furukawa, Furukawa; Konno, Konno; Morinobu, Morinobu; Harai, Harai; Kitamura, Kitamura; Takahashi, Takahashi

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