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Dr. Bob is Robert Hsiung, MD,
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Posted by capricorn on July 11, 2006, at 15:01:27
10/07/2006 - Symptoms of depression act as markers of bipolar II disorder
2006 JUL 9 - -- Symptoms of depression can act as markers of bipolar II disorder. "Under-diagnosis and misdiagnosis of bipolar II disorder as a major depressive disorder are frequently reported.
Medical Letter on the CDC & FDA via NewsEdge Corporation :2006 JUL 9 - (NewsRx.com) -- Symptoms of depression can act as markers of bipolar II disorder.
"Under-diagnosis and misdiagnosis of bipolar II disorder (BP-II) as a major depressive disorder (MDD) are frequently reported. The study aim was to find which symptoms of depression could be possible cross-sectional markers of BP4-II, in order to reduce under-diagnosing BP-H. Consecutive 379 BP-II and 271 MDD major depressive episode (MDE) outpatients were interviewed with the Structured Clinical Interview for DSM-IV, the Hypomania Interview Guide, and the Family History Screen, by a senior psychiatrist in a private practice," a researcher in Italy reports.
"Inside-MDE hypomanic symptoms (elevated mood and increased self-esteem always absent by definition) were systematically assessed," said Franco Benazzi at the Hecker Psychiatry Research Center. "Mixed depression was defined as an MDE plus three or more inside-MDE hypomanic symptoms, a definition validated by Akiskal and Benazzi. The MDE symptoms significantly more common in BP-II versus MDD were weight gain, increased eating, hypersomnia, psychomotor agitation, worthlessness, and diminished ability to concentrate."
Benazzi reported, "The inside-MDE hypomanic symptoms significantly more common in BP-II were distractibility, racing/crowded thoughts, irritability, psychomotor agitation, more talkativeness, increased risky and goal-directed activities. Multiple logistic regression showed that hypersomnia, racing/crowded thoughts, irritability, and psychomotor agitation were independent predictors of BP-II. Irritability had the most balanced combination of sensitivity and specificity predicting BP-H. Psychomotor agitation had the highest specificity but the lowest sensitivity."
"Racing/crowded thoughts had the highest sensitivity but the lowest specificity," noted Benazzi. These symptoms had a similar positive predictive value (PPV) for BP-II, which was around 70% (PPV is more clinically useful than sensitivity and specificity), which in turn was similar to the PPV of mixed depression and atypical depression (two diagnostic clinical markers of BP-II). All possible combinations of these symptoms had a PPV similar to that of the individual symptoms. The validity as BP-II markers of these symptoms was supported by a significant association with bipolar family history."
Benazzi concluded, "Hypersomnia, racing/crowded thoughts, irritability, and psychomotor agitation may be useful, cross-sectional markers of BP-II. Finding these symptoms in depression should lead the clinician to careful probing for history of hypomania, which should reduce the BP-II misdiagnosed as MDD. Results may also have treatment impacts, as antidepressants used alone (i.e., no concurrent mood stabilizing agent) in BP-II depression misdiagnosed as MDD may increase cycling."
(Symptoms of depression as possible markers of bipolar II disorder. Prog Neuropsychopharmacol Biol Psychiatry, 2006;30(3):471-477).
For additional information, contact Franco Benazzi, Via Pozzetto 17, I-48010 Cervia, RA, Italy. E-mail: FrancoBenazzi
FBenazzi.it.
is: Pergamon-Elsevier Science Ltd., The Boulevard, Langford Lane, Kidlington, Oxford OX5 1GB, England.
Keywords: Forli, Italy, Mental Health, Bipolar Disorder Diagnosis, Major Depressive Disorder, Antidepressants, Bipolar Disorder Type II, Depressive Mixed State, Hypersomnia, Irritability, Racing Thoughts, Psychomotor Agitation, Diagnostics.
Posted by Phillipa on July 11, 2006, at 15:57:30
In reply to Symptoms of depression act as markers of bipolar 2, posted by capricorn on July 11, 2006, at 15:01:27
So does this mean if you have been dx'd as major depression and have lack of concentration, but not mania or hypomania you're Bipolar ll? And you need a mood stabalizer like lamictal? I'm not good at interpreting the studies. Love Phillipa
Posted by linkadge on July 11, 2006, at 16:29:04
In reply to Re: Symptoms of depression act as markers of bipolar 2 » capricorn, posted by Phillipa on July 11, 2006, at 15:57:30
Eh, I dont think that
"Hypersomnia, racing/crowded thoughts, irritability, and psychomotor agitation"
need be symtpoms of bipolar disorder. Hypersomnia is a product of depression, racing/crowded thoughts and psychomotor agitation can be a sign of severe anxiety.
Irritiability used to be a sign of depression.
I don't know.
I suppose they are redefining the diagnosis based on which medications they think will help most ?
Linkadge
Posted by nickguy on July 11, 2006, at 19:12:34
In reply to Re: Symptoms of depression act as markers of bipolar 2, posted by linkadge on July 11, 2006, at 16:29:04
my old pdoc thought I was bipolar II and put me on lithium and lamictal and neither one did anything for me. Does anybody know if that means I'm probably not bipolar? I've never felt anything remotely close to mania or risky behavior. I've always thought depression makes more sense as a diagnosis. It seems impossible to know when it's one and not the other.
Posted by linkadge on July 11, 2006, at 20:57:23
In reply to Re: Symptoms of depression act as markers of bipolar 2, posted by linkadge on July 11, 2006, at 16:29:04
I've been on a lot of mood stabilizers too. Lithium, depakote, tegretol, trileptal and the atypicals. They didn't do much.
The AD's had some umph to them, they just stopped working.
Linkadge
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