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Clinical differences between bipolar and unipolar depression

Department of Psychological Medicine, School of Medicine, Cardiff University

Lisa Jones, PhD

Department of Psychiatry, Division of Neuroscience, University of Birmingham

Ian Jones, PhD

Department of Psychological Medicine, School of Medicine, Cardiff University

Sian Caesar, BSc and Carly Cooper, BSc

Department of Psychiatry, Division of Neuroscience, University of Birmingham

Christine Fraser, BSc and Katherine Gordon-Smith, PhD

Department of Psychological Medicine, School of Medicine, Cardiff University

Sally Hyde, BSc

Department of Psychiatry, Division of Neuroscience, University of Birmingham

Anne Farmer, MD and Peter McGuffin, PhD

Medical Research Council Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, London

Nick Craddock, PhD

Department of Psychological Medicine, School of Medicine, Cardiff University, Cardiff

Correspondence: Professor Nick Craddock, Department of Psychological Medicine, Henry Wellcome Building, Wales School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN, UK. Email: craddockn{at}cf.ac.uk

Declaration of interest

Funding from the Wellcome Trust, the UK Medical Research Council and GlaxoSmithKline.

It is commonly – but wrongly – assumed that there are no important differences between the clinical presentations of major depressive disorder and bipolar depression. Here we compare clinical course variables and depressive symptom profiles in a large sample of individuals with major depressive disorder (n=593) and bipolar disorder (n=443). Clinical characteristics associated with a bipolar course included the presence of psychosis, diurnal mood variation and hypersomnia during depressive episodes, and a greater number of shorter depressive episodes. Such features should alert a clinician to a possible bipolar course. This is important because optimal management is not the same for bipolar and unipolar depression.

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Sukhwinder S. Shergill
BJP 2008 192: 18. [Full Text]