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6 - Atypical depression and its relation to bipolar spectrum

Published online by Cambridge University Press:  10 August 2009

By
Franco Benazzi
Edited by
Andreas Marneros  and
Frederick Goodwin
Franco Benazzi
Affiliation:
Hecker Psychiatry Research Center University of California in San Diego (USA) collaborating center Ravenna Italy; University of Szeged (Hungary) National Health Service Forli Italy
Andreas Marneros
Affiliation:
Martin Luther-Universität Halle-Wittenburg, Germany
Frederick Goodwin
Affiliation:
George Washington University, Washington DC
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Summary

Introduction: the relationship of atypical depression to bipolar II disorder

The focus of this chapter on the relationship between atypical depression (AD) (different definitions, including Diagnostic and Statistical Manual of Mental Disorders, 4th edn (DSM-IV): (American Psychiatric Association, 1994) definition) and bipolar (BP) spectrum is the relationship between BP-II and AD, because BP-II is the most common and best-studied disorder of the BP spectrum disorders. BP-II was recently found to be very common in the community (11.0% BP-II versus 11.4% unipolar (UP): Angst et al., 2003) and in major depressive episode (MDE) outpatients (up to 60%: Cassano et al., 1992; Angst, 1996; Benazzi, 1997a, 2001a; Hantouche et al., 1998; Perugi et al., 1998; Akiskal et al., 2000; Benazzi and Akiskal, 2003a). But nevertheless BP-II is still underdiagnosed (Ghaemi et al., 2000). Lumping bipolar-I (BP I) and BP-II together is not supported by the BP-II strong diagnostic stability (Coryell et al., 1995), different family history (more BP-II than BP-I in first-degree relatives of BP-II) (Goodwin and Jamison, 1990; Coryell, 1999), and by linkage studies (McMahon et al., 2001).

The most recent definitions of BP spectrum come from Akiskal and Pinto (1999), Ghaemi et al. (2002), and Angst et al. (2003). Akiskal and Pinto's definition includes BP-I, BP-II (hypomania and MDE ± cyclothymic disorder), BP-III (antidepressant and stimulant-associated hypomania), and BP-IV (depressive mixed state, that is, a MDE plus some concurrent hypomanic symptoms).

Keywords

atypical depressionbipolar spectrumhypomaniamajor depressive episodeunipolar
Type
Chapter
Information
Bipolar Disorders
Mixed States, Rapid Cycling and Atypical Forms
 , pp. 131 - 156
Publisher: Cambridge University Press
Print publication year: 2005

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  • Atypical depression and its relation to bipolar spectrum
    • By Franco Benazzi, Hecker Psychiatry Research Center University of California in San Diego (USA) collaborating center Ravenna Italy; University of Szeged (Hungary) National Health Service Forli Italy
  • Edited by Andreas Marneros, Martin Luther-Universität Halle-Wittenburg, Germany, Frederick Goodwin, George Washington University, Washington DC
  • Book: Bipolar Disorders
  • Online publication: 10 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544019.007
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  • Atypical depression and its relation to bipolar spectrum
    • By Franco Benazzi, Hecker Psychiatry Research Center University of California in San Diego (USA) collaborating center Ravenna Italy; University of Szeged (Hungary) National Health Service Forli Italy
  • Edited by Andreas Marneros, Martin Luther-Universität Halle-Wittenburg, Germany, Frederick Goodwin, George Washington University, Washington DC
  • Book: Bipolar Disorders
  • Online publication: 10 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544019.007
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  • Atypical depression and its relation to bipolar spectrum
    • By Franco Benazzi, Hecker Psychiatry Research Center University of California in San Diego (USA) collaborating center Ravenna Italy; University of Szeged (Hungary) National Health Service Forli Italy
  • Edited by Andreas Marneros, Martin Luther-Universität Halle-Wittenburg, Germany, Frederick Goodwin, George Washington University, Washington DC
  • Book: Bipolar Disorders
  • Online publication: 10 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544019.007
Available formats
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