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Bipolar I and II versus unipolar depression: Clinical differences and impulsivity/aggression traits

Published online by Cambridge University Press:  15 April 2020

K. Dervic ,
M. Garcia-Amador ,
K. Sudol ,
P. Freed ,
D.A. Brent ,
J.J. Mann ,
J.M. Harkavy-Friedman  and
M.A. Oquendo
K. Dervic
Affiliation:
Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute and Columbia University, 1051, Riverside Drive, NY10032, New YorkUSA Department of Psychiatry and Behavioral Science, College of Medicine, United Arab Emirates University, Al Ain, United Arab Emirates
M. Garcia-Amador
Affiliation:
Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
K. Sudol
Affiliation:
Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute and Columbia University, 1051, Riverside Drive, NY10032, New YorkUSA
P. Freed
Affiliation:
286, Madison Ave, New York, NY10016, USA
D.A. Brent
Affiliation:
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
J.J. Mann
Affiliation:
Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute and Columbia University, 1051, Riverside Drive, NY10032, New YorkUSA
J.M. Harkavy-Friedman
Affiliation:
American Foundation for Suicide Prevention, USA
M.A. Oquendo*
Affiliation:
Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute and Columbia University, 1051, Riverside Drive, NY10032, New YorkUSA
*
* Corresponding author. E-mail address:[email protected] (M.A. Oquendo).
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Abstract

Objective:

To investigate distinguishing features between bipolar I, II and unipolar depression, and impulsivity/aggression traits in particular.

Methods:

Six hundred and eighty-five (n = 685) patients in a major depressive episode with lifetime Unipolar (UP) depression (n = 455), Bipolar I (BP-I) disorder (n = 151), and Bipolar II (BP-II) (n = 79) disorder were compared in terms of their socio-demographic and clinical characteristics.

Results:

Compared to unipolar patients, BP-I and BP-II depressed patients were significantly younger at onset of their first depressive episode, and were more likely to experience their first depressive episode before/at age of 15. They also had more previous affective episodes, more first- and second-degree relatives with history of mania, more current psychotic and subsyndromal manic symptoms, and received psychopharmacological and psychotherapy treatment at an earlier age. Furthermore, BP-I and BP-II depressed patients had higher lifetime impulsivity, aggression, and hostility scores. With regard to bipolar subtypes, BP-I patients had more trait-impulsivity and lifetime aggression than BP-II patients whereas the latter had more hostility than BP-I patients. As for co-morbid disorders, Cluster A and B Personality Disorders, alcohol and substance abuse/dependence and anxiety disorders were more prevalent in BP-I and BP-II than in unipolar patients. Whereas the three groups did not differ on other socio-demographic variables, BP-I patients were significantly more often unemployed that UP patients.

Conclusion:

Our findings comport with major previous findings on differences between bipolar and unipolar depression. As for trait characteristics, bipolar I and II depressed patients had more life-time impulsivity and aggression/hostility than unipolar patients. In addition, bipolar I and II patients also differed on these trait characteristics.

Keywords

MoodAggressionImpulsivityPersonality disorderSubstance abuse
Type
Original article
Information
European Psychiatry , Volume 30 , Issue 1 , January 2015 , pp. 106 - 113
Copyright
Copyright © European Psychiatric Association 2020

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