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Onset of depressive episodes is faster in patients with bipolar versus unipolar depressive disorder: Evidence from a retrospective comparative study

Lookup NU author(s): Professor Heinz Grunze

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Abstract

Objective: Depressive episodes can have a very fast onset (< 1 hour) or start very slowly (> 1 month). This interesting aspect, pointing to different neurophysiologicai pathomechanisms, has not been systematically evaluated so far. The aim of this study was to describe speed of onset of depressive episodes in a consecutive sample of patients with at least 1 depressive episode and to investigate potential differences between patients with major depression versus bipolar affective disorders concerning this variable. Method: We examined 158 consecutive adult patients with major depression (N = 108) and bipolar disorder (N = 50) diagnosed according to criteria of the International Statistical Classification of Diseases, 10th revision, by applying the structured Onset-of-Deprcssion Inventory. Patients with acute critical life events preceding the onset were excluded from final analyses. Data were collected between December 2001 and January 2007. Results: There was a significant positive association between speed of onset of the present depressive episode and that of the preceding depressive episode (p = 0.66, p < .001). Patients with bipolar disorder developed full-blown depressive episodes significantly faster than patients with major depression (p < .001): Whereas depressive episodes began within 1 week in 58% of patients with bipolar disorder, this was the case in only 7.4% of patients with major depression. Conclusion: Intraindividually, the speed of onset of depression is similar across different episodes. In the absence of acute critical life events, fast onset of depressive episodes (within 1 week) is common in bipolar disorder but rare in major depression. This aspect might be useful to identify depressive episodes occurring within a bipolar affective illness and might characterize a subgroup of patients with a distinct neurobiology. © 2008 PHYSICIANS POSTGRADUATE PRESS, INC.

Publication metadata

Author(s): Hegerl U, Bottner A-C, Holtschmidt-Täschner B, Born C, Seemüller F, Scheunemann W, Schütze M, Grunze H, Henkel V, Mergl R, Angst J

Publication type: Article

Publication status: Published

Journal: Journal of Clinical Psychiatry

Year: 2008

Volume: 69

Issue: 7

Pages: 1075-1080

ISSN (print): 0160-6689

ISSN (electronic): 1555-2101

Publisher: Physicians Postgraduate Press, Inc.

URL: http://dx.doi.org/10.4088/JCP.v69n0705

DOI: 10.4088/JCP.v69n0705

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