SAN FRANCISCO, May 21, 2003 /PRNewswire via COMTEX/ -- For some time, researchers have noted differences between bipolar depression and unipolar depression. Now, new data from a large epidemiological study of bipolar disorder reinforce these observations, with results showing that disease severity can be significantly worse in people with symptoms of bipolar depression versus those with unipolar depression.(1,2) Data from 2,801 American adult respondents were analyzed to compare the impact of bipolar depression to that of unipolar depression and healthy controls, was presented today at the American Psychiatric Association's (APA) annual scientific meeting.(3)
Researchers found that respondents who screened positive for bipolar depression on the Mood Disorder Questionnaire (MDQ), or who reported a physician diagnosis of bipolar disorder and depression, were significantly more likely to report more disruption in work, social and family functioning and symptom days versus those with unipolar depression.(4) Specifically, those with symptoms of bipolar depression were more likely to report a negative impact on their professional life, including poor work performance, arguments outside the home and a lack of interest in their work compared to those with unipolar depression.(5)
"Those of us who treat patients with bipolar depression have long known how debilitating and devastating it is," said Dr. Robert Hirschfeld, MD, Titus Harris Chair and Professor and Chair of Psychiatry and Behavioral Sciences at the University of Texas Medical Branch in Galveston. "Depression is the bane of bipolar illness and our ability to treat it effectively has been limited. Today our outlook is more positive because we're developing new treatment options that may be particularly effective in the treatment and long-term prevention of bipolar depression."
Compared to unipolar depression, past data show that bipolar depression is characterized by greater episode frequency, earlier onset and greater co- occurring substance abuse.(6,7) Because of potential biological differences, researchers note that treatments differ for unipolar and bipolar depression.(8,9)
People with bipolar disorder often talk to a physician for the first time during a depressive episode and do not mention their manic episodes, frequently resulting in an incorrect diagnosis of unipolar depression.(10,11) A separate analysis presented at APA from this large epidemiological study, showed that 41 percent of respondents who screened positive for symptoms of bipolar disorder were diagnosed with another illness, particularly unipolar depression. Of those who screened positive and received a diagnosis of bipolar disorder, 52 percent used traditional antidepressants, either alone or in combination with other therapies.(12)
"Despite the severity of bipolar depression, people with this illness can lead positive, fulfilling lives," said Lydia Lewis, executive director, Depression and Bipolar Support Alliance. "However, because it so often goes undiagnosed or misdiagnosed and the consequences of improper treatment can be so grave, it is crucial that people work with their doctor to obtain early and accurate diagnosis."
When Diagnosis is Bipolar Disorder, Depression Still Most Burdensome
In another analysis from this epidemiological study, researchers examined the effects of depressive versus manic symptoms in adults who screened positive for bipolar disorder. The results showed depression is associated with significantly greater psychosocial burden compared to mania. The study found that depressive symptoms were more disruptive than mania - significantly affecting work, social and family life -- and that bipolar depression occurred for much longer periods of time.(13)
The depressive episodes associated with bipolar disorder are known to occur more frequently, last longer and result in more death and disease than mania.(14) In fact, nearly all suicides in people with bipolar disorder are associated with bipolar depression.(15)
About the Prevalence and Impact Study
The study was designed to assess the prevalence and impact of bipolar disorder in the United States. The Mood Disorder Questionnaire (MDQ) -- a screening tool for bipolar disorder -- was mailed to 127,800 U.S. adults with a 67 percent (85,358 returns) rate of response. The survey was distributed to a representative sample of adults, balanced to match the 2000 U.S. census data for age, gender, region, market size and household income. A positive MDQ screen was defined as recognition of seven or more out of 13 bipolar symptoms plus co-occurrence of at least two symptoms and patient-rated assessment of moderate or serious degree of functional impairment due to symptoms. The results of impact were then based on survey responses from MDQ respondents.
About Bipolar Disorder
Bipolar disorder, also known as manic-depressive illness, is a life-long, potentially fatal illness characterized by disabling and disruptive mood swings from high (manic) to low (depressed) states. There are two major types of bipolar disorder. Bipolar I disorder is characterized by the occurrence of one or more manic or mixed episodes and often individuals have also had one or more major depressive episodes; in bipolar II disorder, a person experiences hypomania (a milder form of mania with less severe symptoms) and has a history of a major depressive episode. If manic and depressive symptoms occur simultaneously, it is called a "mixed" episode.(16)
Although there is no cure for bipolar disorder, the revised APA guidelines stressed that treatment can significantly improve symptoms associated with the illness.(17) One of the most serious risks of bipolar disorder is suicide, which is associated most often with the depressive phase.(18)
Suicide completion rates may be as high as 10-15 percent of patients with bipolar I disorder,(19,20) during it one of the most serious and deadly psychiatric illnesses. Additionally, researchers estimate that more than 60 percent of individuals with bipolar disorder have problems with alcohol or drugs during their illness.(21) When left untreated, bipolar disorder can worsen and patients can experience a greater frequency of events. For more information on bipolar I disorder, please contact your physician or visit www.dbsalliance.org
About the DBSA
The mission of the Depression and Bipolar Support Alliance (DBSA) is to improve the lives of people living with mood disorders. Founded in 1986 and based in Chicago, DBSA (previously known as the National Depressive and Manic-Depressive Association) is the nation's largest patient-directed, illness-specific organization. Guided by a 65-member Scientific Advisory Board comprised of the leading researchers and clinicians in the field of mood disorders, it has nearly 1,000 support groups across the country. More than two million people request information and assistance each year. For more information on depression and bipolar disorder, visit www.DBSAlliance.org or call 800-826-3632.
Funding for the study was provided by GlaxoSmithKline.
(1) Hirschfeld R., et. al. "Screening for Bipolar Disorder in the
Community." J. Clin. Psy. 2003;64:53-59.
(2) Hirschfeld R., et. al. "Impact of Bipolar Depression Compared to
Unipolar Depression." American Psychiatric Association, May 20, 2003.
(3) Hirschfeld R., et. al. "Impact of Bipolar Depression Compared to
Unipolar Depression." American Psychiatric Association, May 20, 2003.
(4) Hirschfeld R., et. al. "Impact of Bipolar Depression Compared to
Unipolar Depression." American Psychiatric Association, May 20, 2003.
(5) Hirschfeld R., et. al. "Impact of Bipolar Depression Compared to
Unipolar Depression." American Psychiatric Association, May 20, 2003.
(6) Goodwin F. and K. Jamison. Manic-Depressive Illness. Oxford
University Press, New York. 1990.
(7) Jefferson J., et. al. "Mood Disorders". The American Psychiatric
Press Textbook of Psychiatry, American Psychiatric Press, Washington
D.C. 1988.
(8) Hirschfeld RM., et. al. "Practice Guideline for the Treatment of
Patients with Bipolar Disorder" American Journal of Psychiatry;
Washington; Apr 2002.
(9) Hirschfeld RM., et. al. "Practice Guideline for the Treatment of
Patients with Bipolar Disorder" American Journal of Psychiatry;
Washington; Apr 2002.
(10) Hirschfeld R., et. al. "Impact of Bipolar Depression Compared with
Unipolar Depression." American Psychiatric Association, May 20,2003.
(11) Hirschfeld RMA, et. al. "Practice Guideline for the Treatment of
Patients with Bipolar Disorder (Revision)." American Journal of
Psychiatry. 2002; 159:4.
(12) Frye M., et. al. "Patterns of Health Resource Utilization in Subjects
with Bipolar Disorders" American Psychiatric Association, May 21,
2003.
(13) Hirschfeld R., et. al. "Burden of Manic Versus Depressive Symptoms
in Patients with Bipolar Disorder." American Psychiatric Association,
May 20, 2003.
(14) Kaplan H, and Benjamin Sadock. Synopsis of Psychiatry:Behavioral
Sciences/Clinical Psychiatry. Williams & Wilkins:Baltimore, Maryland.
1998.
(15) Oquenda MA., et. al. "Suicidal Behavior in Bipolar Mood Disorder:
Clinical Characteristics of Attempters and Nonattempters."
J. Affect. Disorder. 2000:Aug;59 (2): 107-17.
(16) Depression and Bipolar Support Alliance. "Bipolar Disorder: Rapid
Cycling and its Treatment." Depression and Bipolar Support Alliance
(DBSA). 2002.
(17) Hirschfeld RMA, et. al. "Practice Guideline for the Treatment of
Patients with Bipolar Disorder (Revision)." American Journal of
Psychiatry. 2002; 159:4.
(18) Tondo L, Baldessarini RJ. "Reduced suicide risk during lithium
maintenance treatment." Journal of Clinical Psychiatry 2000; 61
(suppl 9) 97-104.
(19) Baldessarini RJ, et al. "Effects of lithium treatment and its
discontinuation on suicidal behavior in bipolar manic-depressive
disorders." Journal of Clinical Psychiatry 1999; 60 (suppl 2) 77-84.
(20) Hirschfeld RM., et. al. "Practice Guideline for the Treatment of
Patients with Bipolar Disorder" American Journal of Psychiatry;
Washington; Apr 2002.
(21) Regier DA, et al. "Comorbidity of mental disorders with alcohol and
other drug abuse: results from the Epidemiologic Catchment Area (ECA)
Study." JAMA 1990; 264:2511-2518.
SOURCE Depression and Bipolar Support Alliance
CONTACT: Gloria Pope, Depression and Bipolar Support Alliance, External
Relations Director, +1-312-988-1164, gpope@dbsalliance.org; or Abenaa Hayes,
Manning, Selvage & Lee, +1-212-213-7044, +1-646-418-7224,
abenaa.hayes@mslpr.com, for Depression and Bipolar Support Alliance
URL: http://www.DBSAlliance.org http://www.prnewswire.com
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Last updated: 06/19/2003 - 08:53 PM