Simple Screening Assessment Distinguishes Bipolar from Unipolar Depression

In an article just published in the Journal of Clinical Psychiatry, Dr David A Solomon, a clinical associate professor of psychiatry and human behaviour at Brown University, and his colleagues outline a simple 3-factor assessment which they report can in many cases distinguish between bipolar major depression and unipolar major depression.

According to a press release which accompanied the publication of the journal article:

Based on Research Diagnostic Criteria, the sample included 91 subjects with bipolar I major depression, 52 with bipolar II major depression and 338 with unipolar major depression, who were followed for up to 20 years. The researchers divided their study population into three groups: a bipolar I index sample, a bipolar I cross-validation sample and a bipolar II cross-validation sample. Each group included subjects with unipolar and bipolar major depression.

Assessment of 59 possible variables in people with bipolar I major depression compared with subjects with unipolar major depression in the first of the sample groups identified three variables displaying the greatest differences between bipolar I subjects and unipolar subjects. These were the presence of delusions during the current episode of major depression, the number of earlier episodes of major depression, and family history of major depression or mania.

Just the following three factors enabled the screen to identify bipolar major depression with a sensitivity of 0.82 in the bipolar I index sample, 0.72 in the bipolar I cross-validation sample and 0.58 in the bipolar II cross-validation sample:

• presence of delusions during the current episode of major depression
• number of earlier episodes of major depression
• family history of major depression or mania

The study is reported starting on pages 434-442 of the Journal of Clinical Psychiatry, vol. 67:

Distinguishing Bipolar Major Depression From Unipolar Major Depression With the Screening Assessment of Depression-Polarity (SAD-P). David A. Solomon, Andrew C. Leon, Jack D. Maser, Christine J. Truman, William Coryell, Jean Endicott, Jedediah J. Teres, and Martin B. Keller.

See our separate screening test for bipolar disorder and our earlier article “Mistakenly Diagnosing Bipolar Disorder”.

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