RT Journal
A1 Perlis RH, Uher R, Ostacher M, et al
T1 ASsociation between bipolar spectrum features and treatment outcomes in outpatients with major depressive disorder
JF Archives of General Psychiatry
JO Archives of General Psychiatry
YR 2010
FD December 6
VO 68
IS 4
SP 351
OP 360
DO 10.1001/archgenpsychiatry.2010.179
UL http://dx.doi.org/10.1001/archgenpsychiatry.2010.179
AB 
The distinction between major depressive disorder (MDD) and bipolar disorder remains a challenging clinical problem when individuals present with a major depressive episode.1- 3 A number of illness features have been proposed to indicate risk of bipolar disorder in this setting, including earlier age of illness onset,4- 7 greater number of depressive recurrences or briefer episodes,4,6,8- 9 family history of bipolar disorder,6,9- 11 and aspects of temperament such as hyperthymia and cyclothymia.12- 15 Symptomatic differences have also been proposed, among them presence of irritability or anger,16- 19 presence of psychotic symptoms,10- 11,20- 26 suicidality,6,25 and atypical neurovegetative symptoms7,23,27- 29 including psychomotor agitation or slowing.10,30- 31 Moreover, even in individuals who do not meet full syndromal criteria for bipolar I or II disorder, it has been suggested that these illness features may be markers for an underlying bipolar diathesis or bipolar spectrum illness.2,32