Differentiating Bipolar Disorder From Major Depressive Disorder

CE / CME

eCase: Differentiating Bipolar Disorder From Major Depressive Disorder: Clinical Conundrums and Treatment Recommendations

Physician Assistants/Physician Associates: 0.75 AAPA Category 1 CME credit

Social Workers: 0.75 ASWB ACE CE Credit

Pharmacists: 0.75 contact hour (0.075 CEUs)

Psychologists: 0.75 APA CE Credit

Nurses: 0.75 Nursing contact hour

Physicians: Maximum of 0.75 AMA PRA Category 1 Credit

Released: October 17, 2022

Expiration: October 16, 2023

Holly A. Swartz
Holly A. Swartz, MD

Activity

Progress
1
Course Completed

  1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5-TR. Fifth edition, text revision. ed. Washington, DC: American Psychiatric Association Publishing, 2022.
  2. Merikangas KR, Jin R, He JP, et al. Prevalence and correlates of bipolar spectrum disorder in the world mental health survey initiative. Arch Gen Psychiatry. 2011;68:241.
  3. Vieta E, Berk M, Schulze TG, et al. Bipolar disorders. Nat Rev Dis Primers. 2018;4:18008.
  4. Judd LL, Akiskal HS, Schettler PJ, et al. Psychosocial disability in the course of bipolar I and II disorders: a prospective, comparative, longitudinal study. Arch Gen Psychiatry. 2005;62:1322.
  5. Maina G, Albert U, Bellodi L, et al. Health-related quality of life in euthymic bipolar disorder patients: differences between bipolar I and II subtypes. J Clin Psychiatry. 2007;68:207.
  6. Michalak EE, Yatham LN, Lam RW. Quality of life in bipolar disorder: a review of the literature. Health Qual Life Outcomes. 2005;3:72.
  7. Bonnin CM, Sanchez-Moreno J, Martinez-Aran A, et al. Subthreshold symptoms in bipolar disorder: impact on neurocognition, quality of life and disability. J Affect Disord. 2012;136:650.
  8. Novick DM, Swartz HA, Frank E. Suicide attempts in bipolar I and bipolar II disorder: a review and meta-analysis of the evidence. Bipolar Disord. 2010;12:1.
  9. Schaffer A, Isometsa ET, Tondo L, et al. International Society for Bipolar Disorders Task Force on Suicide: meta-analyses and meta-regression of correlates of suicide attempts and suicide deaths in bipolar disorder. Bipolar Disord. 2015;17:1.
  10. Weiner M, Warren L, Fiedorowicz JG. Cardiovascular morbidity and mortality in bipolar disorder. Ann Clin Psychiatry. 2011;23:40.
  11. Forty L, Ulanova A, Jones L, et al. Comorbid medical illness in bipolar disorder. Br J Psychiatry. 2014;205:465.
  12. Kato T, Baba K, Guo W, et al. Impact of bipolar disorder on health-related quality of life and work productivity: estimates from the national health and wellness survey in Japan. J Affect Disord. 2021;295:203.
  13. Simon J, Pari AAA, Wolstenholme J, et al. The costs of bipolar disorder in the United Kingdom. Brain Behav. 2021;11:e2351.
  14. Bessonova L, Ogden K, Doane MJ, et al. The economic burden of bipolar disorder in the United States: a systematic literature review. Clinicoecon Outcomes Res. 2020;12:481.
  15. Ghaemi SN, Ko JY, Goodwin FK. “Cade’s disease” and beyond: misdiagnosis, antidepressant use, and a proposed definition for bipolar spectrum disorder. Can J Psychiatry. 2002;47:125.
  16. Perlis RH. Misdiagnosis of bipolar disorder. Am J Manag Care. 2005;11:S271.
  17. Baldessarini RJ, Tondo L, Baethge CJ, et al. Effects of treatment latency on response to maintenance treatment in manic-depressive disorders. Bipolar Disord. 2007;9:386.
  18. Hirschfeld RM, Calabrese JR, Weissman MM, et al. Screening for bipolar disorder in the community. J Clin Psychiatry. 2003;64:53.
  19. Hirschfeld RM, Lewis L, Vornik LA. Perceptions and impact of bipolar disorder: how far have we really come? Results of the national depressive and manic-depressive association 2000 survey of individuals with bipolar disorder. J Clin Psychiatry. 2003;64:161.
  20. Glauser TA, Cerenzia W, Wiley S, et al. Identifying psychiatrists’ practice patterns when managing depression in patients with bipolar I disorder: a descriptive study to inform education needs. Postgrad Med. 2013;125:144.
  21. Seemüller F, Severus E, Moller HJ, et al. Antidepressants and suicidality in younger adults—is bipolar illness the missing link? Acta Psychiatr Scand. 2009;119:166.
  22. Wehr TA, Goodwin FK. Can antidepressants cause mania and worsen the course of affective illness? Am J Psychiatry. 1987;144:1403.
  23. Judd LL, Akiskal HS, Schettler PJ, et al. The long-term natural history of the weekly symptomatic status of bipolar I disorder. Arch Gen Psychiatry. 2002;59:530.
  24. Kupka RW, Altshuler LL, Nolen WA, et al. Three times more days depressed than manic or hypomanic in both bipolar I and bipolar II disorder. Bipolar Disord. 2007;9:531.
  25. Judd LL, Schettler PJ, Akiskal HS, et al. Long-term symptomatic status of bipolar I vs. bipolar II disorders. Int J Neuropsychopharmacol. 2003;6:127.
  26. Craddock N, Sklar P. Genetics of bipolar disorder. Lancet. 2013;381:1654.
  27. Caspi A, Moffitt TE. Gene-environment interactions in psychiatry: joining forces with neuroscience. Nat Rev Neurosci. 2006;7:583.
  28. Kessler RC, Berglund P, Demler O, et al. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62:593.
  29. Weissman MM, Klerman GL. Sex differences and the epidemiology of depression. Arch Gen Psychiatry. 1977;34:98.
  30. Sachs GS, Nierenberg AA, Calabrese JR, et al. Effectiveness of adjunctive antidepressant treatment for bipolar depression. N Engl J Med. 2007;356:1711.
  31. Bowden CL. A different depression: clinical distinctions between bipolar and unipolar depression. J Affect Disord. 2005;84:117.
  32. Pacchiarotti I, Bond DJ, Baldessarini RJ, et al. The International Society for Bipolar Disorders (ISBD) task force report on antidepressant use in bipolar disorders. Am J Psychiatry. 2013;170:1249.
  33. O'Donovan C, Alda M. Depression preceding diagnosis of bipolar disorder. Front Psychiatry. 2020;11:500.
  34. Hirschfeld RM, Holzer C, Calabrese JR, et al. Validity of the mood disorder questionnaire: a general population study. Am J Psychiatry. 2003;160:178.
  35. Zimmerman M, Galione JN. Screening for bipolar disorder with the Mood Disorders Questionnaire: a review. Harv Rev Psychiatry. 2011;19:219.
  36. Simon NM, Otto MW, Wisniewski SR, et al. Anxiety disorder comorbidity in bipolar disorder patients: data from the first 500 participants in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Am J Psychiatry. 2004;161:2222.
  37. Perugi G, Angst J, Azorin JM, et al. Mixed features in patients with a major depressive episode: the BRIDGE-II-MIX study. J Clin Psychiatry. 2015;76:e351.
  38. Goldberg JF. Antidepressants: the scapegoat of poor outcome bipolar disorder? Aust N Z J Psychiatry. 2012;46:302.
  39. Cuellar AK, Johnson SL, Winters R. Distinctions between bipolar and unipolar depression. Clin Psychol Rev. 2005;25:307.
  40. Berk M, Cowdery S, Williams L, et al. Recalibrating the risks and benefits of lithium therapy. Br J Psychiatry. 2017;211:1.
  41. Malhi GS, Gessler D, Outhred T. The use of lithium for the treatment of bipolar disorder: Recommendations from clinical practice guidelines. J Affect Disord. 2017;217:266.
  42. Perlis RH, Ostacher MJ, Miklowitz DJ, et al. Benzodiazepine use and risk of recurrence in bipolar disorder: a STEP-BD report. J Clin Psychiatry. 2010;71:194.
  43. Yatham LN, Kennedy SH, Parikh SV, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. Bipolar Disord. 2018;20:97.
  44. Loebel A, Cucchiaro J, Silva R, et al. Lurasidone monotherapy in the treatment of bipolar I depression: a randomized, double-blind, placebo-controlled study. Am J Psychiatry. 2014;171:160.
  45. Earley WR, Burgess MV, Khan B, et al. Efficacy and safety of cariprazine in bipolar I depression: a double-blind, placebo-controlled phase 3 study. Bipolar Disord. 2020;22:372.
  46. Calabrese JR, Durgam S, Satlin A, et al. Efficacy and safety of lumateperone for major depressive episodes associated with bipolar I or bipolar II disorder: a phase 3 randomized placebo-controlled trial. Am J Psychiatry. 2021;178:1098.