Patient characteristics associated with diagnostic conversion from major depressive disorder to bipolar disorder
Patient characteristics associated with diagnostic conversion from major depressive disorder to bipolar disorder
Younger age at onset of first episode of major depression
Family history of bipolar disorder
Depressive episode(s) with psychosis (eg, delusions and/or hallucinations) in younger individuals
Depressive episode(s) with some symptoms of hypomania that do not meet diagnostic criteria for bipolar disorder (eg, decreased need for sleep, unusually high energy, increased goal-directed activity)
Treatment-resistant depression
Attention deficit hyperactivity disorder
Substance use disorder
The prevalence of bipolar disorder is significantly lower than that of major depressive disorder (MDD). Although these features can increase the likelihood of a future diagnosis of bipolar disorder, most individuals with MDD who have these characteristics will not develop bipolar disorder. Establishing a diagnosis of bipolar disorder requires the use of specific diagnostic criteria and the presence of either a current or past episode of mania or hypomania.
References:
Bukh JD, Andersen PK, Kessing LV. Rates and predictors of remission, recurrence and conversion to bipolar disorder after the first lifetime episode of depression--A prospective 5-year follow-up study. Psychol Med 2016; 46:1151.
Chen MH, Chen YS, Hsu JW, et al. Comorbidity of ADHD and subsequent bipolar disorder among adolescents and young adults with major depression: A nationwide longitudinal study. Bipolar Disord 2015; 17:315.
Pinto de Oliveira J, Jansen K, Cardoso T, et al. Predictors of conversion from major depressive disorder to bipolar disorder. Psychiatry Res 2021; 297:113740.
Wilde A, Chan HN, Rahman B, et al. A meta-analysis of the risk of major affective disorder in relatives of individuals affected by major depressive disorder or bipolar disorder. J Affect Disord 2014; 158:37.
