Clinical features of soft bipolarity in major depressive inpatients
Article first published online: 6 SEP 2006
Psychiatry and Clinical Neurosciences
Volume 60, Issue 5, pages 611–615, October 2006
How to Cite
UTSUMI, T., SASAKI, T., SHIMADA, I., MABUCHI, M., MOTONAGA, T., OHTANI, T., TOCHIGI, M., KATO, N. and NANKO, S. (2006), Clinical features of soft bipolarity in major depressive inpatients. Psychiatry and Clinical Neurosciences, 60: 611–615. doi: 10.1111/j.1440-1819.2006.01566.x
- Issue published online: 6 SEP 2006
- Article first published online: 6 SEP 2006
- Received 2 December 2005; revised 10 February 2006; accepted 26 February 2006.
- bipolar II disorder;
- borderline personality disorder;
- premorbid personality;
- soft bipolarity;
Abstract Because of the difficulties of ascertaining episode of hypomania by past history of the patients, it is of clinical value to find variables which predict the development of bipolar II disorder in depressive patients. Taking advantage of relatively long hospitalization, the authors tried to elucidate fine clinical features of the soft bipolarity. The subjects were 39 patients with Major Depressive Episode, diagnosed according to the 4th edition of the Diagnostic and Statistical Manual criteria. Among them, 15 patients were diagnosed as bipolar II disorder (BPII), whereas 24 patients were with unipolar depression (UP), using a structured clinical interview to assess the mood spectrum (SCI-MOODS). In addition to ordinary clinical and demographic variables, the authors studied fine symptomatology of depression, premorbid personality, and interpersonal relationship. Continuous variables were analyzed by t-test. Categorical variables were tested by χ2 analysis. In terms of premorbid personality, manic type (Zerssen) was found more frequently in BPII (UP 2/24, BPII 9/15, P < 0.05). Patients with BPII tended to show apparently quick disappearance of depressive symptoms (UP 2/24, BPII 9/15, P = 0.01). The most prominent result was a high prevalence of comorbidity of borderline personality disorder (BPD) among BPII (UP 0/24, BPII 6/15, P = 0.02). As Akiskal indicated that mood lability represents the most powerful predictor of hypomanias, patients with BPII showed quick response in mood to admission. The current subjects with BPII had high frequency of manic type of premorbid personality, indicating the usefulness of this variable for the prediction of hypomanias. Finally, the authors could observe development of BPD during hospitalization exclusively among BPII, to support the possibility of BPD as a state effect of BPII.