FURTHER DISTINCTIONS BETWEEN MANIC-DEPRESSIVE ILLNESS (BIPOLAR DISORDER) AND PRIMARY DEPRESSIVE DISORDER (UNIPOLAR DEPRESSION)

Objective: Patients with bipolar disorder differ from patients with un ipolar depression by having family histories of mania with an earlier onset and by having more episodes over a life-time. This study was des igned to determine whether additional aspects of course of illness, th e presence of medical diseases, childhood traits, and other familial i llnesses separate the two groups. Method: In a large collaborative stu dy, consecutively admitted bipolar and unipolar patients were systemat ically given clinical interviews. Data were collected on medical disea ses and childhood behavioral traits. Systematic family history and fam ily study data were also obtained. The patients were studied every 6 m onths for 5 years. Results: The group of bipolar patients had an earli er onset, a more acute onset, more total episodes, and more familial m ania and were more likely to be male. These differences were relativel y independent of each other. The bipolar patients were also more likel y to have shown traits of hyperactivity as children. The unipolar pati ents had a significantly greater number of lifetime medical/surgical i nterventions than the bipolar patients, even when age was controlled. Alcoholism was more frequently found in the families of the bipolar pa tients, even when alcoholism in the probands was controlled, however, this difference was not significant. Conclusions: This study supports the usefulness of distinguishing between bipolar and unipolar patients in treatment and research studies.