[The probability of bipolarity among patients with recurrent depressive disorder]

Over the last few years researchers have paid a lot of attention to the problem of the correct diagnosis of affective disorders. Propositions have appeared regarding the widening of the officially accepted criteria to be used in diagnosis.

The aim of the study was to assess the probability of various types of bipolar affective disorders (type 1 and 2 CHAD, as well as spectrum) among patients (n = 246) treated for recurrent depressive disorder (CHAJ).

The analysis was based on the broadened criteria for affective disorders introduced by Ghaemi et al. and Hirschfield's Questionnaire on affective disorders.

The appearance in the past of strange, risky behaviour was associated with a greater risk of type 1 CHAD in comparison to CHAJ (OR=24.5), as did extreme, irrational expenditure (OR=21. 1), a lack of criticism with respect to one's own social behaviour (OR=20.3), increased interest in sex (OR=17.7), as well as extreme self confidence (OR=12). A lack of criticism with respect to one's own social behaviour and strange, risky behaviour was associated with a greater risk of type 2 CHAD (OR=12.7 and OR=10, respectively). The greatest risk of spectrum CHAD type disorders were associated with hypomania, including drug induced (OR=15.8). as well as a lack of criticism with respect to one's own social behaviour (OR=11.8). Panic attacks appeared more often in bipolar affective disorders in comparison to recurring depressive disorders, but their frequency was similar in all three groups (CHAD-I, CHAD-II, CHAD-S). The early occurrence of depression (before 25 years of age) increased the risk of each of the three types of bipolar affective disorders significantly (by a factor of 3 to 5).

The findings indicate the necessity of discussion on sharp criteria of bipolar affective disorders. The results should be helpful in the diagnosis of such disorders, which could have important consequences for effective therapy.