[Predictive factors in the bipolarization of depressive disorders]

Since 1966 maniac-depressive illness has been divided into bipolar disorder (BP) and unipolar disorder (UP). Both groups are still in the process of subtyping (bipolar I,II,III and the tentative subtyping of unipolar group by Winokur). When affective disorder begins with depressive episodes is it possible to predict future mania and anticipate BP diagnosis? Are they variables of good predicting value for bipolarization? The issue is of importance since handicap, evolution, prognosis, treatment are somewhat different for UP and BP. Several studies indicate some possible predictors of bipolarization: pharmacological mania, bipolar familial antecedents, postpartum first episode, hypersomnia and psychomotor retardation, psychotic depression, etc. Special attention is given to switch to mania during antidepressant treatment.