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Diagnostic conversion from unipolar to bipolar affective disorder-A population-based study.
Young Tak Jo1, Sung Woo Joo1, Harin Kim1
1Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Journal of Affective Disorders
|January 22, 2022
Summary
Diagnostic conversion from unipolar to bipolar disorder occurs in 6.5% of patients. Younger age and antidepressant use, particularly SNRIs, increase this risk, highlighting the need for clinical vigilance.
Area of Science:
- Psychiatry
- Epidemiology
- Pharmacology
Background:
- Distinguishing unipolar and bipolar affective disorders is clinically crucial.
- Diagnostic conversion, where unipolar depression is later diagnosed as bipolar disorder, presents a challenge.
Purpose of the Study:
- To investigate the rate and risk factors of diagnostic conversion from unipolar to bipolar affective disorder.
- To analyze the influence of antidepressant use on diagnostic conversion.
Main Methods:
- Utilized nationwide population-based register data from Korea's Health Insurance Review Agency (2007-2020).
- Identified a cohort of patients diagnosed with unipolar depression in 2009, excluding those with prior psychiatric diagnoses.
- Analyzed diagnostic conversion rates and associated risk factors, focusing on antidepressant usage.
Main Results:
- Approximately 6.5% of patients experienced diagnostic conversion during the study period.
- Younger age at disease onset and antidepressant use were significant risk factors for conversion.
- Serotonin-norepinephrine reuptake inhibitor (SNRI) users had over double the risk of conversion compared to non-users.
Conclusions:
- Diagnostic conversion from unipolar to bipolar disorder is confirmed, with younger age and antidepressant use (especially SNRIs) as key risk factors.
- Clinicians must remain aware of diagnostic conversion due to differing prognoses and treatment strategies for unipolar and bipolar disorders.
Keywords:
Bipolar affective disorderDiagnostic conversionPopulation registerRisk factorsUnipolar affective disorderMore Related Videos
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