The psychological assessment of depression: unipolars versus bipolars

Psychological test differences between unipolar (UD) and bipolar (BD) depressed inpatients were examined using the Minnesota Multiphasic Personality Inventory (MMPI, Hathaway and McKinley, 1943; MMPI-2, Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989), Millon Clinical Multiaxial Inventory (MCMI, Millon, 1983; MCMI-II, Millon 1987), and Symptom Checklist-90 (SCL-90-R, Derogatis, 1983). One hundred fifty-eight UD patients and 26 BD patients took these self-report tests at the beginning of their hospitalization. Results indicate that there were few consistent findings across the three tests (or versions of tests). Contrary to some previous studies, the BD patients did not exhibit a "social desirability" response set, nor did they produce "normal" test profiles. Although the tests were not able to identify depressed patients with past manic episodes, BD patients were more narcissistic, driven, and willing to engage in antisocial practices than were UD patients. These findings are discussed in terms of the clinical similarities between UD and BD patients during a depressive episode as well as the limitations of cross-sectional self-report measures to evaluate historical information regarding course of illness.