A Comparative Study of Depressive Episode in Major Depressive Disorder and Bipolar Disorder

Distinguishing between major depressive disorder (MDD) and bipolar disorder is important because there are differences in the optimal management of these conditions. Antidepressant treatment of bipolar depression (BPD) can adversely affect long-term prognosis by causing destabilization of mood and more frequent depressive episodes, and can lead to the development of treatment resistance. Most people with bipolar disorder experience depression rather than mania as their first episode of illness. It is clinically desirable to recognize, or at least to suspect, bipolar depression at an early stage of a bipolar illness. The objective of our study is comparison of depressive episode in major depressive disorder and bipolar affective disorder in a tertiary care general hospital, psychiatry unit. Eighty cases of unipolar depression and 54 cases of bipolar depression were compared on the basis of socio-demographic profile, family history of mood disorder and clinical features using semi structured questionnaire for socio-demographic profile, validated Bengali version of Beck Depression Inventory (BDI). At the end of the study, we find that bipolar depression (BPD) is characterized by early age of onset, more number of previous episodes, positive family history, more severe in nature associated with prominent features of guilt feeling, self dislike, self accusation, suicidal ideas, irritability, social withdrawal, fatigability and loss of libido. Major depressive disorder shows female preponderance, more number of stressful life events before episodes. Body image change, insomnia, anorexia, weight loss, somatic pre-occupation are more in unipolar depression.