A comparative study of clinical features of major depressive episode in major depressive disorder and bipolar disorder at tertiary care centre of Saurashtra region

ABSTRACT

Background: Robust clinical research data are available distinguishing clinical features of the major depressive episode between bipolar depression and major depressive disorder (MDD). Depression is having a highly heterogeneous clinical presentation. MDD and bipolar depression show a significant difference in terms of epidemiology, natural course, genetics, outcome, treatment, and disability thus becoming the major areas of rising concern which need to be addressed. Objectives: The aim was to study and compare clinical features of the major depressive episode in MDD and bipolar disorder. Materials and Methods: We compared 40 patients with bipolar depression (all 40 patients had bipolar I disorder) and 40 patients with MDD using semi-structured pro forma, DSM-5 criteria for diagnosis, Hamilton rating scale for depression (HRSD-17), Montgomery-Asberg depression rating scale (MADRS), and mood disorder questionnaire. Results: Patients with bipolar depression had early age of onset of illness, positive family history of bipolar disorders in family members, longer illness duration, greater rates of any lifetime suicide attempt, higher percentage of hypersomnia, psychomotor retardation, delusions, social withdrawal, and leaden paralysis and scored higher on individual depressive symptoms of the MADRS items in apparent sadness, reported sadness, concentration difficulties, lassitude, inability to feel and of the HRSD in work and interest, and retardation compared to the patients with MDD. Conclusions: Subtle differences in phenomenological presentation of unipolar and bipolar depression indicate requirement of a large multicentre, long term prospective and comparative study.