Phenomological differences between Unipolar & Bipolar depression
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Phenomological differences between Unipolar & Bipolar depression Dr.Mohammad Hussein Sep. 2015
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Phenomological differences between Unipolar & Bipolar depression
- 1. Phenomological differences between Unipolar & Bipolar depression
- 2. Phenomology from Greek phainómenon "that which appears"
- 4. Differences in the course Age of onset, Episode frequency, Duration, Severity Course
- 5. Differences in the course case-register 38000 participants internationally Course (Weissman et al., 1996) Age of onset
- 6. Differences in the course the age of onset for bipolar disorder was 6 years younger than for that of unipolar depression Course (Weissman et al., 1996) Age of onset
- 7. Differences in the course retrospective study suggests that bipolar disorder is More depressive episodes than unipolar disorder Course (Roy-Byrne et al., 1985) Episode frequency,
- 8. Differences in the course Several studies suggest that bipolar depressions are shorter and quicker to onset than unipolar depression Course (Furukawa et al., 2000; Mitchell et al., 1992) Duration
- 9. Differences in the course bipolar disorder more in females than males Course (Weissman et al., 1996) Gender
- 10. Differences in the course ? Course Severity bias
- 11. Differences in the course Ahearn and Carroll Course Ahearn and Carroll (1996) Severity Unipolar Bipolar Severity & social impairment
- 12. Differences in the course Ahearn and Carroll Course Ahearn and Carroll (1996) Severity Unipolar Bipolar bipolar depressed participants exhibiting greater short-term mood variability
- 13. Differences in the course Course To sum-up To sum-up bipolar dep. 6 years younger unipolar dep. Age of onset bipolar disorder has More depressive episodes Frequency bipolar depressions are shorter and quicker to onset Duration bipolar disorder more in females than males gender equal severity &social impairment greater short-term mood variability in Bipolar dep. Severity
- 15. Early studies Symptoms differences Unipolar depression more typical vegetative greater weight loss initial insomnia more affective symptoms, such as anxiety, anger, and agitation bipolar depression more atypical symptoms hypersomnia
- 16. Recent studies Symptoms differences ? Recent studies indicated findings have been much more inconsistent
- 17. Recent studies Symptoms differences Initial insomnia &Hypersomnia Unipolar Bipolar (Goodwin & Jamison, 1990)
- 19. Recent studies Symptoms differences (Beigel & Murphy, 1971; Katz et al., 1982; Kuhs & Reschke, 1992) Unipolar depression more anxiety more activity More somatization More appetite loss More agitation Less anhedonia Drug washout Period
- 20. Recent studies Symptoms differences anger mood reactivity melancholia psychosis psychomotor retardation not consistent across studies
- 21. Sleep suicidality Symptoms differences = to sum up anger mood reactivity melancholia psychosis psychomotor retardation not consistent Unipolar Bipolar Unipolar depression more anxiety more activity More somatization More appetite loss More agitation Less anhedonia
- 23. Psychosocial Reactivity differences Reactivity to social environment • unipolar depression is a reaction to life stressors • bipolar depression is an unfolding of endogenous, biological processes.
- 24. Psychosocial Reactivity differences Recent studies reaction to life stressors Unipolar Bipolar
- 25. correlated with symptom severity in bipolar disorder Psychosocial Reactivity differences correlated with symptom severity in unipolar disorder social variables family environment life stressors psychological variables personality cognition Psychosocial variables Recent studies
- 26. Psychosocial Reactivity differences social variables family environment life stressors psychological variables personality cognition Psychosocial variables
- 27. Psychosocial Reactivity differences Socio- environmental variables Studies (less was prospective) Life events bipolar dep. 11 – 28% of participants experienced such an event before a depressive episode Life events influence unipolar depression only (Hunt, Bruce-Jones, & Silverstone, 1992; Malkoff-Schwartz et al., 1998; McPherson,)
- 28. Psychosocial Reactivity differences Socio- environmental variables life events Unipolar Bipolar ? Less is known
- 29. Psychosocial Reactivity differences Socio- environmental variables Low social support Unipolar Bipolar ( Johnson et al., 1999) More frequent episodes
- 30. Psychosocial Reactivity differences Socio- environmental variables Low social support Negative life events Bipolar dep. Unipolar dep.
- 31. Psychosocial Reactivity differences social variables family environment life stressors psychological variables personality cognition Psychosocial variables
- 32. Psychosocial Reactivity differences psychological variables Personality trait can personality traits predict the course of illness in bipolar depression? • Heerlein, Richter, • Lozano & Johnson (Heerlein, Richter, Gonzalez, & Santander, 1998; Lozano & Johnson, 2001) neuroticism associated with increases in depressive symptoms, regardless of whether the depression is within unipolar or bipolar disorder.
- 33. Psychosocial Reactivity differences social variables family environment life stressors psychological variables personality cognition Psychosocial variables
- 34. Psychosocial Reactivity differences psychological variables Cognitive styles I. Cognition during depressive episodes Assessment By • Attributional Style Questionnaire (Seligman et al., 1988),
- 35. Psychosocial Reactivity differences psychological variables Cognitive styles I. Cognition during depressive episodes • low self-esteem (in both unipolar & bipolar dep. bipolar disorder, comparable to unipolar disorder, is associated with a negative cognitive style (Seligman et al., 1988),
- 36. Psychosocial Reactivity differences psychological variables Cognitive styles I. Cognition during remission • the negative cognitions diminish (in both unipolar & bipolar dep. bipolar disorder, higher self-esteem (see Johnson & Kizer, 2002).
- 37. Psychosocial Reactivity differences To sum-up Low social support Negative life events Bipolar dep. Unipolar dep. neuroticism associated with increases in depressive symptoms, regardless of whether the depression is within unipolar or bipolar disorder. Cognitive style during episode low self-esteem (in both unipolar & bipolar dep). bipolar disorder, associated with a negative cognitive style Cognitive style after episode higher self-esteem in bipolar disorder the negative cognitions diminish (in both unipolar & bipolar dep.