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J Psychiatr Res. 2010 Oct;44(14):979-85. doi: 10.1016/j.jpsychires.2010.03.010. Epub 2010 Apr 15.

DSM-IV depressive symptom expression among individuals with a history of hypomania: a comparison to those with or without a history of mania.

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  • 1Psychosocial Research Program, Warren Alpert Medical School of Brown University and Butler Hospital, 345 Blackstone Boulevard, Providence, RI 02906, United States. lauren_weinstock@brown.edu


In an effort to advance an understanding of the phenomenology of bipolar II depression, the current study used methods based in item response theory to evaluate differences in DSM-IV depression symptom endorsement in an epidemiological sample of individuals with a history of hypomania (i.e., bipolar II depression) in comparison to: a) individuals with a history of mania (i.e., bipolar I depression), and b) individuals without a history of hypomania or mania (i.e., unipolar depression). Clinical interview data were drawn from a subsample (n = 13,753) of individuals with bipolar II, bipolar I, or unipolar depression who had participated in the National Epidemiologic Survey on Alcohol and Related Conditions. A two-parameter item response model was used to estimate differential item functioning (DIF) between these groups. Differences in severity parameter estimates revealed that suicidal ideation/attempt was less likely to be endorsed across most levels of depression severity in bipolar II versus bipolar I disorder. There were no significant differences between groups on the remaining DSM-IV symptoms. Although preliminary, current study data are consistent with recent assertions that depression may be understood as a clinical phenomenon that is consistent across the major affective disorders. An exception to this conclusion may be in the area of suicidal ideation, which requires additional attention.

Copyright © 2010 Elsevier Ltd. All rights reserved.

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