Objectives. To study the clinical features of depressive episode with onset in late adolescence associated with the risk of developing bipolar affective disorder (BAD). Materials and methods. A total of 40 patients with BAD (ICD-10 F31) after manifest depressive state, corresponding to the diagnostic criteria for “depressive episode” (F32), at age 15–18 years were studied. The duration of follow-up was 3–5 years. Psychopathological, follow-up, and statistical methods were used. Results. The duration of manifest depressive episodes in patients with BAD was no greater than six months in 70% of cases. Clinical features included frequent psychomotor inhibition, anergy, anhedonia, melancholy, irritability, affective instability with elevated emotional reactivity, and hypersomnia. Less typical were “atypical” depressive symptoms. Suicidal tendencies accompanying psychopathy-like behavioral abnormalities and abuse of psychoactive substances were seen at signifi cant frequency. In most cases, manifest depressive state was accompanied by deterioration in social functioning and led to school maladaptation. Conclusions. Bipolar depression manifest in late adolescence was characterized by a relatively short duration, a predominance of typical depressive symptoms (melancholy, psychomotor inhibition), irritability, increased emotional reactivity, hypersomnia, and an elevated frequency of suicidal tendencies.
Similar content being viewed by others
References
V. A. Gur’eva, Psychogenic Disorders in Children and Adolescents, Kron-Press, MV (1996).
A. E. Lichko, Adolescent Psychiatry. Manual for Physicians, Meditsina, Leningrad (1985), 2nd ed.
F. J. Kochman, E. G. Hantouche, P. Ferrari, et al., “Cyclothymic temperament as a prospective predictor of bipolarity and suicidality in children and adolescents with major depressive disorder,” J. Affect. Disord., 85, No. 1–2, 181–189 (2005), https://doi.org/10.1016/j.jad.2003.09.009.
B. Birmaher and D. А. Axelson, “Bipolar disorder in children and adolescents,” in: Bipolar Disorders. Mixed States, Rapid-Cycling, and Atypical Forms, A. Marneros and F. K. Goodwin (eds.), Cambridge Univ. Press, Cambridge (2005), https://doi.org/10.1192/bjp.bp.105.019992.
B. Birmaher, N. D. Ryan, D. E. Williamson, et al., “Childhood and adolescent depression: a review of the past 10 years. Part I,” J. Am. Acad. Child. Adolesc. Psychiatry, 35, No. 11, 1427–1439 (1996), https://doi.org/10.1097/00004583-199611000-00011.
R. M. Hirschfeld, “Differential diagnosis of bipolar disorder and major depressive disorder,” J. Affect. Disord., 169, No. S1, 12–16 (2014), https://doi.org/10.1016/S0165-0327(14)70004-7.
L. Bardensteyn, Ya. Slavgorodsky, N. Beglyankin, et al., “PS62. Early recognition of bipolar depression,” Int. J. Neuropsychopharmacol., 19, No. 1, 21–22 (2016), https://doi.org/10.1093/ijnp/pyw043.062.
A. V. Ushkalova, E. G. Kostyukova, and S. N. Mosolov, “Modern treatment of the depressive phase in bipolar affective disorder (review),” Zh. Nevrol. Psikhiat., 11, No. 2, 67–76 (2012), https://www.mediasphera.ru/issues/zhurnal-nevrologii-i-psikhiatrii-im-ss-korsakova-2/2012/11/031997-729820121127.
P. B. Mitchell, G. M. Goodwin, and G. F. Johnson, “Diagnostic guidelines for bipolar depression: a probabilistic approach,” Bipolar Disord., 10, No. 1, 144–152 (2008), https://doi.org/10.1111/j.1399-5618.2007.00559.x.
H. Akiskal, M. L. Bourgeois, J. Angst, et al., “Reevaluating the prevalence of and diagnostic composition within the broad clinical spectrum of bipolar disorders,” J. Affect. Disord., 59, No. 1, 5–30 (2000), https://doi.org/10.1016/s0165-0327(00)00203-2.
H. S. Akiskal and O. I. Pinto, “The evolving bipolar spectrum: prototypes, I, II, III, and IV,” Pschiatr. Clin. North Am., 22, 517–534 (1999), https://doi.org/10.1016/S0193-953X(05)70093-9.
J. Angst, A. Gamma, C. L. Bowden, et al., “Evidence-based definitions of bipolar-I and bipolar-II disorders among 5,635 patients with major depressive episodes in the Bridge Study: validity and comorbidity,” Eur. Arch. Psych. Clin. Neurosci., 263, No. 8, 663–673 (2013), https://doi.org/10.1007/s00406-013-0393-4.
G. G. Simutkin, “Modern tools for screening for bipolar affective disorders (literature review),” Obozr. Psikhiatr. Med. Psikhol., 3, 34–41 (2012), https://psychiatr.ru/files/magazines/2012_09_obozr_358.pdf.
The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines, World Health Organization, Geneva (1992), https://www.who.int/classifications/icd/en/bluebook.pdf.
Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association, Washington, DC (2013).
S. N. Ghaemi, M. Bauer, F. Cassidy, et al., ISBD Diagnostic Guidelines Task Force, Diagnostic guidelines for bipolar disorder: a summary of the International Society for Bipolar Disorders Diagnostic Guidelines Task Force Report,” Bipolar Disord., 10, No. 1–2, 117–128 (2008), https://doi.org/10.1111/j.1399-5618.2007.00556.x.
P. M. Lewinsohn, D. N. Klein, and J. R. Seeley, “Bipolar disorder during adolescence and young adulthood in a community sample,” Bipolar Disord., 2, 281–293 (2000), https://doi.org/10.1034/j.1399-5618.2000.20309.x.
R. H. Perlis, S. Miyahara, L. B. Marangell, et al., STEP-BD Investigators, “Long-term implications of early onset in bipolar disorder: data from the first 1,000 participants in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD),” Biol. Psychiatry, 55, No. 9, 875–881 (2004), https://doi.org/10.1016/j.biopsych.2004.01.022.
G. A. Carlson, and J. H. Kashani, “Phenomenology of major depression from childhood through adulthood: analysis of three studies,” Am. J. Psychiatry, 145, 1222–1225 (1988), https://doi.org/10.1176/ajp.145.10.1222.
M. Strober, and G. Carlson, “Bipolar illness in adolescents with major depression: clinical, genetic, and psychopharmacologic predictors in a three- to four-year prospective follow-up investigation,” Arch. Gen. Psychiatry, 39, No. 5, 549–555 (1982), https://doi.org/1001/archpsyc.1982.04290050029007.
H. S. Akiskal, “Developmental pathways to bipolarity: are juvenile-onset depressions pre-bipolar,” J. Am. Acad. Child Adolesc. Psychiatry, 34, 754–763 (1995), https://doi.org/10.1097/00004583-199506000-00016.
P. M. Lewinsohn, D. N. Klein, and J. R. Seeley, “Bipolar disorders in a community sample of older adolescents: prevalence, phenomenology, comorbidity, and course,” J. Am. Acad. Child Adolesc. Psychiatry, 34, 454–463 (1995), https://doi.org/10.1097/00004583-199504000-00012.
L. M. Bardenshteyn, “Bipolar affective disorder,” Ross. Med. Zh., 2, 50–53 (2009).
J. Аngst, А. Gamma, V. Ajdacic, et al., “Recurrent brief depression as an indicator of severe mood disorders,” in: Bipolar Disorders. Mixed States, Rapid-Cycling, and Atypical Forms, A. Marneros and F. K. Goodwin (eds.), Cambridge University Press, Cambridge (2005), https://doi.org/10.1192/bjp.bp.105.019992.
J. Angst, J. M. Azorin, C. L. Bowden, et al., BRIDGE Study Group, Prevalence and characteristics of undiagnosed bipolar disorders in patients with a major depressive episode: the BRIDGE study,” Arch. Gen. Psychiatry, 68, No. 8, 791–798 (2011), https://doi.org/10.1001/archgenpsychiatry.2011.87.
N. A. Tyuvina and V. N. Smirnova, “Bipolar affective disorders: features of the course and maintenance pharmacotherapy,” Nevrol. Neiropsikh. Psikhosom., 1, 87–95 (2013), https://doi.org/10.14412/2074-2711-2013-2406.
D. Axelson, B. Goldstein, T. Goldstein, et al., “Diagnostic precursors to bipolar disorder in offspring of parents with bipolar disorder: A longitudinal study,” Am. J. Psychiatry, 172, No. 7, 638–646 (2015), https://doi.org/10.1176/appi.ajp.2014.14010035.
N. E. Kravchenko, “Modern concepts of depressive mood disorders in adolescence and some problems in their therapy (analytical review),” Sovrem. Ter. Psikhich. Rasstr., 3, 4–20 (2007), https://psypharma.ru/ru/sovremennye-predstavleniya-o-depressivnyh-rasstroystvah-nastroeniya-v-podrostkovom-vozraste-i.
N. A. Mazaeva, N. E. Kravchenko, and E. I. Ivanova, “Depressive disorders in adolescence and features of their therapy,” Sovrem. Ter. Psikhich. Rasstr., 2, 23–28 (2008), https://www.psypharma.ru/ru/depressivnyerasstroystva-v.
Author information
Authors and Affiliations
Corresponding author
Additional information
Translated from Zhurnal Nevrologii i Psikhiatrii imeni S. S. Korsakova, Vol. 119, No. 1, Iss. 2, Depression, pp. 22–27, January, 2019.
Rights and permissions
About this article
Cite this article
Beglyankin, N.I., Burygina, L.A., Levin, M.E. et al. Features of Depressive Episode with Onset in Adolescence and the Risk of Developing Bipolar Depression. Neurosci Behav Physi 50, 35–39 (2020). https://doi.org/10.1007/s11055-019-00865-2
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11055-019-00865-2