Skip to main content

Main menu

  • HOME
  • ARTICLES
    • Current Issue
    • Ahead of Print
    • Archives
    • Abstracts In Press
    • Special Issue Archive
    • Subject Collections
  • INFO FOR
    • Authors
    • Reviewers
    • Call For Papers
    • Subscribers
    • Advertisers
  • SUBMIT
    • Manuscript
    • Peer Review
  • ABOUT
    • The JABFM
    • The Editing Fellowship
    • Editorial Board
    • Indexing
    • Editors' Blog
  • CLASSIFIEDS
  • Other Publications
    • abfm

User menu

Search

  • Advanced search
American Board of Family Medicine
  • Other Publications
    • abfm
American Board of Family Medicine

American Board of Family Medicine

Advanced Search

  • HOME
  • ARTICLES
    • Current Issue
    • Ahead of Print
    • Archives
    • Abstracts In Press
    • Special Issue Archive
    • Subject Collections
  • INFO FOR
    • Authors
    • Reviewers
    • Call For Papers
    • Subscribers
    • Advertisers
  • SUBMIT
    • Manuscript
    • Peer Review
  • ABOUT
    • The JABFM
    • The Editing Fellowship
    • Editorial Board
    • Indexing
    • Editors' Blog
  • CLASSIFIEDS
  • JABFM on Bluesky
  • JABFM On Facebook
  • JABFM On Twitter
  • JABFM On YouTube
OtherEvidence-Based Clinical Medicine

Is Your Depressed Patient Bipolar?

Neil S. Kaye
The Journal of the American Board of Family Practice July 2005, 18 (4) 271-281; DOI: https://doi.org/10.3122/jabfm.18.4.271
Neil S. Kaye
MD, DFAPA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • References
  • Info & Metrics
  • PDF
Loading

References

  1. ↵
    Stiebel V, Schwartz CE. Physicians at the medicine/psychiatric interface: what do internist/psychiatrists do? Psychosomatics 2001; 42: 377–81.
    OpenUrlCrossRefPubMed
  2. ↵
    Ballenger JC, Davidson JR, Lecrubier Y, et al. Consensus statement on the primary care management of depression from the International Consensus Group on Depression and Anxiety. J Clin Psychiatry 1999; 60 Suppl 7: 54–61.
    OpenUrl
  3. ↵
    Angst J, Sellaro R. Historical perspectives and natural history of bipolar disorder. Biol Psychiatry 2000; 48: 445–57.
    OpenUrlCrossRefPubMedWeb of Science
  4. ↵
    Compton MT, Nemeroff CB. The treatment of bipolar depression. J Clin Psychiatry 2000; 61: 57–67.
  5. ↵
    Thase ME, Sachs GS. Bipolar depression: pharmacotherapy and related therapeutic strategies. Biol Psychiatry 2000; 48: 558–72.
    OpenUrlCrossRefPubMedWeb of Science
  6. ↵
    Sachs GS, Printz DJ, Kahn DA, Carpenter D, Docherty JP. The expert consensus guideline series: medication treatment of bipolar disorder 2000. Postgrad Med 2000;Spec No: 1–104
  7. ↵
    American Psychiatric Association. Practice guideline for the treatment of patients with bipolar disorder (revision). Am J Psychiatry 2002; 159: 1–50.
  8. ↵
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th ed. Washington DC: American Psychiatric Publishing, Inc; 1994.
  9. ↵
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th ed, text rev. Washington DC: American Psychiatric Publishing, Inc; 2000.
  10. ↵
    Regier DA, Farmer ME, Rae DS, et al. Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study. JAMA 1990; 264: 2511–8.
    OpenUrlCrossRefPubMedWeb of Science
  11. ↵
    Angst J. The emerging epidemiology of hypomania and bipolar II disorder. J Affect Disord 1998; 50: 143–51.
    OpenUrlCrossRefPubMedWeb of Science
  12. ↵
    Angst J, Gamma A, Benazzi F, Ajdacic V, Eich D, Rossler W. Toward a re-definition of subthreshold bipolarity: epidemiology and proposed criteria for bipolar-II, minor bipolar disorders and hypomania. J Affect Disord 2003; 73: 133–46.
    OpenUrlCrossRefPubMedWeb of Science
  13. Akiskal HS, Bourgeois ML, Angst J, Post R, Moller H, Hirschfeld R. Re-evaluating the prevalence of and diagnostic composition within the broad clinical spectrum of bipolar disorders. J Affect Disord 2000; 59 Suppl 1: S5–30.
    OpenUrl
  14. ↵
    Benazzi F. Depression with DSM-IV atypical features: a marker for bipolar II disorder. Eur Arch Psychiatry Clin Neurosci 2000; 250: 53–5.
    OpenUrlCrossRefPubMed
  15. ↵
    Benazzi F. Frequency of bipolar spectrum in 111 private practice depression outpatients. Eur Arch Psychiatry Clin Neurosci 2003; 253: 203–8.
    OpenUrlCrossRefPubMedWeb of Science
  16. Judd LL, Akiskal HS. The prevalence and disability of bipolar spectrum disorders in the US population: re-analysis of the ECA database taking into account subthreshold cases. J Affect Disord 2003; 73: 123–31.
    OpenUrlCrossRefPubMedWeb of Science
  17. Akiskal HS, Pinto O. The evolving bipolar spectrum. Prototypes I, II, III, and IV. Psychiatr Clin North Am 1999; 22: 517–34, vii.
    OpenUrlCrossRefPubMedWeb of Science
  18. ↵
    Goodwin FK, Jamison KR. Suicide. Manic-depressive illness. New York: Oxford University Press, Inc; 1990. p. 227–46.
  19. ↵
    Hirschfeld RM, Lewis L, Vornik LA. Perceptions and impact of bipolar disorder: how far have we really come? Results of the National Depressive and Manic-Depressive Association 2000 survey of individuals with bipolar disorder. J Clin Psychiatry 2003; 64: 161–74.
    OpenUrlCrossRefPubMedWeb of Science
  20. ↵
    Manning JS, Haykal RF, Akiskal HS. The role of bipolarity in depression in the family practice setting. Psychiatr Clin North Am 1999; 22: 689–703, x.
    OpenUrlCrossRefPubMedWeb of Science
  21. ↵
    Manning JS. Bipolar disorder in primary care. J Fam Pract 2003; Suppl: S6–9.
  22. ↵
    Bowden CL. Strategies to reduce misdiagnosis of bipolar depression. Psychiatr Serv 2001; 52: 51–5.
    OpenUrlCrossRefPubMedWeb of Science
  23. ↵
    Pini S, Cassano GB, Dell’Osso L, Amador XF. Insight into illness in schizophrenia, schizoaffective disorder, and mood disorders with psychotic features. Am J Psychiatry 2001; 158: 122–5.
    OpenUrlCrossRefPubMedWeb of Science
  24. Dell’Osso L, Pini S, Cassano GB, Mastrocinque C, Seckinger RA, Saettoni M, et al. Insight into illness in patients with mania, mixed mania, bipolar depression and major depression with psychotic features. Bipolar Disord 2002; 4: 315–22.
    OpenUrlPubMed
  25. ↵
    Yen CF, Chen CS, Yeh ML, Ker JH, Yang SJ, Yen JY. Correlates of insight among patients with bipolar I disorder in remission. J Affect Disord 2004; 78: 57–60.
    OpenUrlCrossRefPubMedWeb of Science
  26. ↵
    Brickman AL, LoPiccolo CJ, Johnson SL. Screening for bipolar disorder. Psychiatr Serv 2002; 53: 349.
    OpenUrlCrossRefPubMed
  27. ↵
    Ghaemi SN, Sachs GS, Chiou AM, Pandurangi AK, Goodwin K. Is bipolar disorder still underdiagnosed? Are antidepressants overutilized? J Affect Disord 1999; 52: 135–44.
    OpenUrlCrossRefPubMedWeb of Science
  28. ↵
    Ghaemi SN, Boiman EE, Goodwin FK. Diagnosing bipolar disorder and the effect of antidepressants: a naturalistic study. J Clin Psychiatry 2000; 61: 804–8.
    OpenUrlPubMedWeb of Science
  29. ↵
    Hirschfeld RM. Bipolar spectrum disorder: improving its recognition and diagnosis. J Clin Psychiatry 2001; 62 Suppl 14: 5–9.
    OpenUrl
  30. ↵
    Benazzi F. Bipolar II disorder is common among depressed outpatients. Psychiatry Clin Neurosci 1999; 53: 607–9.
    OpenUrlPubMed
  31. ↵
    Lish JD, Dime-Meenan S, Whybrow PC, Price RA, Hirschfeld RM. The National Depressive and Manic-Depressive Association (DMDA) survey of bipolar members. J Affect Disord 1994; 31: 281–94.
    OpenUrlCrossRefPubMedWeb of Science
  32. ↵
    Jamison KR. Suicide and bipolar disorder. J Clin Psychiatry 2000; 61: 47–51.
    OpenUrlCrossRefPubMedWeb of Science
  33. ↵
    Wehr TA, Goodwin FK. Can antidepressants cause mania and worsen the course of affective illness? Am J Psychiatry 1987; 144: 1403–11.
    OpenUrlPubMedWeb of Science
  34. ↵
    Altshuler LL, Post RM, Leverich GS, Mikalauskas K, Rosoff A, Ackerman L. Antidepressant-induced mania and cycle acceleration: A controversy revisited. Am J Psychiatry 1995; 152: 1130–8.
    OpenUrlPubMedWeb of Science
  35. ↵
    Akiskal HS. The prevalent clinical spectrum of bipolar disorders: beyond DSM-IV. J Clin Psychopharmacol 1996; 16: 4S–14S.
    OpenUrlPubMed
  36. Dunner DL, Tay LK. Diagnostic reliability of the history of hypomania in bipolar II patients and patients with major depression. Compr Psychiatry 1993; 34: 303–7.
    OpenUrlCrossRefPubMedWeb of Science
  37. Cassano GB, Dell’Osso L, Frank E, et al. The bipolar spectrum: a clinical reality in search of diagnostic criteria and an assessment methodology. J Affect Disord 1999; 54: 319–28.
    OpenUrlCrossRefPubMedWeb of Science
  38. ↵
    Judd LL, Akiskal HS, Schettler PJ, et al. A prospective investigation of the natural history of the long-term weekly symptomatic status of bipolar II disorder. Arch Gen Psychiatry 2003; 60: 261–9.
    OpenUrlCrossRefPubMedWeb of Science
  39. ↵
    Hirschfeld RM, Williams JB, Spitzer RL, et al. Development and validation of a screening instrument for bipolar spectrum disorder: The Mood Disorder Questionnaire. Am J Psychiatry 2000; 157: 1873–5.
    OpenUrlCrossRefPubMedWeb of Science
  40. ↵
    Benazzi F. Improving the Mood Disorder Questionnaire to detect bipolar II disorder. Can J Psychiatry 2003; 48: 770–1.
    OpenUrlPubMed
  41. ↵
    Abrams R, Taylor MA. A comparison of unipolar and bipolar depressive illness. Am J Psychiatry 1980; 137: 1084–7.
    OpenUrlPubMedWeb of Science
  42. Geller B, Craney JL, Bolhofner K, DelBello MP, Williams M, Zimerman B. One-year recovery and relapse rates of children with a prepubertal and early adolescent bipolar disorder phenotype. Am J Psychiatry 2001; 158: 303–5.
    OpenUrlCrossRefPubMedWeb of Science
  43. ↵
    Akiskal HS, Maser JD, Zeller PJ, et al. Switching from ‘unipolar’ to bipolar II. An 11-year prospective study of clinical and temperamental predictors in 559 patients. Arch Gen Psychiatry 1995; 52: 114–23.
    OpenUrlCrossRefPubMedWeb of Science
  44. ↵
    Goldberg JF, Harrow M, Whiteside JE. Risk for bipolar illness in patients initially hospitalized for unipolar depression. Am J Psychiatry 2001; 158: 1265–70.
    OpenUrlCrossRefPubMedWeb of Science
  45. ↵
    Goldberg AL, Elledge SJ, Harper JW. The cellular chamber of doom. Sci Am 2001; 284: 68–73.
    OpenUrlPubMedWeb of Science
  46. ↵
    Manning JS, Haykal RF, Connor PD, Akiskal HS. On the nature of depressive and anxious states in a family practice setting: the high prevalence of bipolar II and related disorders in a cohort followed longitudinally. Compr Psychiatry 1997; 38: 102–8.
    OpenUrlCrossRefPubMedWeb of Science
  47. Goodwin FK, Jamison KR. Medical treatment of acute bipolar depression. In: Manic-depressive illness. Oxford (UK): Oxford University Press, Inc.; 1990. p. 630–64.
  48. ↵
    Coryell W. Bipolar II disorder: the importance of hypomania. In: Goldberg JF and Harrow M, editors. Bipolar disorders: clinical course and outcome. Washington DC: American Psychiatric Publishing; 1999. p. 219–36.
  49. ↵
    Weissman MM, Wickramaratne P, Adams P, Wolk S, Verdeli H, Olfson M. Brief screening for family psychiatric history: the family history screen. Arch Gen Psychiatry 2000; 57: 675–82.
    OpenUrlCrossRefPubMedWeb of Science
  50. ↵
    Ghaemi SN, Ko JY, Goodwin FK. The bipolar spectrum and the antidepressant view of the world. J Psychiatr Pract 2001; 7: 287.
  51. ↵
    Akiskal HS, Benazzi F. Family history validation of the bipolar nature of depressive mixed states. J Affect Disord 2003; 73: 113–22.
    OpenUrlPubMed
  52. ↵
    Whybrow PC. A mood apart: depression, mania, and other afflictions of the self. New York: HarperCollins; 1997.
  53. ↵
    Robling SA, Paykel ES, Dunn VJ, Abbott R, Katona C. Long-term outcome of severe puerperal psychiatric illness: a 23 year follow-up study. Psychol Med 2000; 30: 1263–71.
    OpenUrlCrossRefPubMedWeb of Science
  54. ↵
    Potter WZ. Bipolar depression: specific treatments. J Clin Psychiatry 1998; 59 Suppl 18: 30–6.
    OpenUrl
  55. ↵
    Kupfer DJ, Frank E, Grochocinski VJ, Cluss PA, Houck PR, Stapf DA. Demographic and clinical characteristics of individuals in a bipolar disorder case registry. J Clin Psychiatry 2002; 63: 120–5.
    OpenUrlPubMedWeb of Science
  56. ↵
    Tohen M, Vieta E, Calabrese J, et al. Efficacy of olanzapine and olanzapine-fluoxetine combination in the treatment of bipolar I depression. Arch Gen Psychiatry 2003; 60: 1079–88.
    OpenUrlCrossRefPubMedWeb of Science
  57. ↵
    Physicians’ Desk Reference. 59th ed. Montvale (NJ): Medical Economics Company, Inc; 2005. Eskalith; p. 1486.
  58. ↵
    Tondo L, Baldessarini RJ, Floris G. Long-term clinical effectiveness of lithium maintenance treatment in types I and II bipolar disorders. Br J Psychiatry Suppl 2001; 41: s184–90.
    OpenUrlPubMed
  59. Goodwin FK, Fireman B, Simon GE, Hunkeler EM, Lee J, Revicki D. Suicide risk in bipolar disorder during treatment with lithium and divalproex. JAMA 2003; 290: 1467–73.
    OpenUrlCrossRefPubMedWeb of Science
  60. ↵
    Kleindienst N, Greil W. Differential efficacy of lithium and carbamazepine in the prophylaxis of bipolar disorder: results of the MAP study. Neuropsychobiology 2000; 42: 2–10.
  61. ↵
    Physicians’ Desk Reference, 57th ed. Montvale (NJ): Thomson PDR; 2003. Depakote; p. 430–41.
  62. ↵
    Physicians’ Desk Reference. 59th ed. Montvale (NJ): Medical Economics Company, Inc; 2005. Tegretol; p. 436–41.
  63. ↵
    Calabrese JR, Bowden CL, Sachs GS, Ascher JA, Monaghan E, Rudd GD. A double-blind placebo-controlled study of lamotrigine monotherapy in outpatients with bipolar I depression. Lamictal 602 Study Group. J Clin Psychiatry 1999; 60: 79–88.
    OpenUrlCrossRefPubMedWeb of Science
  64. ↵
    Bowden CL, Calabrese JR, Sachs G, et al. A placebo-controlled 18-month trial of lamotrigine and lithium maintenance treatment in recently manic or hypomanic patients with bipolar I disorder. Arch Gen Psychiatry 2003; 60: 392–400.
    OpenUrlCrossRefPubMedWeb of Science
  65. ↵
    Calabrese JR, Bowden CL, Sachs G, et al. A placebo-controlled 18-month trial of lamotrigine and lithium maintenance treatment in recently depressed patients with bipolar I disorder. J Clin Psychiatry 2003; 64: 1013–24.
    OpenUrlPubMedWeb of Science
  66. ↵
    Physicians’ desk reference, 57th ed. Montvale (NJ): Thomson PDR; 2003. Lamictal; p. 1559–66.
  67. ↵
    Allison DB, Casey DE. Antipsychotic-induced weight gain: a review of the literature. J Clin Psychiatry 2001; 62 Suppl 7: 22–31.
    OpenUrl
  68. ↵
    Schwenkreis P, Assion HJ. Atypical antipsychotics and diabetes mellitus. World J Biol Psychiatry 2004; 5: 73–82.
    OpenUrlCrossRefPubMedWeb of Science
  69. ↵
    American Diabetes Association; American Psychiatric Association; American Association of Clinical Endocrinologists; North American Association for the Study of Obesity. Consensus development conference on antipsychotic drugs and obesity and diabetes. Diabetes Care 2004; 27: 596–601.
    OpenUrlFREE Full Text
  70. ↵
    Ghaemi SN, Ko JY, Goodwin FK. “Cade’s disease” and beyond: misdiagnosis, antidepressant use, and a proposed definition for bipolar spectrum disorder. Can J Psychiatry 2002; 47: 125–34.
    OpenUrlPubMedWeb of Science
PreviousNext
Back to top

In this issue

The Journal of the American Board of Family Practice: 18 (4)
The Journal of the American Board of Family Practice
Vol. 18, Issue 4
July-August 2005
  • Table of Contents
  • Index by author
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on American Board of Family Medicine.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Is Your Depressed Patient Bipolar?
(Your Name) has sent you a message from American Board of Family Medicine
(Your Name) thought you would like to see the American Board of Family Medicine web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
3 + 6 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
Citation Tools
Is Your Depressed Patient Bipolar?
Neil S. Kaye
The Journal of the American Board of Family Practice Jul 2005, 18 (4) 271-281; DOI: 10.3122/jabfm.18.4.271

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Is Your Depressed Patient Bipolar?
Neil S. Kaye
The Journal of the American Board of Family Practice Jul 2005, 18 (4) 271-281; DOI: 10.3122/jabfm.18.4.271
Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Abstract
    • How Common Are Bipolar Disorders?
    • Misdiagnosing Bipolar Depression As Unipolar Depression
    • Consequences of Misdiagnosis
    • Distinguishing between Unipolar and Bipolar Depression
    • Making the Correct Diagnosis
    • Treating the Patient with Bipolar Depression
    • Conclusion
    • Notes
    • References
  • Figures & Data
  • References
  • Info & Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • A Simplified Approach to Evaluate and Manage Shoulder Pain
  • Practical Recommendations for Minimizing Pain and Anxiety with IUD Insertion
  • Treatment of Vasomotor Symptoms
Show more Evidence-Based Clinical Medicine

Similar Articles

Navigate

  • Home
  • Current Issue
  • Past Issues

Authors & Reviewers

  • Info For Authors
  • Info For Reviewers
  • Submit A Manuscript/Review

Other Services

  • Get Email Alerts
  • Classifieds
  • Reprints and Permissions

Other Resources

  • Forms
  • Contact Us
  • ABFM News

© 2025 American Board of Family Medicine

Powered by HighWire