Major Depression & BiPolar Disorder may be variations of same disorder ?

Q.Patients with recurrent major depression may experience several manic or hypomanic symptoms throughout their lifetimes, suggesting that major depression and bipolar depression are not two distinct disorders.

A.Are major depressive disorder and bipolar disorder related? There are various reasons to think so. For instance, bipolar disorder is sometimes misdiagnosed as recurrent major depressive disorder. Bipolar disorder and severe major depression are also known to aggregate in families, and this overlap appears to be due to genetic factors. And now still more reason to believe that major depression and bipolar disorder are related comes from a study conducted by Italian and American psychiatric researchers. It found that subjects with recurrent major depression experienced a substantial number of manic/hypomanic symptoms over their lifetimes. The principal author of the study is Giovanni Cassano, M.D., director of the department of psychiatry, neurobiology, pharmacology, and biotechnology at the University of Pisa. Results of the study appeared in the July American Journal of Psychiatry. Recruited to participate in the study were 117 patients with remitted recurrent major depression and 106 patients with bipolar I disorder. Patients in both groups included inpatients and outpatients from nine academic settings in Italy. The investigators confirmed all of the subjects' diagnoses with the Mini International Neuropsychiatric Interview, a brief structured interview designed to diagnose Axis I disorders and antisocial personality disorder according to DSM-IV and ICD-10 criteria. The reliability of this instrument has proven to be excellent in multicenter clinical trials and in epidemiological and clinical studies. The subjects were also given the Structured Clinical Interview for the Spectrum of Mood Disorders. It was developed by Italian and American psychiatrists, including several of the authors of this study, to assess subjects' lifetime symptoms, traits, and lifestyles that characterize threshold and subthreshold mood episodes as well as temperamental features related to mood dysregulation.

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