Bipolar Disorders: Mixed States, Rapid-Cycling, and Atypical Forms

145 Atypical depression and bipolar spectrumTable 6.2 Discriminant analysis of bipolar II (BP-II), female gender, early onset, majordepressive episode with more than two concurrent hypomanic symptoms (depressivemixed state; DMX), and BP family history for predicting atypical depression (n ¼ 433)Variable Coefficient Z PBP-II 0.4 1.3 0.188Female 0.5 2.0 0.046Onset –0.0 –3.4 0.001DMX 0.6 2.1 0.031BP family history 0.2 0.9 0.329BP family history for predicting AD (n ¼ 433 sample) is presented in Table 6.2.Resultsfound that AD was significantly associated only with female gender, early onset, andDMX. BP-II AD versus UP AD (Table 6.3) had significantly lower age of onset, morerecurrences, more depression chronicity, more depressive mixed state, more BP familyhistory, and more irritability. AD symptom frequency was not significantly different.Sensitivity, specificity, correctly classified, and receiver-operating characteristics(ROC) area of AD, BP family history, early onset of first MDE, many MDErecurrences (> 4), and DMX for predicting BP-II diagnosis, by logistic regression,are presented in Table 6.4. Results showed that AD had a high specificity forpredicting BP-II, second only to BP family history. Discriminant analysis of AD,BP family history, early onset of first MDE, many MDE recurrences, and DMX forpredicting BP-II diagnosis are presented in Table 6.5. Results showed that AD wasa near-significant predictor of BP-II compared to the other variables.Associations among AD symptoms in the whole sample are presented inTable 6.6. Mood reactivity was significantly associated with all AD symptoms,apart from leaden paralysis (4/5). All the other AD symptoms were significantlyassociated with each other. Associations among AD symptoms in the BP-II subsampleare presented in Table 6.7. Mood reactivity was significantly associatedwith 3/5 AD symptoms. The other AD symptoms were often, but not always,significantly associated with each other (7/10). Associations among AD symptomsin the UP subsample are presented in Table 6.8. Mood reactivity was not significantlyassociated with any AD symptom. The other AD symptoms were often, butnot always, significantly associated with each other (8/10).A comparison of AD symptoms between mood-reactive (MR) and non-moodreactive(N-MR) MDE patients is presented in Table 6.9. Findings showed that ADsymptoms were significantly more common in MR MDE.Given the strong significant association between BP-II and AD, the associationbetween BP-II and mood reactivity was tested. Logistic regression of BP-II versusmood reactivity found OR ¼ 2.0, z ¼ 2.6, P ¼ 0.009.