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

147 Atypical depression and bipolar spectrumTable 6.4 Sensitivity (SE), specificity (SP), correctly classified (CC), and receiver operatingcharacteristics (ROC) area of atypical depression (AD), positive family history of bipolar (I þ II)disorders, early-onset first major depressive episode (MDE), many MDE recurrences (> 4),MDE with more than two concurrent hypomanic symptoms (depressive mixed state: DMX)for predicting BP-II diagnosis, by logistic regression (n ¼ 405)Variable, % SE SP CC ROCBipolar family history 56.6 79.8 66.3 0.68AD 53.5 76.2 62.7 0.64DMX 59.3 73.1 64.9 0.66> 4 MDEs 80.9 40.2 64.4 0.60Early onset 86.2 39.0 67.0 0.70Table 6.5 Discriminant analysis of atypical depression (AD), positive family history of bipolar(I þ II) disorders, early-onset first major depressive episode (MDE), many MDE recurrences(> 4), MDE with more than two concurrent hypomanic symptoms (depressive mixed state:DMX) for predicting bipolar II diagnosis (n ¼ 405)Variable Coefficient Z PBipolar family history 1.2 3.5 0.000AD 0.6 1.9 0.054DMX 0.6 1.9 0.049> 4 MDEs 0.7 1.8 0.062Early onset –0.0 –3.9 0.000Table 6.6 Associations among atypical depression symptoms in the whole sample (n ¼ 405),by univariate logistic regression (odds ratio, *P < 0.05; **P < 0.01)MoodreactivityWeightgainOvereating HypersomniaLeadenparalysisWeight gain 3.1*Overeating 9.3** 83.7**Hypersomnia 4.6** 8.8** 9.4**Leaden paralysis 1.5 3.0** 3.5** 2.6**Interpersonal rejectionsensitivity 2.2** 2.0* 1.7* 2.4** 2.4**