Clin Psychopharmacol Neurosci.  2018 Aug;16(3):262-266. 10.9758/cpn.2018.16.3.262.

Dissociative Experience in Unipolar and Bipolar Depression: Exploring the Great Divide

Affiliations
  • 1Department of Psychiatry, NIMHANS, Bangalore, India. drsschatterjee@gmail.com
  • 2Department of Psychiatry, Calcutta Medical College and Hospital, Kolkata, India.
  • 3Consultant Psychiatrist, Kolkata, India.

Abstract

OBJECTIVE: Unipolar and bipolar depression (UD and BD) differ strikingly in respect to neurobiology, course and management, but their apparent clinical similarity often leads to misdiagnosis resulting in chronicity of course and treatment failure. In this study we have tried to assess whether UD and BD can be differentiated on the basis of their dissociative symptoms.
METHODS
Thrty-six UD patients and 35 BD patients in active episodes, without any psychiatric comorbidity were selected from outpatient department and compared for depressive and dissociative symptoms using Hamilton Depression Rating Scale and Dissociative Experience Scale-II (DES-II).
RESULTS
We found that thought the two groups didn’t differ in terms of the socio-demographic or clinical variables, BD group had significantly higher dissociative experience (U=343, p=0.001) than UD and the difference remained significant even after adjusting for the confounding factors.
CONCLUSION
Our study shows that dissociative symptoms are significantly more prevalent in the depressive episodes of bipolar affective disorder as compared to the UD and can be an important tool in differentiating between the two disorders with very similar clinical profile. The difference can be measured using a simple self-report questionnaire like DES-II.

Keyword

Dissociative disorders; Bipolar disorder; Bipolar depression
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