Browsing by Subject "kaksisuuntainen mielialahäiriö"

Objectives. Bipolar disorder is a mood disorder in which the mood varies between depressive state and mania or hypomania. In earlier studies it has been observed that the depressive episode of bipolar disorder might be often inaccurately diagnosed as recurrent depression or unipolar depression. This might lead to lengthening of the symptoms and at worst, to use of antidepressants without the simultaneous use of mood stabilizers which in turn might lead to mania or hypomania. Thus, the objective of this review is to study the distinctive factors of the depressive episodes between bipolar disorder type I and II and unipolar depression, emphasizing genetic factors, the symptoms during depressive episodes, comorbid disorders, subthreshold hypomanic symptoms and the effects of pharmacotherapy during the depressive episodes. Results and conclusions. In the review it was found that many factors distinguished the depressive episodes of bipolar disorder and unipolar depression although for comorbid disorders, especially for alcohol and substance dependence and abuse, the number of depressive episodes, and the severity of depressive symptoms the evidence was contradictory. The family history of bipolar disorder, the depressive symptoms and the age at the onset of the mood disorder were found to be associated with the onset of bipolar disorder. The use of antidepressants in bipolar disorder without the simultaneous use of mood stabilizers was noted to possibly lead to a switch from depression to mania or hypomania. Bipolar disorder was also found to share genetic factors with depression and schizophrenia which supports the idea that mood disorders constitute a dimension. In the future, it would be important to increase the accuracy of diagnostics and diagnostic criteria should be re-evaluated. Moreover, the caregivers should be educated about the differences between the depressive episodes in bipolar disorder and unipolar depression and the assessment of family history of bipolar disorder should be established as a basic procedure in the assessment of a mood disorder. Also, one should pay more attention to the occurrence of subthreshold hypomanic symptoms and the use of pharmacotherapy and its effects on the individual during the treatment of a depressive episode. It would also be important to develop a pharmacological treatment that could be used in the treatment of both unipolar depression and bipolar depressive episode.