Distinguishing young people with emerging bipolar disorders from those with unipolar depression

Elizabeth M. Scott, Daniel F. Hermens, Sharon L. Naismith, Adam J. Guastella, Tamara De Regt, Django White, Jim Lagopoulos, Ian B. Hickie*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

44 Citations (Scopus)


Background: To facilitate early intervention, there is a need to distinguish unipolar versus bipolar illness trajectories in adolescents and young adults with adult-type mood disorders. Methods: Detailed clinical and neuropsychological evaluation of 308 young persons (aged 12 to 30 years) with moderately severe unipolar and bipolar affective disorders. Results: Almost 30% (90/308) of young people (mean age=19.4±4.4 yr) presenting for care with affective disorders met criteria for a bipolar-type syndrome (26% with bipolar I). Subjects with bipolar- and unipolar-type syndromes were of similar age (19.8 vs. 19.2 yr) and reported comparable ages of onset (14.5 vs. 14.3 yr). Clinically, those subjects with unipolar and bipolar-type disorders reported similar levels of psychological distress, depressive symptoms, current role impairment, neuropsychological dysfunction and alcohol or other substance misuse. Subjects with unipolar disorders reported more social anxiety (p<0.01). Subjects with bipolar disorders were more likely to report a family history of bipolar (21% vs. 11%; [χ2=4.0, p<.05]) or psychotic (19% vs. 9%; [χ2=5.5, p<.05]), or substance misuse (35% vs. 23%; [χ2=3.9, p<.05]), but not depressive (48% vs. 53%; χ2=0.3, p=.582]) disorders. Conclusions: Young subjects with bipolar disorders were best discriminated by a family history of bipolar, psychotic or substance use disorders. Early in the course of illness, clinical features of depression, or neuropsychological function, do not readily differentiate the two illness trajectories.

Original languageEnglish
Pages (from-to)208-215
Number of pages8
JournalJournal of Affective Disorders
Issue number3
Publication statusPublished - 25 Jan 2013
Externally publishedYes


  • Bipolar
  • Family history
  • Neuropsychology
  • Unipolar
  • Youth


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