Bipolar type I and II disorders: manifestations of a single disease or two independent nosologies?

The aim is to compare patients with bipolar type I and II disorders according to socio–demographic characteristics, the structure of depressive and hypo-/manic episodes, as well as patterns of concomitant mental disorders.Materials and methods: 173 patients with bipolar disorder were included in thi...

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Main Authors: Evgeny D. Kasyanov, Yana V. Yakovleva, Egor S. Shchepkin, Galina E. Mazo
Format: Article
Language:Russian
Published: Federal State Budget Scientific Institution National Medical Research Center for Psychiatry and Neurology n.a. V.M. Bekhterev Ministry of Health of the Russian Federation 2024-04-01
Series:Обозрение психиатрии и медицинской психологии имени В.М. Бехтерева
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Online Access:https://www.bekhterevreview.com/jour/article/view/1168
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author Evgeny D. Kasyanov
Yana V. Yakovleva
Egor S. Shchepkin
Galina E. Mazo
author_facet Evgeny D. Kasyanov
Yana V. Yakovleva
Egor S. Shchepkin
Galina E. Mazo
author_sort Evgeny D. Kasyanov
collection DOAJ
description The aim is to compare patients with bipolar type I and II disorders according to socio–demographic characteristics, the structure of depressive and hypo-/manic episodes, as well as patterns of concomitant mental disorders.Materials and methods: 173 patients with bipolar disorder were included in this multicenter cross-sectional study, 46.8% of them with type I (n=81). The study participants independently filled out a computerized structured questionnaire for screening for affective disorders, where symptoms of depression and hypo-/mania were recorded. After that, the participants underwent a structured interview with a researcher to verify the diagnosis and identify concomitant mental disorders. The analysis was performed in RStudio version 4.4.0 using the standard R package and the "psych“ package.Results: In patients with bipolar type I and II disorders, there were no significant differences in age, sex, and level of education, as well as the frequency of concomitant mental disorders. Patients with bipolar type I disorder were significantly more likely to have symptoms of depression such as psychomotor retardation and thoughts of self–harm or death, and patients with bipolar type II disorder had symptoms of decreased energy levels. In addition, patients with bipolar type I disorder, compared with patients with bipolar type II disorder, were significantly more likely to have all the symptoms of mania, with the exception of hyperthymia and increased talkativeness. Nevertheless, the classification of bipolar type I and II disorders based on cluster analysis for all symptoms of depression and hypo-/mania had sensitivity = 77.92% and specificity = 56.63%.Conclusion: There are no symptoms of depression and hypo-/mania that are pathognomonic only to type I or type II bipolar disorder. Despite some significant differences, clustering-based classification has moderate sensitivity and low specificity. Thus, a single bipolar disorder cannot be divided into two independent nosologies based solely on the structure of mood episodes.
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publisher Federal State Budget Scientific Institution National Medical Research Center for Psychiatry and Neurology n.a. V.M. Bekhterev Ministry of Health of the Russian Federation
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series Обозрение психиатрии и медицинской психологии имени В.М. Бехтерева
spelling doaj-art-82784d56b1594db6a68f1316b7dee9dd2025-08-03T13:06:39ZrusFederal State Budget Scientific Institution National Medical Research Center for Psychiatry and Neurology n.a. V.M. Bekhterev Ministry of Health of the Russian FederationОбозрение психиатрии и медицинской психологии имени В.М. Бехтерева2313-70532713-055X2024-04-010010.31363/2313-7053-2025-3-1053611Bipolar type I and II disorders: manifestations of a single disease or two independent nosologies?Evgeny D. Kasyanov0Yana V. Yakovleva1Egor S. Shchepkin2Galina E. Mazo3V.M. Bekhterev National Medical Research Center for Psychiatry and NeurologyV.M. Bekhterev National Medical Research Center for Psychiatry and NeurologyV.M. Bekhterev National Medical Research Center for Psychiatry and NeurologyV.M. Bekhterev National Medical Research Center for Psychiatry and NeurologyThe aim is to compare patients with bipolar type I and II disorders according to socio–demographic characteristics, the structure of depressive and hypo-/manic episodes, as well as patterns of concomitant mental disorders.Materials and methods: 173 patients with bipolar disorder were included in this multicenter cross-sectional study, 46.8% of them with type I (n=81). The study participants independently filled out a computerized structured questionnaire for screening for affective disorders, where symptoms of depression and hypo-/mania were recorded. After that, the participants underwent a structured interview with a researcher to verify the diagnosis and identify concomitant mental disorders. The analysis was performed in RStudio version 4.4.0 using the standard R package and the "psych“ package.Results: In patients with bipolar type I and II disorders, there were no significant differences in age, sex, and level of education, as well as the frequency of concomitant mental disorders. Patients with bipolar type I disorder were significantly more likely to have symptoms of depression such as psychomotor retardation and thoughts of self–harm or death, and patients with bipolar type II disorder had symptoms of decreased energy levels. In addition, patients with bipolar type I disorder, compared with patients with bipolar type II disorder, were significantly more likely to have all the symptoms of mania, with the exception of hyperthymia and increased talkativeness. Nevertheless, the classification of bipolar type I and II disorders based on cluster analysis for all symptoms of depression and hypo-/mania had sensitivity = 77.92% and specificity = 56.63%.Conclusion: There are no symptoms of depression and hypo-/mania that are pathognomonic only to type I or type II bipolar disorder. Despite some significant differences, clustering-based classification has moderate sensitivity and low specificity. Thus, a single bipolar disorder cannot be divided into two independent nosologies based solely on the structure of mood episodes.https://www.bekhterevreview.com/jour/article/view/1168bipolar disorderclassificationdepressionhypomaniamania
spellingShingle Evgeny D. Kasyanov
Yana V. Yakovleva
Egor S. Shchepkin
Galina E. Mazo
Bipolar type I and II disorders: manifestations of a single disease or two independent nosologies?
Обозрение психиатрии и медицинской психологии имени В.М. Бехтерева
bipolar disorder
classification
depression
hypomania
mania
title Bipolar type I and II disorders: manifestations of a single disease or two independent nosologies?
title_full Bipolar type I and II disorders: manifestations of a single disease or two independent nosologies?
title_fullStr Bipolar type I and II disorders: manifestations of a single disease or two independent nosologies?
title_full_unstemmed Bipolar type I and II disorders: manifestations of a single disease or two independent nosologies?
title_short Bipolar type I and II disorders: manifestations of a single disease or two independent nosologies?
title_sort bipolar type i and ii disorders manifestations of a single disease or two independent nosologies
topic bipolar disorder
classification
depression
hypomania
mania
url https://www.bekhterevreview.com/jour/article/view/1168
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AT egorsshchepkin bipolartypeiandiidisordersmanifestationsofasinglediseaseortwoindependentnosologies
AT galinaemazo bipolartypeiandiidisordersmanifestationsofasinglediseaseortwoindependentnosologies