ASPOFAFF :: Journal - Volume 1 :: Issue 2 :: Vol 1 - Iss 2 - Short Communication - A dimensional approach using a new tool permits to discriminate clearly two types of bipolar depression


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ASPOFAFF :: Journal - Volume 1 :: Issue 2 :: Vol 1 - Iss 2 - Short Communication - A dimensional approach using a new tool permits to discriminate clearly two types of bipolar depression

Vol 1 - Iss 2 - Short Communication - A dimensional approach using a new tool permits to discriminate clearly two types of bipolar depression #23

A dimensional approach using a new tool permits to discriminate clearly two types of bipolar depression Chantal Henry, Katia M’Bailara, Anne-Aurelie Casteret, Alain Desage, Bernard Antoniol: Corresponding author: Dr Chantal Henry, Hôpital Charles Perrens, Bordeaux, France. Email: chenry@perrens.aquisante.fr. Background: A major depressive episode (MDE)(DSM-IV) is characterised by a depressive mood and/or anhedonia, associated with 5 symptoms, leading to many profiles of depression. Moreover, in bipolar patients some depressions seem to be worsened by antidepressant. This raises the issue to better characterise which type of bipolar depression for which therapeutic strategy. Because current classification do not allow to discriminate different types of depression we have built a new scale based on a dimensional approach in order to assess if there are various types of bipolar depressions. Method: We used the Thymic Visual Analogic Scale by Henry et al. assessing 5 dimensions: emotion, cognition, motricity, motivation, sensoriality. Each dimension might variate from inhibition to excitation. The frequency of different types of emotion was also assessed. The validation of this scale is on process on 198 subjects. In this study, 60 depressive bipolar patients were assessed using the EVA and were also interviewed using the Diagnostic Interview for Genetic Studies providing DSM-IV diagnoses. Results: A discriminant analysis (cluster) has shown that a dimensional approach discriminates very clearly 2 types of bipolar depression D1 (n=38) and D2 (n=22). These two depressive episodes were different on all dimensions: emotion (t=8.75; p<0.000); cognition (t=5.63; p<0.000); motricity (t=8.22; p<0.000); motivation (t=5.43; p<0.000); sensoriality (t=8.0; p<0.000). D1 is characterised by an emotional hyporeactivity, a cognitive retardation, a slowness motricity, a loss of motivation and a decreased sensoriality. D2 is defined by an emotional hyperreactivity, a cognitive acceleration, a motor agitation, and without real disturbance in motivation and sensoriality. Moreover, frequency of sadness is the same in the 2 types of depression but the second type is associated with a high irritability (t=5.65; p<0.000) and anxiety (t=4.56; p<0.000). Conclusion: A dimensional approach of mood episodes discriminate 2 types of depressions in BP patients, one characterised by an inhibition of all dimensions and another one better defined by an excitation. This dimensional approach should help to better define the different types of BP or UP depressions proposed in the literature like agitated depression, dysphoric form of melancholia, mixed depression, irritable-hostile depression.

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