Clinical distinctions in symptomatology and psychiatric comorbidities between misdiagnosed bipolar I and bipolar II disorder versus major depressive disorder.

BACKGROUND: To explore the demographic and clinical features of current depressive episode that discriminate patients diagnosed with major depressive disorder (MDD) from those with bipolar I (BP-I) and bipolar II (BP-II) disorder who were misdiagnosed as having MDD . METHODS: The Mini-International Neuropsychiatric Interview (MINI) assessment was performed to establish DSM-IV diagnoses of MDD, and BP-I and BP-II, previously being misdiagnosed as MDD. Demographics, depressive symptoms and psychiatric comorbidities were compared between 1463 patients with BP-I, BP-II and MDD from 8 psychiatric settings in mainland China. A multinomial logistic regression model was performed to assess clinical correlates of diagnoses. RESULTS: A total of 14.5% of the enrolled patients initially diagnosed with MDD were eventually diagnosed with BP. Broad illness characteristics including younger age, higher prevalence of recurrence, concurrent dysthymia, suicidal attempts, agitation, psychotic features and psychiatric comorbidities, as well as lower prevalence of insomnia, weight loss and somatic symptoms were featured by patients with BP-I and/or BP-I, compared to those with MDD. Comparisons between BP-I and BP-II versus MDD indicated distinct symptom profiles and comorbidity patterns with more differences being observed between BP-II and MDD, than between BP-I and MDD . CONCLUSION: The results provide evidence of clinically distinguishing characteristics between misdiagnosed BP-I and BP- II versus MDD. The findings have implications for guiding more accurate diagnoses of bipolar disorders.

Gender differences in prevalence and associations between cognitive symptoms and suicidal ideation in patients with recurrent major depressive disorder: findings from the Chinese NSSD study.

BACKGROUND: This study aimed to explore gender differences in associations between cognitive symptoms and suicidal ideation (SI) among patients with recurrent major depressive disorder (MDD). METHODS: We recruited 1222 patients with recurrent MDD from the National Survey on Symptomatology of Depression (NSSD), a survey designed to investigate the symptoms experienced during current major depressive episodes in China. A four-point Likert questionnaire was used to assess the frequency of cognitive symptoms and SI in the past two weeks. RESULTS: Gender differences in clinical features and cognitive symptoms of participants with recurrent MDD were found. Specifically, male patients had a higher prevalence of memory loss, decreased verbal output, indecisiveness, and impaired interpersonal relationships, while female patients exhibited a higher prevalence of impaired social and occupational functioning (all P < 0.05). No significant difference in SI prevalence was found between male and female patients. The logistic regression analysis revealed that in male patients, SI was associated with indecisiveness and impaired interpersonal relationships. In female patients, reduced verbal output and impaired social and professional functions were also associated with SI in addition to the above-mentioned variables. CONCLUSION: The findings of gender differences in associations between cognitive symptoms and SI highlight the need to carefully assess gender-specific cognitive predictors of SI in patients with recurrent MDD. This has further implications for more targeted prevention and treatment strategies for SI based on gender.

Exploring fear of happiness among university students: The role of perfectionism, academic burnout, loneliness, and hopelessness.

Due to its impact on mental health and well-being, fear of happiness is beginning to receive more attention in research. This study, conducted in Hungary, explored the relationship between fear of happiness, perfectionism, loneliness, hopelessness, and academic burnout. Participants aged between 18 and 35 years (N = 1,148, M = 22 years, SD = 4.5) completed an online questionnaire that included self-report measures of these constructs. In the present study, males showed higher levels of fear of happiness and perfectionism than did females. Analyses also revealed that both adaptive and maladaptive perfectionism, academic burnout, loneliness, and hopelessness were positively related to fear of happiness. In multiple regression analysis, gender had a positive and age had a negative role in the levels of fear of happiness. Maladaptive perfectionism, academic burnout, loneliness, and hopelessness were positive predictors, while adaptive perfectionism almost reached statistical significance. These findings highlight the predictive role of previously unexplored variables in fear of happiness.

Orthorexic Tendency in Light of Eating Disorder Attitudes, Social Media Addiction and Regular Sporting Among Young Hungarian Women.

This study examined a set of background psychological and other variables of orthorexic (ON) tendency in a sample of young women with special interest in healthy lifestyle. The sample consisted of female young adults (N = 310; aged 18-35 years; mean age = 24.3 years; SD = 4.97 years) who were recruited through social media health sites. Besides Orthorexia Nervosa Questionnaire (ORTO­15), BMI, regular sporting activity, the following scales were used: Eating Disorder Inventory (EDI, drive for thinness, ineffectiveness and maturity fears); Bergen Social Media Addiction Scale (BSMAS); and The Proactive Coping Inventory. In this sample, 37.7% were at risk for ON. Eating disorder attitudes, regular sporting and social media addiction were the most relevant predictors of orthorexic tendency with drive for thinness being the strongest contributor (ß = 0.54, p < 0.001). For young women with a special interest in healthy lifestyle, drive for thinness together with regular sporting, ON tendency may serve as a tool for achieving their goal. Social media addiction and other psychological problems (feeling of ineffectiveness or maturity fears) can also contribute to orthorexic rendency. It would be important to ask for support from qualified health professionals when changing nutritional practices.

Curative Factors in Adolescent Day Programs: Participant, Therapist, and Parent Perspectives.

Adolescent day programs (ADPs) have treatment outcomes as good as, or better than, regular outpatient treatment for adolescents who present with emotional, behavioral, social, and psychiatric disorders. However, they may be more costly, and the mechanisms of change within them are unknown. Identification of the most important curative factors could enable the streamlining of these programs. This descriptive study examined the perceptions of curative factors in ADP treatment as rated by 38 participants, 51 of their parents, and 14 clinicians. Findings were variable across informant groups. Adolescent respondents reported Universality, Acceptance, Learning from Interpersonal Action, Decision Making, Altruism, Guidance, and Instillation of Hope to be equally the most helpful curative factors in the program. Clinicians ranked Acceptance to be the most important factor, followed by Decision Making, Self-Understanding, Vicarious Learning, and Universality. Parents ranked Acceptance, Universality, Guidance, and Instillation of Hope as being most helpful. The findings provide directions for the enhancement of ADPs.