Language
Country/Area
No result found
Unraveling the hallmarks of unipolar mania: How do its symptoms differ from those of bipolar disorder?
Unipolar mania is a special form of bipolar disorder in which the patient experiences only manic episodes without depressive symptoms. Features associated with depression are often characterized by prolonged lows, decreased energy, and suicidal thoughts, while manic episodes are characterized by racing thoughts, decreased need for sleep, and psychomotor agitation. As early as the 19th century, the concept of bipolar disorder was first proposed by Baylakir, Fallet, and Grinzinger; however, the German psychiatrist Emil Kraepelin first established the classification of manic-depressive disorder. And eventually the term bipolar disorder was introduced. The term "cyclical mania" was first used by Kraepelin in 1889 to describe patients who had frequent episodes of mania without depression.
Although unipolar disorder is not recognized as a separate disorder in the DSM-5 (American Psychiatric Association's Diagnostic and Statistical Manual, 5th edition), research suggests that unipolar disorder is similar to bipolar disorder. There are significant differences between them. Patients with unipolar mania are less likely to have depressive features, mood swings, hallucinations, comorbid anxiety disorders, and suicidal thoughts or attempts; however, they are more likely to experience delusions, exhibit formal thought disorders, and have used drugs (eg, marijuana). and amphetamines), and more commonly, a persistent elevated mood. Notably, patients with unipolar mania are also more likely to have episodes accompanied by psychotic features.Over time, the diagnosis of unipolar disorder has lost validity because of the variability of symptoms between different patients.
Epidemiology and diagnostic criteria
Currently, there is a lack of clear data on the prevalence of unipolar mania, as different studies have used different definitions and diagnostic criteria for the disorder, resulting in reported prevalence rates ranging from 1.1% to 65.3%. For example, Carlo Peris' 1966 definition states that unipolar mania is considered present when an individual experiences at least one manic episode and no depressive episodes. Based on this criterion, the prevalence rate could reach 35.2%. Inconsistency in diagnostic criteria is shown to affect epidemiological studies of unipolar mania.
In some long-term follow-up studies, some cases of unipolar mania were eventually reclassified as bipolar disorder, demonstrating the instability of this diagnosis.
Socio-demographic characteristics
Most studies on bipolar disorder come from non-Western countries, but this does not mean that the disorder is more common in these countries. According to a cross-cultural study in France and Tunisia, researchers found that the rate of monopolar disorder in Tunisia is three times that in France, a finding that requires further research to verify the reasons behind it. As for gender differences, a 1979 study found that most patients were men, and a 1986 study confirmed that the incidence rate in men was twice that in women. Regarding age of onset, unipolar mania generally develops at an earlier age than bipolar disorder in patients, however these results have not been consistently replicated in subsequent studies.
Research Progress
Because unipolar disorder is considered an invalid diagnosis, research in this area focuses on the exploration of symptom variation and patient characteristics. The Long-Term Internal Follow-up Evaluation study showed that patients whose manic episodes were not accompanied by depressive symptoms did not develop signs of depression in the subsequent 15 years, suggesting that unipolar mania should be included in the unique diagnosis category. Meta-analyses have also shown that there is significant variation in the individual manifestations of unipolar mania.
The study of monopolar disorder has been criticized due to the diversity of diagnostic criteria and the differences in the length of follow-up periods for patients.
In addition, some case studies are also exploring the clinical differences between unipolar mania and bipolar disorder. The findings from these studies help to further reveal its symptoms, treatment options and future research directions. However, there is still a lack of effective explanation for the causes and treatment of monopolar disorder. Whether monopolar disorder can really be considered an independent diagnostic criterion still requires more in-depth research support. When faced with such a complex situation, we might as well think about: How can we better identify and understand the unique needs of this group of patients in clinical practice?
