Journal of Affective Disorders
Volume 74, Issue 2 , Pages 173-184 , April 2003

The Munich Vulnerability Study on Affective Disorders: risk factors for unipolarity versus bipolarity

  • Sieglinde Modell

      Affiliations

    • Max Planck Institute of Psychiatry, Kraepelinstrasse 10, D-80804 Munich, Germany
    • Corresponding Author InformationCorresponding author. Tel.: +49-89-3062-2637; fax: +49-89-3062-2493
  • ,
  • Johannes Huber

      Affiliations

    • Max Planck Institute of Psychiatry, Kraepelinstrasse 10, D-80804 Munich, Germany
  • ,
  • Florian Holsboer

      Affiliations

    • Max Planck Institute of Psychiatry, Kraepelinstrasse 10, D-80804 Munich, Germany
  • ,
  • Christoph J Lauer

      Affiliations

    • Sleep Disorder Center, Hospital Angermuehle, Deggendorf, Germany

Received 18 December 2000 ,Revised 11 December 2001 ,Accepted 11 December 2001.

References 

  1. American Psychiatric Association, 1994. Diagnostic and Statistical Manual of Mental Disorders. 4th Edition, American Psychiatric Association, Washington, DC.
  2. Amsterdam JD, Maislin G. Hormonal responses during insulin-induced hypoglycemia in manic depressed, unipolar depressed, and healthy control subjects. J. Clin. Endocrinol. Metab. 1991;73:541–548
  3. Amsterdam JD, Winokur A, Caroff SN, et al.  The dexamethasone suppression test in outpatients with primary affective disorder and healthy control subjects. Am. J. Psychiatry. 1982;139:287–291
  4. Angst, J., 1966. Zur Ätiologie und Nosologie endogener depressiver Psychosen. In: Monogr. Gesamtgeb. Neurol. Psychiatr. Springer, Berlin.
  5. Buchsbaum MS, Wu J, DeLisi LE, et al.  Frontal cortex and basal ganglia metabolic rates assessed by positron emission tomography with [18F]2-deoxyglucose in affective illness. J. Affect. Disord. 1986;10:137–152
  6. Buysse DJ, Frank E, Lowe KK, et al.  Electroencephalographic sleep correlates of episode and vulnerability to recurrence in depression. Biol. Psychiatry. 1997;41:406–418
  7. Carroll BJ, Curtis GC, Davies BM, et al.  Urinary free cortisol excretion in depression. Psychol. Med. 1976;6:43–50
  8. Clayton PJ, Ernst C, Angst J. Premorbid personality traits of men who develop unipolar or bipolar disorders. Eur. Arch. Psychiatry Clin. Neurosci. 1994;243:340–346
  9. de Maertelaer V, Hofmann G, Lemaire M, et al.  Sleep spindle activity changes in patients with affective disorders. Sleep. 1987;10:443–451
  10. Duncan WC, Pettigrew KD, Gillin JC. REM architecture changes in bipolar and unipolar depression. Am. J. Psychiatry. 1979;136:1424–1427
  11. Feinberg M, Gillin JC, Carroll BJ, et al.  EEG studies of sleep in the diagnosis of depression. Biol. Psychiatry. 1982;17:305–316
  12. Gershon ES, Hamovit J, Guroff JJ, et al.  A family study of schizoaffective bipolar I, bipolar II, unipolar, and normal control probands. Arch. Gen. Psychiatry. 1982;39:1157–1167
  13. Giles DE, Jarett RB, Rottwarg HP, et al.  Reduced rapid eye movement latency: a predictor of recurrence in depression. J. Neuropsychopharmacol. 1987;1:33–39
  14. Giles DE, Kupfer DJ, Rush AJ, et al.  Controlled comparison of electrophysiological sleep in families of probands with unipolar depression. Am. J. Psychiatry. 1998;155:192–199
  15. Giles DE, Rush AJ, Roffwarg HP. Sleep parameters in bipolar I, bipolar II and unipolar depressions. Biol. Psychiatry. 1986;21:1340–1343
  16. Gillin, J.C., Bunney Jr., W.E., Buchbinder, R., 1975. Sleep changes in unipolar and bipolar depressed patients as compared with normals. Presented at the 2nd International Sleep Research Congress and 15th Annual Meeting of the Association for the Psychophysiological Study of Sleep. Edinburgh, UK.
  17. Hecht H, van Calker D, Berger M, et al.  Personality in patients with affective disorders and their relatives. J. Affect. Disord. 1988;51:33–43
  18. Hecht H, van Calker D, Spraul G, et al.  Premorbid personality in patients with uni- and bipolar affective disorders and controls: assessment by the Biographical Personality Interview (BPI). Eur. Arch. Psychiatry Clin. Neurosci. 1997;247:23–30
  19. Hiller W, Zaudig M, Mombour W. Development of diagnostic checklists for use in routine clinical care. A guideline designed to assess DSM-III-R diagnoses. Arch. Gen. Psychiatry. 1990;47:782–784
  20. Hirschfeld RMA, Klerman GL, Keller MB, et al.  Personality of recovered patients with bipolar affective disorder. J. Affect. Disord. 1986;11:81–89
  21. Hirschfeld RMA, Klerman GL, Lavori P, et al.  Premorbid personality assessment of first onset of major depression. Arch. Gen. Psychiatry. 1989;46:345–350
  22. Holsboer F. The rationale for corticotropin-releasing hormone receptor (CRH-R) antagonists to treat depression and anxiety. J. Psychiatr. Res. 1999;33:181–214
  23. Holsboer F, Lauer CJ, Schreiber W, et al.  Altered hypothalamic–pituitary–adrenocortical regulation in healthy subjects at high familial risk for affective disorders. Neuroendocrinology. 1995;62:340–347
  24. Kerkhofs M, Kempenaers C, Linkowski P, et al.  Multivariate study of sleep EEG in depression. Acta Psychiatr. Scand. 1988;77:463–468
  25. Lauer CJ, Bronisch T, Kainz M, et al.  Premorbid psychometric profile of subjects at high familial risk for affective disorders. Psychol. Med. 1997;27:355–362
  26. Lauer CJ, Schreiber W, Holsboer F, et al.  In quest of identifying vulnerability markers for psychiatric disorders by all-night polysomnography. Arch. Gen. Psychiatry. 1995;52:145–153
  27. Lauer CJ, von Zerssen D, Schreiber W, et al.  The premorbid psychometric profile is stable over time in subjects at high familial risk for affective disorders. J. Affect. Disord. 1998;51:45–53
  28. Lauer CJ, Wiegand M, Krieg J-C. All-night electroencephalographic sleep and cranial computed tomography in depression. A study of unipolar and bipolar patients. Eur. Arch. Psychiatry Clin. Neurosci. 1992;242:59–68
  29. Leonhard K. Aufteilung der endogenen Psychosen. 2nd Edition. Berlin: Akademie-Verlag; 1959;
  30. Linkowski P, Brauman H, Mendlewicz J. Prolactin and growth hormone response to levodopa in affective illness. Neuropsychobiology. 1983;9:108–112
  31. Maier W, Minges J, Lichtermann D, et al.  Personality disorders and personality variations in relatives of patients with bipolar affective disorders. J. Affect. Disord. 1996;53:173–181
  32. Matussek P, Feil WB. Personality attributes of depressive patients: result of group comparisons. Arch. Gen. Psychiatry. 1983;40:783–790
  33. Meltzer HY, Perline R, Tricou BJ, et al.  Effect of 5-hydroxytryptophan on serum cortisol levels in major affective disorders. II. Relation to suicide, psychosis, and depressive symptoms. Arch. Gen. Psychiatry. 1984;41:379–387
  34. Modell S, Lauer CJ, Schreiber W, et al.  Hormonal response pattern in the combined Dex/CRH test is stable over time in subjects at high familial risk for affective disorders. Neuropsychopharmacology. 1998;18:253–262
  35. Perris, C., 1966. A study of bipolar (manic depressive) and unipolar recurrent depressive psychoses. Acta Psychiatr. Neurol. Scand. Suppl. 42, 1–189.
  36. Pichot P. The birth of the bipolar disorder. Eur. Psychiatry. 1995;10:1–10
  37. Reich T, Rice J, Cloninger CR, et al.  The use of multiple thresholds and segregation analysis in analyzing the phenotypic heterogeneity of multifactorial traits. Ann. Hum. Genet. 1979;42:371–389
  38. Reynolds CF, Kupfer DJ. Sleep research in affective illness: state of the art circa 1987. Sleep. 1987;10:199–215
  39. Richter P, Diebold K, Schutzwoh IM. On the personality of unipolar depressive and bipolar manic-depressive patients. Nervenarzt. 1993;64:572–577
  40. Samuelson SD, Winokur G, Pitts AF. Elevated cerebrospinal fluid protein in men with unipolar or bipolar depression. Biol. Psychiatry. 1994;35:539–544
  41. Schatzberg AF, Rotschild AJ, Stahl JB, et al.  The dexamethasone suppression test: identification of subtypes of depression. Am. J. Psychiatry. 1983;140:88–91
  42. Schlegel S, Kretzschmar K. Computed tomography in affective disorders. Part I. Ventricular and sulcal measurements. Biol. Psychiatry. 1987;22:4–14
  43. Schlesser MA, Winokur G, Sherman BM. Hypothalamic–pituitary–adrenal axis activity in depressive illness. Its relationship to classification. Arch. Gen. Psychiatry. 1980;37:737–747
  44. Schreiber W, Lauer CJ, Krumrey K, et al.  Cholinergic REM sleep induction test in subjects at high risk for psychiatric disorders. Biol. Psychiatry. 1992;32:79–90
  45. Staner L, van Veeren K, Stefos G, et al.  Neuroendocrine and clinical characteristics of major depressed patients exhibiting sleep-onset REM. Biol. Psychiatry. 1998;43:817–821
  46. Stokes PE, Stoll PM, Koslow SH, et al.  Pretreatment DST in hypothalamic–pituitary–adrenocortical function in depressed patients and comparison groups. Arch. Gen. Psychiatry. 1984;41:257–267
  47. Taylor MA, Abrams R, Hayman MA. The classification of affective disorders—a reassessment of the bipolar–unipolar dichotomy. A clinical, laboratory, and family study. J. Affect. Disord. 1980;2:95–109
  48. Tsuang M, Winokur G, Crowe R. Morbidity risks of schizophrenia and affective disorders among first degree relatives of patients with schizophrenia, mania, depression and surgical conditions. Br. J. Psychiatry. 1980;137:497–504
  49. von Zerssen D, Tauscher R, Pössl J. The relationship of premorbid personality to subtypes of an affective illness. A replication study by means of an operationalized procedure for the diagnosis of personality structures. J. Affect. Disord. 1994;32:61–72
  50. Winokur G, Cadoret R. Genetic studies in depressive disorders. In:  Burrow GD editors. Handbook of Studies on Depression. Amsterdam: Excerpta Medica; 1977;p. 69–77
  51. Wittchen H-U, Zaudig M, Schramm E, et al.  SKID Strukturiertes Klinisches Interview für DSM-III-R. Weinheim: Beltz-Verlag; 1990;
  52. World Health Organization, 1995. International Classification of Diseases, 10th revision, Chapter 5 (F: Mental and Behavioral Disorders. Clinical Description and Diagnostic Guidelines). World Health Organization, Geneva.
  53. Yatham LN, Srisurapanont M, Zis AP, et al.  Comparative studies of the biological distinction between unipolar and bipolar depressions. Life Sci. 1997;15:1445–1455
  54. Young LT, Bagby M, Cooke RG, et al.  A comparison of Tridimensional Personality Questionnaire dimensions in bipolar disorder and unipolar depression. Psychiatry Res. 1995;58:139–143
  55. Young LT, Li PP, Kamble A, et al.  Mononuclear leukocyte levels of G proteins in depressed patients with bipolar disorder or major depressive disorder. Am. J. Psychiatry. 1994;151:594–596

PII: S0165-0327(02)00010-1

doi: 10.1016/S0165-0327(02)00010-1

Journal of Affective Disorders
Volume 74, Issue 2 , Pages 173-184 , April 2003