Keywords
Bipolar disorder
Differential diagnosis
Therapeutics
How to Cite
Copyright © | All rights reserved.
The journal holds the exclusive copyright for the publication of this article under the terms of Brazilian law 9610/98.
Partial reproduction
The use of parts of the texts, figures and questionnaire of the article is free, being mandatory the citation of the authors and journal.
Total reproduction
It is expressly prohibited and must be authorized by the journal.
Abstract
Objective: To analyze the psychopathological expressions present in depressive episodes of Major Depressive Disorder (MDD) and Bipolar Affective Disorder (BAD), aiming to identify clinical markers that aid in the differential diagnosis between the two disorders and discuss the therapeutic implications arising from an accurate diagnostic identification. Methods: This study is an integrative literature review conducted following the PVO strategy. Searches were performed in the PubMed Central (PMC) database using specific terms, resulting in 1,299 articles. After applying inclusion criteria — articles from the last 5 years related to the topic — 11 articles were selected. Results: The differential diagnosis between Major Depressive Disorder and Bipolar Affective Disorder is essential to guide proper treatment. Appropriate selection of medications and personalized interventions improves therapeutic efficacy and prevents relapses. Advances in biomarkers and neuroimaging promise to enhance diagnosis and clinical management, but further research is needed to optimize protocols and prognoses. Conclusions: Future investigations and continuous professional updating are necessary to improve the quality of life for patients with Major Depressive Disorder and Bipolar Affective Disorder.
References
AGIUS M, et al. Assessing the trajectory of bipolar disorder effectively in order to treat effectively. Psychiatria Danubina, 2024; Vol. 36, Suppl. 2, pp. 52–60.
BRIELER JA, KEEGAN-GARRETT E. Diagnosis and Treatment of Bipolar Illness in the Primary Care Office. Science of Medicine | Feature Series, 2022; 119:3.
COSCI F, GIOVANNI AF. When Anxiety and Depression Coexist: The Role of Differential Diagnosis Using Clinimetric Criteria. Psychotherapy and Psychosomatics, 2021; vol. 90, 5: 308–317.
DACROCE BN, et al. Diagnóstico diferencial entre transtorno depressivo maior com sintomas psicóticos e esquizofrenia: relato de caso. Thêma et Scientia, 2021; Vol. 11.
DUBOVSKY ASL, et al. Psychotic Depression: Diagnosis, Differential Diagnosis, and Treatment. Psychother Psychosom, 2020.
GILLETT G, et al. Digital Communication Biomarkers of Mood and Diagnosis in Borderline Personality Disorder, Bipolar Disorder, and Healthy Control Populations. Frontiers in Psychiatry, 2021; vol. 12: 610457.
HE E, et al. White Matter Alterations in Depressive Disorder. Front. Immunol., 2022; 13:826812.
KISHI T, et al. Antidepressants for the treatment of adults with major depressive disorder in the maintenance phase: a systematic review and network meta-analysis. Mol Psychiatry, 2023; 28(1):402–409.
KIM H, et al. Systematic review of structured care pathways in major depressive disorder and bipolar disorder. BMC Psychiatry, 2023; 23:85.
MENCULINI G, et al. Major challenges in youth psychopathology: treatment-resistant depression. A narrative review. Front. Psychiatry, 2024; 15:1417977.
MENEZES I, et al. Differential Diagnosis of Major Depressive Disorder and Bipolar Disorder: Genetic and Hormonal Assessment and the Influence of Early-Life Stress. Brain Sciences, 2022; vol. 12, 11: 1476.
PALAMARCHUK IS, et al. Fisiopatologia celular relacionada ao estresse como um fator de risco de interferência para transtornos neurocognitivos e psiquiátricos. BMC Neurosci, 2023; 24:65.
PANG Y, et al. Combined static and dynamic functional connectivity signatures differentiating bipolar depression from major depressive disorder. Australian & New Zealand Journal of Psychiatry, 2020; 00(0).
PASTRNAK M, et al. Insula activity in resting‐state differentiates bipolar from unipolar depression: a systematic review and meta‐analysis. Scientific Reports - Nature Portfolio, 2021; 11:16930.
POLETTI S, et al. Inflammatory mediators in major depression and bipolar disorder. Translational Psychiatry, 2024; 14:247.
SACCARO LF, et al. Inflammation, anxiety, and stress in bipolar disorder and borderline personality disorder: A narrative review. Neuroscience and Biobehavioral Reviews, 2021; vol. 127: 184–192.
SQUITTI R, et al. Neurofilament Light Protein as a Biomarker in Severe Mental Disorders: A Systematic Review. Int. J. Mol. Sci., 2025; 26:61.
WU Z, et al. Clinical distinctions in symptomatology and psychiatric comorbidities between misdiagnosed bipolar I and bipolar II disorder versus major depressive disorder. BMC Psychiatry, 2024; 24:352.
YANG R, et al. Differentiation between bipolar disorder and major depressive disorder in adolescents: from clinical to biological biomarkers. Front. Hum. Neurosci., 2023; 17:1192544.
ZHONG R, et al. Using Digital Phenotyping to Discriminate Unipolar Depression and Bipolar Disorder: Systematic Review. J Med Internet Res, 2025; vol. 27: e72229.