Clin Psychopharmacol Neurosci 2018; 16(3): 262-266  
Dissociative Experience in Unipolar and Bipolar Depression: Exploring the Great Divide
Seshadri Sekhar Chatterjee1, Arghya Pal2, Nitu Mallik2, Malay Ghosal2, Goutam Saha3
1Department of Psychiatry, NIMHANS, Bangalore, 2Department of Psychiatry, Calcutta Medical College and Hospital, Kolkata, 3Consultant Psychiatrist, Kolkata, India
Correspondence to: Seshadri Sekhar Chatterjee, MD
Department of Psychiatry, NIMHANS, Bangalore, India
Tel: +91-80-2699-5000
E-mail: drsschatterjee@gmail.com
ORCID: https://orcid.org/0000-0002-5554-2216
Received: February 28, 2018; Revised: March 28, 2018; Accepted: March 29, 2018; Published online: August 31, 2018.
© The Korean College of Neuropsychopharmacology. All rights reserved.

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Objective: Unipolar and bipolar depression (UD and BD) differ strikingly in respect to neurobiology, course and management, but their apparent clinical similarity often leads to misdiagnosis resulting in chronicity of course and treatment failure. In this study we have tried to assess whether UD and BD can be differentiated on the basis of their dissociative symptoms.
Methods: Thrty-six UD patients and 35 BD patients in active episodes, without any psychiatric comorbidity were selected from outpatient department and compared for depressive and dissociative symptoms using Hamilton Depression Rating Scale and Dissociative Experience Scale-II (DES-II).
Results: We found that thought the two groups didn’t differ in terms of the socio-demographic or clinical variables, BD group had significantly higher dissociative experience (U=343, p=0.001) than UD and the difference remained significant even after adjusting for the confounding factors.
Conclusion: Our study shows that dissociative symptoms are significantly more prevalent in the depressive episodes of bipolar affective disorder as compared to the UD and can be an important tool in differentiating between the two disorders with very similar clinical profile. The difference can be measured using a simple self-report questionnaire like DES-II.
Keywords: Dissociative disorders; Bipolar disorder; Bipolar depression.


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