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Current Neuropharmacology

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ISSN (Print): 1570-159X
ISSN (Online): 1875-6190

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Research Article

Gender Differences in the Psychopathology of Mixed Depression in Adolescents with a Major Depressive Episode

Author(s): Massimo Apicella, Giulia Serra, Maria Elena Iannoni, Monia Trasolini, Gino Maglio, Elisa Andracchio and Stefano Vicari*

Volume 21, Issue 6, 2023

Published on: 11 January, 2023

Page: [1343 - 1354] Pages: 12

DOI: 10.2174/1570159X20666221012113458

Price: $65

Abstract

Background: Gender differences have been reported in the severity and psychopathological features of major depressive disorders among adults but are poorly reported in adolescent samples.

Objective: This study aimed to examine gender differences in the psychopathology of mixed depression among adolescents.

Methods: We analyzed 341 outpatients with the current major depressive episode (MDE) retrospectively to identify patients with DSM-5 MDE with mixed features. We compared examiner-rated depressive and (hypo)manic symptoms and self- and parent-reported symptoms between sexes.

Results: We identified 76 patients with an MDE with mixed features (67.1% females, 32.9% with bipolar disorder). Depression severity was significantly greater in females versus males (CDRS-R total score 56.2 vs. 48.2, p = 0.014). Depressive symptoms were significantly and independently found to be more severe among females in a logistic regression model, including excessive fatigue (OR 1.68; p = 0.025), low self-esteem (OR 1.67; p = 0.04), excessive weeping (OR 1.62; p = 0.021), and CBCL AAA index (OR 1.04; p = 0.015). None of the depressive symptoms scored greater in males. Males had higher levels of motor activity (2.12 vs. 1.69; p = 0.048) and pressured speech (1.80 vs. 1.24; p = 0.004). Self-rated anxiety (69.3 vs. 56.8, p = 0.047) and CBCL AAA index (207 vs. 189; p = 0.007) were higher in females.

Conclusion: Adolescent depression with mixed features is more severe in women, with a higher expression of core affective symptoms and excessive fatigue. While in males, slightly higher levels of psychomotor activation are reported, in females, emotional dysregulation and excessive weeping may subtend a difference in a broader spectrum of mixed features.

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[1]
Serra, G.; Uchida, M.; Battaglia, C.; Casini, M.; Chiara, L.; Biederman, J.; Vicari, S.; Wozniak, J. Pediatric mania: The controversy between euphoria and irritability. Curr. Neuropharmacol., 2017, 15(3), 386-393.
[http://dx.doi.org/10.2174/1570159X14666160607100403] [PMID: 28503110]
[2]
Ferrari, A.J.; Charlson, F.J.; Norman, R.E.; Patten, S.B.; Freedman, G.; Murray, C.J.L.; Vos, T.; Whiteford, H.A. Burden of depressive disorders by country, sex, age, and year: Findings from the global burden of disease study 2010. PLoS Med., 2013, 10(11), e1001547.
[http://dx.doi.org/10.1371/journal.pmed.1001547] [PMID: 24223526]
[3]
Malhi, G.S.; Mann, J.J. Depression. Lancet, 2018, 392(10161), 2299-2312.
[http://dx.doi.org/10.1016/S0140-6736(18)31948-2] [PMID: 30396512]
[4]
Avenevoli, S.; Swendsen, J.; He, J.P.; Burstein, M.; Merikangas, K.R. Major depression in the national comorbidity survey-adolescent supplement: Prevalence, correlates, and treatment. J. Am. Acad. Child Adolesc. Psychiatry, 2015, 54(1), 37-44.e2.
[http://dx.doi.org/10.1016/j.jaac.2014.10.010] [PMID: 25524788]
[5]
Merikangas, K.R.; He, J.; Burstein, M.; Swanson, S.A.; Avenevoli, S.; Cui, L.; Benjet, C.; Georgiades, K.; Swendsen, J. Lifetime prevalence of mental disorders in U.S. adolescents: Results from the National Comorbidity Survey Replication-Adolescent Supplement (NCS-A). J. Am. Acad. Child Adolesc. Psychiatry, 2010, 49(10), 980-989.
[http://dx.doi.org/10.1016/j.jaac.2010.05.017] [PMID: 20855043]
[6]
Kuehner, C. Why is depression more common among women than among men? Lancet Psychiatry, 2017, 4(2), 146-158.
[http://dx.doi.org/10.1016/S2215-0366(16)30263-2] [PMID: 27856392]
[7]
Breslau, J.; Gilman, S.E.; Stein, B.D.; Ruder, T.; Gmelin, T.; Miller, E. 2017 Sex differences in recent first-onset depression in an epidemiological sample of adolescents. Transl. Psychiatry, 2017, 7(5), e1139.
[http://dx.doi.org/10.1038/tp.2017.105]
[8]
Salk, R.H.; Petersen, J.L.; Abramson, L.Y.; Hyde, J.S. The contemporary face of gender differences and similarities in depression throughout adolescence: Development and chronicity. J. Affect. Disord., 2016, 205, 28-35.
[http://dx.doi.org/10.1016/j.jad.2016.03.071] [PMID: 27391269]
[9]
Kessing, L.V. Gender differences in the phenomenology of bipolar disorder. Bipolar Disord., 2004, 6(5), 421-425.
[http://dx.doi.org/10.1111/j.1399-5618.2004.00135.x] [PMID: 15383135]
[10]
Oakley Browne, M.A.; Elisabeth Wells, J.; Scott, K.M.; Mcgee, M.A. Lifetime prevalence and projected lifetime risk of DSM-IV disorders in Te Rau Hinengaro: The New Zealand Mental Health Survey. Aust. N. Z. J. Psychiatry, 2006, 40(10), 865-874.
[http://dx.doi.org/10.1080/j.1440-1614.2006.01905.x] [PMID: 16959012]
[11]
Viguera, A.C.; Baldessarini, R.J.; Tondo, L. Response to lithium maintenance treatment in bipolar disorders: Comparison of women and men. Bipolar Disord., 2001, 3(5), 245-252.
[http://dx.doi.org/10.1034/j.1399-5618.2001.30503.x] [PMID: 11903207]
[12]
Altshuler, L.L.; Kupka, R.W.; Hellemann, G.; Frye, M.A.; Sugar, C.A.; McElroy, S.L.; Nolen, W.A.; Grunze, H.; Leverich, G.S.; Keck, P.E.; Zermeno, M.; Post, R.M.; Suppes, T. Gender and depressive symptoms in 711 patients with bipolar disorder evaluated prospectively in the Stanley Foundation bipolar treatment outcome network. Am. J. Psychiatry, 2010, 167(6), 708-715.
[http://dx.doi.org/10.1176/appi.ajp.2009.09010105] [PMID: 20231325]
[13]
Sherazi, R.; McKeon, P.; McDonough, M.; Daly, I.; Kennedy, N. What’s new? The clinical epidemiology of bipolar I disorder. Harv. Rev. Psychiatry, 2006, 14(6), 273-284.
[http://dx.doi.org/10.1080/10673220601070047] [PMID: 17162652]
[14]
Nivoli, A.M.A.; Pacchiarotti, I.; Rosa, A.R.; Popovic, D.; Murru, A.; Valenti, M.; Bonnin, C.M.; Grande, I.; Sanchez-Moreno, J.; Vieta, E.; Colom, F. Gender differences in a cohort study of 604 bipolar patients: The role of predominant polarity. J. Affect. Disord., 2011, 133(3), 443-449.
[http://dx.doi.org/10.1016/j.jad.2011.04.055] [PMID: 21620480]
[15]
Cavanagh, A.; Wilson, C.J.; Kavanagh, D.J.; Caputi, P. Differences in the expression of symptoms in men versus women with depression: A systematic review and meta-analysis. Harv. Rev. Psychiatry, 2017, 25(1), 29-38.
[http://dx.doi.org/10.1097/HRP.0000000000000128] [PMID: 28059934]
[16]
Parker, G.; Fletcher, K.; Paterson, A.; Anderson, J.; Hong, M. Gender differences in depression severity and symptoms across depressive sub-types. J. Affect. Disord., 2014, 167, 351-357.
[http://dx.doi.org/10.1016/j.jad.2014.06.018] [PMID: 25020270]
[17]
Parker, G.; Brotchie, H. Gender differences in depression. Int. Rev. Psychiatry, 2010, 22(5), 429-436.
[http://dx.doi.org/10.3109/09540261.2010.492391] [PMID: 21047157]
[18]
Cuffe, S.P.; Waller, J.L.; Cuccaro, M.L.; Pumariega, A.J.; Garrison, C.Z. Race and gender differences in the treatment of psychiatric disorders in young adolescents. J. Am. Acad. Child Adolesc. Psychiatry, 1995, 34(11), 1536-1543.
[http://dx.doi.org/10.1097/00004583-199511000-00021] [PMID: 8543522]
[19]
Bennett, D.S.; Ambrosini, P.J.; Kudes, D.; Metz, C.; Rabinovich, H. Gender differences in adolescent depression: Do symptoms differ for boys and girls? J. Affect. Disord., 2005, 89(1-3), 35-44.
[http://dx.doi.org/10.1016/j.jad.2005.05.020] [PMID: 16219362]
[20]
Roberts, R.; Lewinsohn, P.M.; Seeley, J.R. Symptoms of DSM-IIIR major depression in adolescence: Evidence from an epidemiological survey. J. Am. Acad. Child Adolesc. Psychiatry, 1995, 34(12), 1608-1617.
[http://dx.doi.org/10.1097/00004583-199512000-00011] [PMID: 8543532]
[21]
Kovacs, M. Gender and the course of major depressive disorder through adolescence in clinically referred youngsters. J. Am. Acad. Child Adolesc. Psychiatry, 2001, 40(9), 1079-1085.
[http://dx.doi.org/10.1097/00004583-200109000-00017] [PMID: 11556632]
[22]
Sørensen, M.J.; Nissen, J.B.; Mors, O.; Thomsen, P.H. Age and gender differences in depressive symptomatology and comorbidity: An incident sample of psychiatrically admitted children. J. Affect. Disord., 2005, 84(1), 85-91.
[http://dx.doi.org/10.1016/j.jad.2004.09.003] [PMID: 15620389]
[23]
Masi, G.; Favilla, L.; Mucci, M.; Poli, P.; Romano, R. Depressive symptoms in children and adolescents with dysthymic disorder. Psychopathology, 2001, 34(1), 29-35.
[http://dx.doi.org/10.1159/000049277] [PMID: 11150928]
[24]
Koukopoulos, A.; Sani, G.; Ghaemi, S.N. Mixed features of depression: Why DSM-5 is wrong (and so was DSM-IV). Br. J. Psychiatry, 2013, 203(1), 3-5.
[http://dx.doi.org/10.1192/bjp.bp.112.124404] [PMID: 23818531]
[25]
Miller, S.; Suppes, T.; Mintz, J.; Hellemann, G.; Frye, M.A.; McElroy, S.L.; Nolen, W.A.; Kupka, R.; Leverich, G.S.; Grunze, H.; Altshuler, L.L.; Keck, P.E., Jr; Post, R.M. Mixed depression in bipolar disorder: Prevalence rate and clinical correlates during naturalistic follow-up in the stanley bipolar network. Am. J. Psychiatry, 2016, 173(10), 1015-1023.
[http://dx.doi.org/10.1176/appi.ajp.2016.15091119] [PMID: 27079133]
[26]
Biederman, J.; Mick, E.; Faraone, S.V.; Spencer, T.; Wilens, T.E.; Wozniak, J. Pediatric mania: A developmental subtype of bipolar disorder? Biol. Psychiatry, 2000, 48(6), 458-466.
[http://dx.doi.org/10.1016/S0006-3223(00)00911-2] [PMID: 11018219]
[27]
Frazier, E.A.; Swenson, L.P.; Mullare, T.; Dickstein, D.P.; Hunt, J.I. Depression with mixed features in adolescent psychiatric patients. Child Psychiatry Hum. Dev., 2017, 48(3), 393-399.
[http://dx.doi.org/10.1007/s10578-016-0666-z] [PMID: 27349656]
[28]
Sloan, D.M.E.; Kornstein, S.G. Gender differences in depression and response to antidepressant treatment. Psychiatr. Clin. North Am., 2003, 26(3), 581-594.
[http://dx.doi.org/10.1016/S0193-953X(03)00044-3] [PMID: 14563099]
[29]
Payne, S.; Swami, V.; Stanistreet, D.L. The social construction of gender and its influence on suicide: A review of the literature. J. Men’s Health, 2008, 5(1), 23-35.
[http://dx.doi.org/10.1016/j.jomh.2007.11.002]
[30]
Nock, M.K.; Green, J.G.; Hwang, I.; McLaughlin, K.A.; Sampson, N.A.; Zaslavsky, A.M.; Kessler, R.C. Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents: Results from the National Comorbidity Survey Replication Adolescent Supplement. JAMA Psychiatry, 2013, 70(3), 300-310.
[http://dx.doi.org/10.1001/2013.jamapsychiatry.55] [PMID: 23303463]
[31]
Pompili, M.; Masocco, M.; Vichi, M.; Lester, D.; Innamorati, M.; Tatarelli, R.; Vanacore, N. Suicide among Italian adolescents: 1970–2002. Eur. Child Adolesc. Psychiatry, 2009, 18(9), 525-533.
[http://dx.doi.org/10.1007/s00787-009-0007-x] [PMID: 19290562]
[32]
Suppes, T.; Mintz, J.; McElroy, S.L.; Altshuler, L.L.; Kupka, R.W.; Frye, M.A.; Keck, P.E., Jr; Nolen, W.A.; Leverich, G.S.; Grunze, H.; Rush, A.J.; Post, R.M. Mixed hypomania in 908 patients with bipolar disorder evaluated prospectively in the Stanley Foundation Bipolar Treatment Network: A sex-specific phenomenon. Arch. Gen. Psychiatry, 2005, 62(10), 1089-1096.
[http://dx.doi.org/10.1001/archpsyc.62.10.1089] [PMID: 16203954]
[33]
Kaufman, J.; Birmaher, B.; Brent, D.; Rao, U.; Flynn, C.; Moreci, P.; Williamson, D.; Ryan, N. Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): Initial reliability and validity data. J. Am. Acad. Child Adolesc. Psychiatry, 1997, 36(7), 980-988.
[http://dx.doi.org/10.1097/00004583-199707000-00021] [PMID: 9204677]
[34]
Poznanski, E.O.; Grossman, J.A.; Buchsbaum, Y.; Banegas, M.; Freeman, L.; Gibbons, R. Preliminary studies of the reliability and validity of the children’s depression rating scale. J. Am. Acad. Child Psychiatry, 1984, 23(2), 191-197.
[http://dx.doi.org/10.1097/00004583-198403000-00011] [PMID: 6715741]
[35]
Axelson, D.; Birmaher, B.J.; Brent, D.; Wassick, S.; Hoover, C.; Bridge, J.; Ryan, N. A preliminary study of the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children mania rating scale for children and adolescents. J. Child Adolesc. Psychopharmacol., 2003, 13(4), 463-470.
[http://dx.doi.org/10.1089/104454603322724850] [PMID: 14977459]
[36]
Kovacs, M. Children's depression inventory 2nd edition: Technical manual. In: Multi-Health System; , 2011.
[37]
Shaffer, D.; Gould, M.S.; Brasic, J.; Ambrosini, P.; Fisher, P.; Bird, H.; Aluwahlia, S. A children’s global assessment scale (CGAS). Arch. Gen. Psychiatry, 1983, 40(11), 1228-1231.
[http://dx.doi.org/10.1001/archpsyc.1983.01790100074010] [PMID: 6639293]
[38]
March, J.S. Multidimensional anxiety scale for children In: MASC 2, 2nd ed.; MultiHealth Systems: Toronto, Canada, 2012.
[http://dx.doi.org/10.1037/t05050-000]
[39]
Achenbach, T.M.; Rescorla, L.A. Manual for the ASEBA school-age forms & profiles; University of Vermont, Research Center for Children, Youth, and Families: Burlington, VT, 2001.
[40]
Posner, K.; Brown, G.K.; Stanley, B.; Brent, D.A.; Yershova, K.V.; Oquendo, M.A.; Currier, G.W.; Melvin, G.A.; Greenhill, L.; Shen, S.; Mann, J.J. The columbia-suicide severity rating Scale: Initial validity and internal consistency findings from three multisite studies with adolescents and adults. Am. J. Psychiatry, 2011, 168(12), 1266-1277.
[http://dx.doi.org/10.1176/appi.ajp.2011.10111704] [PMID: 22193671]
[41]
Serra, G.; Iannoni, M.E.; Trasolini, M.; Maglio, G.; Frattini, C.; Casini, M.P.; Baldessarini, R.J.; Vicari, S. Characteristics associated with depression severity in 270 juveniles in a major depressive episode. Brain Sci., 2021, 11(4), 440.
[http://dx.doi.org/10.3390/brainsci11040440] [PMID: 33805486]
[42]
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed; , 2013.
[43]
Masi, G.; Perugi, G.; Toni, C.; Millepiedi, S.; Mucci, M.; Bertini, N.; Akiskal, H.S. The clinical phenotypes of juvenile bipolar disorder: Toward a validation of the episodic-chronic-distinction. Biol. Psychiatry, 2006, 59(7), 603-610.
[http://dx.doi.org/10.1016/j.biopsych.2005.08.034] [PMID: 16487492]
[44]
Posner, K.; Brodsky, B.; Yershova, K.; Buchanan, J.; Mann, J. The classification of suicidal behavior. In: The Oxford Handbook of Suicide and Self-Injury; , 2014; pp. 7-22.
[45]
Biederman, J.; Spencer, T.; Lomedico, A.; Day, H.; Petty, C.R.; Faraone, S.V. Deficient emotional self-regulation and pediatric attention deficit hyperactivity disorder: A family risk analysis. Psychol. Med., 2012, 42(3), 639-646.
[http://dx.doi.org/10.1017/S0033291711001644] [PMID: 21861953]
[46]
Stringaris, A.; Goodman, R.; Ferdinando, S.; Razdan, V.; Muhrer, E.; Leibenluft, E.; Brotman, M.A. The affective reactivity index: A concise irritability scale for clinical and research settings. J. Child Psychol. Psychiatry, 2012, 53(11), 1109-1117.
[http://dx.doi.org/10.1111/j.1469-7610.2012.02561.x] [PMID: 22574736]
[47]
Sani, G.; Vöhringer, P.A.; Barroilhet, S.A.; Koukopoulos, A.E.; Ghaemi, S.N. The koukopoulos mixed depression rating scale (KMDRS): An international mood network (IMN) validation study of a new mixed mood rating scale. J. Affect. Disord., 2018, 232, 9-16.
[http://dx.doi.org/10.1016/j.jad.2018.01.025] [PMID: 29459190]
[48]
Winkler, D.; Pjrek, E.; Heiden, A.; Wiesegger, G.; Klein, N.; Konstantinidis, A.; Kasper, S. Gender differences in the psychopathology of depressed inpatients. Eur. Arch. Psychiatry Clin. Neurosci., 2004, 254(4), 209-214.
[http://dx.doi.org/10.1007/s00406-004-0471-8] [PMID: 15309388]
[49]
Baldwin, D.S.; Papakostas, G.I. Symptoms of fatigue and sleepiness in major depressive disorder. J. Clin. Psychiatry, 2006, 67(Suppl. 6), 9-15.
[PMID: 16848671]
[50]
Hildebrandt, M.G.; Stage, K.B.; Kragh-Soerensen, P. Gender and depression: A study of severity and symptomatology of depressive disorders (ICD-10) in general practice. Acta Psychiatr. Scand., 2003, 107(3), 197-202.
[http://dx.doi.org/10.1034/j.1600-0447.2003.02108.x] [PMID: 12580826]
[51]
Fava, M.; Hwang, I.; Rush, A.J.; Sampson, N.; Walters, E.E.; Kessler, R.C. The importance of irritability as a symptom of major depressive disorder: Results from the National Comorbidity Survey Replication. Mol. Psychiatry, 2010, 15(8), 856-867.
[http://dx.doi.org/10.1038/mp.2009.20] [PMID: 19274052]
[52]
Kovess-Masfety, V.; Alonso, J.; Angermeyer, M.; Bromet, E.; de Girolamo, G.; de Jonge, P.; Demyttenaere, K.; Florescu, S.E.; Gruber, M.J.; Gureje, O.; Hu, C.; Huang, Y.; Karam, E.G.; Jin, R.; Lépine, J.P.; Levinson, D.; McLaughlin, K.A.; Medina-Mora, M.E.; O’Neill, S.; Ono, Y.; Posada-Villa, J.A.; Sampson, N.A.; Scott, K.M.; Shahly, V.; Stein, D.J.; Viana, M.C.; Zarkov, Z.; Kessler, R.C. Irritable mood in adult major depressive disorder: Results from the world mental health surveys. Depress. Anxiety, 2013, 30(4), 395-406.
[http://dx.doi.org/10.1002/da.22033] [PMID: 23364997]
[53]
Winkler, D.; Pjrek, E.; Kasper, S. Anger attacks in depression--evidence for a male depressive syndrome. Psychother. Psychosom., 2005, 74(5), 303-307.
[http://dx.doi.org/10.1159/000086321] [PMID: 16088268]
[54]
Martin, L.A.; Neighbors, H.W.; Griffith, D.M. The experience of symptoms of depression in men vs women: Analysis of the national comorbidity survey replication. JAMA Psychiatry, 2013, 70(10), 1100-1106.
[http://dx.doi.org/10.1001/jamapsychiatry.2013.1985] [PMID: 23986338]
[55]
Treynor, W.; Gonzalez, R.; Nolen-Hoeksema, S. Rumination reconsidered: A psychometric analysis. Cognit. Ther. Res., 2003, 27(3), 247-259.
[http://dx.doi.org/10.1023/A:1023910315561]
[56]
Mezulis, A.H.; Abramson, L.Y.; Hyde, J.S. Domain specificity of gender differences in rumination. J. Cogn. Psychother., 2002, 16(4), 421-434.
[http://dx.doi.org/10.1891/jcop.16.4.421.52524]
[57]
Gladstone, T.R.G.; Kaslow, N.J.; Seeley, J.R.; Lewinsohn, P.M. Sex differences, attributional style, and depressive symptoms among adolescents. J. Abnorm. Child Psychol., 1997, 25(4), 297-306.
[http://dx.doi.org/10.1023/A:1025712419436] [PMID: 9304446]
[58]
Mathes, B.M.; Morabito, D.M.; Schmidt, N.B. Epidemiological and clinical gender differences in OCD. Curr. Psychiatry Rep., 2019, 21(5), 36.
[http://dx.doi.org/10.1007/s11920-019-1015-2] [PMID: 31016410]
[59]
Mors, O.; Perto, G.P.; Mortensen, P.B. The Danish psychiatric central research register. Scand. J. Public Health, 2011, 39(7_suppl), 54-57.
[http://dx.doi.org/10.1177/1403494810395825] [PMID: 21775352]
[60]
Arnold, L.M. Gender differences in bipolar disorder. Psychiatr. Clin. North Am., 2003, 26(3), 595-620.
[http://dx.doi.org/10.1016/S0193-953X(03)00036-4] [PMID: 14563100]
[61]
Vieta, E.; Salagre, E.; Grande, I.; Carvalho, A.F.; Fernandes, B.S.; Berk, M.; Birmaher, B.; Tohen, M.; Suppes, T. Early intervention in bipolar disorder. Am. J. Psychiatry, 2018, 175(5), 411-426.
[http://dx.doi.org/10.1176/appi.ajp.2017.17090972] [PMID: 29361850]
[62]
Birmaher, B.; Axelson, D.; Goldstein, B.; Strober, M.; Gill, M.K.; Hunt, J.; Houck, P.; Ha, W.; Iyengar, S.; Kim, E.; Yen, S.; Hower, H.; Esposito-Smythers, C.; Goldstein, T.; Ryan, N.; Keller, M. Four-year longitudinal course of children and adolescents with bipolar spectrum disorders: The Course and Outcome of Bipolar Youth (COBY) study. Am. J. Psychiatry, 2009, 166(7), 795-804.
[http://dx.doi.org/10.1176/appi.ajp.2009.08101569] [PMID: 19448190]
[63]
Cicero, D.C.; Epler, A.J.; Sher, K.J. Are there developmentally limited forms of bipolar disorder? J. Abnorm. Psychol., 2009, 118(3), 431-447.
[http://dx.doi.org/10.1037/a0015919] [PMID: 19685942]

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