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The evidence as to whether depressive episodes occurring in persons who later convert to bipolar disorder are symptomatically distinct from episodes of unipolar depression remains controversial. As there are crucial differences in the therapeutic management, symptom profiles indicating subsequent bipolar conversion may aid in appropriate treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A representative community sample of originally <jats:italic>N<\/jats:italic>\u00a0=\u00a03021 adolescents and young adults aged 14\u201324\u00a0years at baseline was assessed up to four times over 10\u00a0years. Assessment of symptoms was conducted by clinically trained interviewers using the standardized M\u2010<jats:styled-content style=\"fixed-case\">CIDI<\/jats:styled-content>. Symptom profiles of depressive episodes were compared via logistic regression between subjects that subsequently developed (hypo\u2010)manic episodes (<jats:italic>n<\/jats:italic>\u00a0=\u00a035) or remained unipolar depressive (<jats:italic>n<\/jats:italic>\u00a0=\u00a0659).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Initial depression amongst prospective converters was characterized by significantly increased suicidality (odds ratio, <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a02.31), higher rates of feelings of worthlessness and excessive guilt (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a02.52), complete loss of pleasure (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a02.53) and diurnal variation (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a04.30). No differences were found for hyperphagia, hypersomnia and psychomotor alterations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Findings suggest that the symptom profile of initial depressive episodes may be useful in the identification of subjects with an elevated risk for the subsequent conversion to bipolar disorder.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acps.12469","type":"journal-article","created":{"date-parts":[[2015,8,7]],"date-time":"2015-08-07T11:46:45Z","timestamp":1438948005000},"page":"196-204","source":"Crossref","is-referenced-by-count":36,"title":["Symptom characteristics of depressive episodes prior to the onset of mania or hypomania"],"prefix":"10.1111","volume":"133","author":[{"given":"A.","family":"Pfennig","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Psychotherapy Carl Gustav Carus University Hospital Technische Universit\u00e4t Dresden Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. 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