Karger Publishers, Neuropsychobiology, 4-5(79), p. 313-323, 2019
DOI: 10.1159/000503686
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<b><i>Background:</i></b> Although differences in symptom profiles and outcome between depressive patients with an underlying major depressive disorder (MDD) and bipolar depression (BD) have been reported, studies with sequential short-interval assessments in a real-life inpatient setting are scarce. <b><i>Objectives:</i></b> To examine potential differences in symptom profile and course of depressive symptomatology in depressive inpatients with underlying MDD and BD. <b><i>Methods:</i></b> A cohort of 276 consecutive inpatients with MDD (<i>n</i> = 224) or BD (<i>n</i> = 52) was followed during their hospitalization using routine outcome monitoring (ROM), which included a structured diagnostic interview at baseline (Mini-International Neuropsychiatric Interview Plus [MINI-Plus]) and repeated 17-item Hamilton Depression Rating Scale every 2 weeks. MDD and BD were compared regarding their symptom profiles and time to response and remission. Furthermore, the concordance between the MINI-Plus and clinical diagnosis was analyzed. <b><i>Results:</i></b> Patients were on average 52 and 47 years old in the MDD and BD group, respectively, and 66 versus 64% were female. Compared to patients with BD, patients with MDD scored higher on weight loss (<i>p</i> = 0.02), whereas the BD group showed a higher long-term likelihood of response (hazard ratio = 1.93, 95% confidence interval 1.16–3.20, <i>p</i> for interaction with time = 0.04). Although the same association was seen for remission, the interaction with time was not significant (<i>p</i> = 0.48). Efficiency between the MINI-Plus and clinical diagnosis of BD was high (0.90), suggesting that the MINI-Plus is an adequate ROM diagnostic tool. <b><i>Conclusions:</i></b> In routine clinical inpatient care, minor differences in the symptom profile and the course of depressive symptomatology may be helpful in distinguishing MDD and BD, particularly when using sequential ROM assessments.