12.1 Risk Factors That Differentiate Bipolar Depression From Unipolar Depression and Predict Manic Switches in Youth

Differentiating between pediatric unipolar major depressive disorder (unipolar MDD) and bipolar major depression (bipolar MDD) poses a unique challenge for clinicians; this is particularly true given the high rate of switching from unipolar MDD to bipolar MDD (manic switches) among children. We examined the scientific literature to synthesize knowledge on the clinical features and correlates that differentiate the two types of major depression and predict bipolar switches.