Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 8 1 2013 03 15 1 6 Seyed Ali Ahmadi Abhari Department of Psychiatry and Psychiatry Research Center, Tehran University of Medical Sciences, Tehran, Iran. Majid Sadeghi Department of Psychiatry and Psychiatry Research Center, Tehran University of Medical Sciences, Tehran, Iran. Seyed Mehdi Samimi Ardestani Behavioral Sciences Research Center Shahid Beheshti University of Medical Sciences Yousef Semnani Behavioral Sciences Research Center Shahid Beheshti University of Medical Sciences Gholamreza Mirsepassi Department of Psychiatry and Psychiatry Research Center, Tehran University of Medical Sciences Seyed Saeed Sadr Behavioral Sciences Research Center Shahid Beheshti University of Medical Sciences Atefe Kamaloo Department of Psychiatry and Psychiatry Research Center, Tehran University of Medical Sciences Morvarid Ahadi Department of Psychiatry and Psychiatry Research Center, Tehran University of Medical Sciences Behin Pourmirza Sanofi Medical Departments Elham Mir Sanofi Medical Departments 2015 10 14 Objective: Bipolar spectrum disorders may often go undiagnosed or unrecognized. The aim of this study was to determine the proportion of bipolar disorder symptoms in Iranian patients with a major depressive episode. Methods: 313 patients with a current DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders 4th ed. Text rev.) diagnosed with a major depressive episode entered this cross-sectional study. Thirty two items revised Hypomania/ mania Symptoms Checklist (HCL-32) was used to determine the frequency of bipolar episodes. Results: Considerable proportion of patients (53.9%) previously diagnosed as major depressive disorder fulfilled the criteria for bipolar disorder by Bipolarity Specifier. The Bipolarity Specifier additionally identified significant association for manic / hypomanic states during antidepressants therapy (p<0.0003) and current mixed mood symptoms (p<0.0001). Conclusion: Bipolar symptoms meeting the criteria for bipolar disorders in depressed patients who have not been previously diagnosed with bipolar disorder are frequent. Current DSM criteria may not be sufficient to diagnose more subtle or atypical forms of bipolar disorders. https://ijps.tums.ac.ir/index.php/ijps/article/view/210 https://ijps.tums.ac.ir/index.php/ijps/article/download/210/206