| Objective:The present study aimed to explore difference between the unipolar and bipolar depression and to find biomarkers to distinguish the two kinds of depression.The present study will provide theoretical support for the clinical diagnosis of two kinds of depression.Methods:Two groups of patients with unipolar depression（Unipolar Depression,UD）and patients with bipolar depression（BD）respectively were recruited.All patients met the diagnostic criteria of DSM-IV（the fourth edition of the American Handbook for the Diagnosis and Statistics of Mental Disorders）in Zhumadian Second People’s Hospital during July 2018 to August 2019.The volunteers as the normal controls group with age,gender,and educational level matched were recruited.The Hamilton Depression Rating Scale for Depression（HAMD）,the Hamilton Anxiety Scale（HAMA）,and the Young Mania Rating Scale（YMRS）were used to assess the depressive symptoms,anxiety symptoms of patients and the severity of mania symptoms.Six facial expressions tests and 8 concentrations(10-5mol/L,10-4 mol/L,10-3.5 mol/L,10-3 mol/L,10-2.5 mol/L,10-2 mol/L,10-1.5 mol/L,10-1 mol/L)gradient forearm niacin skin flushing response test are conducted respectively.Results:1.Facial expression recognition:Compared with the normal control group,UD group and BD group showed differences in the facial expressions of happy-sadness（P=0.009）,happy-anger（P=0.001）,happy-surprise（P=0.034）and surprise-disgust（P=0.038）.Compared with the normal control group,there were significant differences in the happy-sadness（P=0.009）and happy-anger（P=0.009）groups respectively.The facial expression recognition accuracy of normal people was noted higher than that of the patients with BD.Compared with UD patients,BD patients showed significant differences in the happy-sadness（P=0.005）and happy-anger（P=0.002）groups respectively.The recognition accuracy of UD patients was higher than that of BD patients.The duration of facial expression recognition in the three groups was different,and the duration of facial expression recognition in the normal control group was significantly shorter than that in the UD and BD groups respectively.Compared with the two groups,the patients with BD took longer time to recognize happy expressions,and the patients with UD took longer time to recognize negative and neutral expressions.2.Niacin skin flushing reaction:when the niacin concentration was 10-3.5mol/L and 10-3mol/L,the blood flow（BF）of the two groups was significantly lower than that of the normal control group,and the differences were both significant（P<0.001）.The log EC50 of the normal control group was significantly lower than that of the patients groups respectively,and the difference was significant（P<0.001）.When niacin concentration was 10-3.5mol/L,the BF value of UD patients was noted lower than that of the normal control group（P<0.001）.When the niacin concentration was 10-3.5mol/L and 10-3mol/L,the BF value of patients with BD was significantly lower than that of the normal control group（P<0.001）.Log EC50 of the three groups was negatively correlated with BMI（r=-0.23;P=0.020）.Maximum blood flow（MBF）was positively correlated with gender（r=0.311;P=0.002）.Conclusion:1.The recognition of happy expressions decreases in patients with BD,and the recognition duration is longer;UD patients have a longer time to recognize negative expressions.Rapid facial expression recognition may be an underlying endophenotype for distinguishing UD from BD.2.Niacin skin flushing response can be used to distinguish the UD and BD group from the normal control group. |
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