Dr. Hagop S. Akiskal’s “rule of three” conceptualization , which identified behavioral markers tied to bipolarity, proved effective in evaluating and differentiating patients with bipolar disorder from those with unipolar depression, according to Dr. Diogo R. Lara and his associates.

A univariate analysis of more than 70,000 samples found 29 behavioral markers significantly differentiated bipolar patients from patients with unipolar depression. Of these 29, 10 markers had odds ratios greater than 4 for bipolarity.

In a multivariate analysis, 11 markers differentiating bipolar from unipolar depression were confirmed, including reversed circadian rhythms and high debts for both genders; 3 or more provoked car accidents and talent for poetry in men; frequent book reading; 3 or more religion changes; 60 or more sexual partners; experiencing pathological love 2 or more times; heavy cursing; and extravagant dressing styles in women; found Dr. Lara of the Pontifíícia Universidade Católica do Rio Grande do Sul in Porto Alegre, Brazil, and his associates.

“Most behaviors were expressed in a minority of patients (usually 5%-30%) and usually the ‘rule of three’ was the best numerical marker to distinguish those with bipolarity,” the investigators noted.

Find the full study here: J Affect Disord. 2015 Sept 1;183:195-204. doi: 10.1016/j.jad.2015.04.046).