Gordon B Parker1, Rebecca K Graham2. 1. School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; Black Dog Institute, Prince of Wales Hospital, Hospital Rd., Randwick, Sydney 2031, NSW, Australia. Electronic address: g.parker@unsw.edu.au. 2. School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; Black Dog Institute, Prince of Wales Hospital, Hospital Rd., Randwick, Sydney 2031, NSW, Australia.
Abstract
BACKGROUND: DSM-IV and DSM-5 provide identical symptom criteria and cut-off scores in defining mania and hypomania, a model seemingly counter-intuitive for classificatory differentiation. We designed a study to examine the impact of such DSM criteria and propose alternative models. METHODS: Prevalence and severity of hypo/manic symptoms as measured by the Mood Swings Questionnaire (MSQ) were compared in age and gender-matched bipolar I and II patients. Use of the MSQ allowed both DSM and additional items to be evaluated in terms of their capacity to differentiate the two bipolar conditions. RESULTS: In comparison to bipolar II participants, the bipolar I participants reported higher prevalence scores on six MSQ symptoms, severity scores on twelve MSQ symptoms and total MSQ scores. While bipolar I and II participants reported similar prevalence rates of DSM-5 symptoms, bipolar I participants returned higher prevalence rates on five (non-DSM) MSQ items. LIMITATIONS: Bipolar sub-type was not formally assessed by a structured diagnostic interview. The degree to which assigned MSQ items corresponded with DSM items might not necessarily have high equivalence. The study would have been enriched by evaluating a number of other symptom constructs. CONCLUSIONS: Findings suggest several optional approaches to differentiating mania and hypomania. The model we favor is one with a core set of features integral to mania and hypomania that is complemented by certain differentiating features. Psychotic features and over-valued ideas might provide the domain for such differentiation.
BACKGROUND: DSM-IV and DSM-5 provide identical symptom criteria and cut-off scores in defining mania and hypomania, a model seemingly counter-intuitive for classificatory differentiation. We designed a study to examine the impact of such DSM criteria and propose alternative models. METHODS: Prevalence and severity of hypo/manic symptoms as measured by the Mood Swings Questionnaire (MSQ) were compared in age and gender-matched bipolar I and II patients. Use of the MSQ allowed both DSM and additional items to be evaluated in terms of their capacity to differentiate the two bipolar conditions. RESULTS: In comparison to bipolar II participants, the bipolar I participants reported higher prevalence scores on six MSQ symptoms, severity scores on twelve MSQ symptoms and total MSQ scores. While bipolar I and II participants reported similar prevalence rates of DSM-5 symptoms, bipolar I participants returned higher prevalence rates on five (non-DSM) MSQ items. LIMITATIONS: Bipolar sub-type was not formally assessed by a structured diagnostic interview. The degree to which assigned MSQ items corresponded with DSM items might not necessarily have high equivalence. The study would have been enriched by evaluating a number of other symptom constructs. CONCLUSIONS: Findings suggest several optional approaches to differentiating mania and hypomania. The model we favor is one with a core set of features integral to mania and hypomania that is complemented by certain differentiating features. Psychotic features and over-valued ideas might provide the domain for such differentiation.
Authors: Adrian A Chrobak; Marcin Siwek; Dominika Dudek; Janusz K Rybakowski Journal: Int J Methods Psychiatr Res Date: 2018-07-30 Impact factor: 4.035
Authors: Jane E Persons; Paul Lodder; William H Coryell; John I Nurnberger; Jess G Fiedorowicz Journal: Psychiatry Res Date: 2021-11-21 Impact factor: 3.222