Inhibition/activation in bipolar disorder: validation of the Multidimensional Assessment of Thymic States scale (MAThyS)

BMC Psychiatry

Michael Lukasiewicz³  Bruno Falissard³  Elena Perrin⁵  Stephanie Gerard⁵  Marcel Zins-Ritter¹  Hélène Sapin⁵  Christophe Lançon⁶  Amandine Luquiens⁴  Chantal Henry² 

[1] Private practice, Orvault, France;INSERM, U995, IMRB, Department of Genetics, AP-HP, Henri Mondor-Albert Chenevier Group, Psychiatry, Univ Paris 12, Faculty of Medicine, IFR10, Créteil, France;INSERM, U669, Univ Paris-Sud and Univ Paris Descartes, UMR-S0669, Paris, France;AP-HP, Paul-Brousse Hospital, Department of Psychiatry and Addictology, Villejuif, France;Eli Lilly and Company, 24 Boulevard Vital Bouhot, Neuilly-Sur-Seine, 92200, France;Department of Psychiatry, Sainte-Marguerite University Hospital, Marseille, France

关键词: Olanzapine;    Clinical trial;    Scale;    Factorial analysis;    Bipolar disorder;    Emotional reactivity;   

Others  :  1124114
DOI  :  10.1186/1471-244X-13-79

 received in 2012-11-29, accepted in 2013-03-05,  发布年份 2013

【 摘 要 】

Background

One of the major issues in clinical practice is the accurate differential diagnosis between mixed states and depression, often leading to inappropriate prescriptions of antidepressants in mixed states, and as a consequence, increasing the risk of manic switch and suicide. In order to better define the spectrum of mixed states, it may be useful to develop a dimensional approach. In this context, the MAThyS (Multidimensional Assessment of Thymic States) scale was built to assess activation/inhibition levels in all bipolar mood episodes, and to determine whether a clinical description in terms of activation/inhibition can help better define bipolar states with which both manic and depressive symptoms are associated. The aim of this paper is the validation of the MAThyS scale in 141 bipolar patients in acute states (manic, hypomanic, mixed, or depressive).

Methods

The validation of the MAThyS scale was the primary outcome of this 24-week, phase III, open-label, olanzapine single-arm clinical trial. Principal component, factorial analysis, and Cronbach’s coefficient calculation (internal consistency) were performed. Concurrent validity (correlations with 17-item Hamilton Depression Rating Scale [HAMD-17], Hamilton Anxiety Rating Scale [HAMA], and Young Mania Rating Scale [YMRS]) and responsiveness to the clinical intervention were assessed (change in MAThyS scale and effect size) at 6 and 24 weeks.

Results

Scree plot of eigenvalues identified a 2-dimension structure (“activation/inhibition level” and “emotional component”). Psychometric properties were good: Cronbach’s coefficient was >0.9. Concurrent validity was good with low correlation (−0.19) with the HAMA scale and a higher correlation at baseline with the YMRS (0.72) and HAMD-17(−0.43). As expected, the activation state was predominant in manic, hypomanic, and mixed states while inhibition was predominant in depressive states. MAThyS score improvement was observed (effect size: -0.3 at 6 and 24 weeks).

Conclusions

The MAThyS demonstrated good psychometric properties. The MAThyS scale may help clinicians to better discriminate and follow bipolar episodes, especially the broad spectrum of mixed episodes.

Trial registration

ClinicalTrials.gov registration identification number: NCT#002592722

【 授权许可】

   
2013 Henry et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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