Phenomenology of manic episodes according to the presence or absence of depressive features as defined in DSM-5: Results from the IMPACT self-reported online survey

JOURNAL OF AFFECTIVE DISORDERS

卷:156

Article

Vieta, Eduard¹  Grunze, Heinz²  Azorin, Jean-Michel³  Fagiolini, Andrea^4,5 

[1] Univ Barcelona, Hosp Clin, Inst Neurosci, Bipolar Disorder Programme,IDIBAPS,CIBERSAM, E-08036 Barcelona, Catalonia, Spain

[2] Inst Neurosci, Newcastle Upon Tyne NE4 5PL, Tyne & Wear, England

[3] Hosp Ste Marguerite, F-13274 Marseille, France

[4] Univ Siena, Sch Med, Dept Mol Med, I-53100 Siena, Italy

[5] Univ Siena, Med Ctr, Dept Mental Hlth, I-53100 Siena, Italy

关键词: Bipolar disorder;    Manic episode;    Mixed features;    Depressive symptoms;    Survey;    Self-reported;   

DOI  :  10.1016/j.jad.2013.12.031

来源: Elsevier

【 摘 要 】

Background: The aim of this study was to describe the phenomenology of mania and depression in bipolar patients experiencing a manic episode with mixed features as defined in the new Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Methods: In this multicenter, international on-line survey (the IMPACT study), 700 participants completed a 54-item questionnaire on demographics, diagnosis, symptomatology, communication of the disease, impact on life, and treatment received. Patients with a manic episode with or without DSM-5 criteria for mixed features were compared using descriptive and inferential statistics. Results: Patients with more than 3 depressive symptoms were more likely to have had a delay in diagnosis, more likely to have experienced shorter symptom-free periods, and were characterized by a marked lower prevalence of typical manic manifestations. All questionnaire items exploring depressive symptomatology, including the DSM-5 criteria defining a manic episode as with mixed features, were significantly overrepresented in the group of patients with depressive symptoms. Anxiety associated with irritability/agitation was also more frequent among patients with mixed features. Limitations: Retrospective cross-sectional design, sensitive to recall bias. Two of the 6 DSM-5 required criteria for the specifier with mixed features were not explored: suicidality and psychomotor retardation. Conclusions: Bipolar disorder patients with at least 3 depressive symptoms during a manic episode self-reported typical symptomatology. Anxiety with irritability/agitation differentiated patients with depressive symptoms during mania from those with pure manic episodes. The results support the use of DSM-5 mixed features specifier and its value in research and clinical practice. (C) 2014 Elsevier By, All rights reserved.

【 授权许可】

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