Header

UZH-Logo

Maintenance Infos

Diagnostic criteria for bipolarity based on an international sample of 5,635 patients with DSM-IV major depressive episodes


Angst, J; Gamma, A; Bowden, C L; Azorin, J M; Perugi, G; Vieta, E; Young, A H (2012). Diagnostic criteria for bipolarity based on an international sample of 5,635 patients with DSM-IV major depressive episodes. European Archives of Psychiatry and Clinical Neuroscience, 262(1):3-11.

Abstract

To assess the clinical validity of individual DSM-IV criteria for hypomania. In an international sample of 5,635 patients with major depressive episodes (Bridge Study), DSM-IV criteria for hypomania (stem questions, number and quality of symptoms, duration and exclusion criteria) were systematically assessed and their validity analysed on the basis of clinical data including family history, course, and other clinical characteristics. Three stem questions for hypomania, irritability, elevated mood and the added question of increased activity, showed comparable validity. The results support the current DSM-IV requirement for a higher symptom threshold (4 of 7 hypomanic symptoms) in cases of irritable mood. Longer durations of hypomanic episodes were associated with higher scores on all validators. The results did not support the DSM-IV durational requirements for hypomanic episodes (4days) and manic episodes (7days). Brief hypomanic episodes of 1, 2 or 3days were valid and would meet validity criteria for inclusion. The three exclusion criteria in DSM-IV (hypomania due to the use of antidepressants or of other substances, or to other medical conditions) were found to exclude patients with bipolar depression and should therefore not be retained. These results support several revisions of the DSM-IV concept of hypomanic episodes: specifically, the inclusion of increased activity as a gate question, the inclusion of 1 or 2 to 3-day episodes and the elimination of all exclusion criteria

Abstract

To assess the clinical validity of individual DSM-IV criteria for hypomania. In an international sample of 5,635 patients with major depressive episodes (Bridge Study), DSM-IV criteria for hypomania (stem questions, number and quality of symptoms, duration and exclusion criteria) were systematically assessed and their validity analysed on the basis of clinical data including family history, course, and other clinical characteristics. Three stem questions for hypomania, irritability, elevated mood and the added question of increased activity, showed comparable validity. The results support the current DSM-IV requirement for a higher symptom threshold (4 of 7 hypomanic symptoms) in cases of irritable mood. Longer durations of hypomanic episodes were associated with higher scores on all validators. The results did not support the DSM-IV durational requirements for hypomanic episodes (4days) and manic episodes (7days). Brief hypomanic episodes of 1, 2 or 3days were valid and would meet validity criteria for inclusion. The three exclusion criteria in DSM-IV (hypomania due to the use of antidepressants or of other substances, or to other medical conditions) were found to exclude patients with bipolar depression and should therefore not be retained. These results support several revisions of the DSM-IV concept of hypomanic episodes: specifically, the inclusion of increased activity as a gate question, the inclusion of 1 or 2 to 3-day episodes and the elimination of all exclusion criteria

Statistics

Citations

Dimensions.ai Metrics
60 citations in Web of Science®
64 citations in Scopus®
Google Scholar™

Altmetrics

Downloads

50 downloads since deposited on 23 Nov 2018
25 downloads since 12 months
Detailed statistics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:National licences > 142-005
Dewey Decimal Classification:150 Psychology
Scopus Subject Areas:Health Sciences > Psychiatry and Mental Health
Life Sciences > Biological Psychiatry
Health Sciences > Pharmacology (medical)
Language:English
Date:1 February 2012
Deposited On:23 Nov 2018 16:30
Last Modified:31 Jul 2020 02:31
Publisher:Springer
ISSN:0940-1334
OA Status:Green
Publisher DOI:https://doi.org/10.1007/s00406-011-0228-0
Related URLs:https://www.swissbib.ch/Search/Results?lookfor=nationallicencespringer101007s0040601102280 (Library Catalogue)
PubMed ID:21818629

Download

Green Open Access

Download PDF  'Diagnostic criteria for bipolarity based on an international sample of 5,635 patients with DSM-IV major depressive episodes'.
Preview
Content: Published Version
Language: English
Filetype: PDF (Nationallizenz 142-005)
Size: 226kB
View at publisher