More inclusive bipolar mixed depression definition by permitting overlapping and non-overlapping mood elevation symptoms

Objective The objective of this study was to assess the strengths and limitations of a mixed bipolar depression definition made more inclusive than that of the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM‐5) by counting not only ‘non‐overlapping’ mood elevation symptoms (...

Full description

Saved in:
Bibliographic Details
Published in:Acta psychiatrica Scandinavica 2016-09, Vol.134 (3), p.199-206
Main Authors: Kim, H., Kim, W., Citrome, L., Akiskal, H. S., Goffin, K. C., Miller, S., Holtzman, J. N., Hooshmand, F., Wang, P. W., Hill, S. J., Ketter, T. A.
Format: Article
Language:English
Subjects:
Adult
Affect
Bipolar disorder
Bipolar Disorder - diagnosis
Bipolar Disorder - psychology
depression
diagnosis
Diagnosis, Differential
Diagnostic and Statistical Manual of Mental Disorders
Female
Humans
Interview, Psychological
Male
Mental depression
Middle Aged
Mood Disorders - diagnosis
Mood Disorders - psychology
nosology
Outpatients - psychology
Psychiatric Status Rating Scales
Psychiatry
Psychomotor Agitation
psychopathology
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objective The objective of this study was to assess the strengths and limitations of a mixed bipolar depression definition made more inclusive than that of the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM‐5) by counting not only ‘non‐overlapping’ mood elevation symptoms (NOMES) as in DSM‐5, but also ‘overlapping’ mood elevation symptoms (OMES, psychomotor agitation, distractibility, and irritability). Methods Among bipolar disorder (BD) out‐patients assessed with the Systematic Treatment Enhancement Program for BD (STEP‐BD) Affective Disorders Evaluation, we assessed prevalence, demographics, and clinical correlates of mixed vs. pure depression, using more inclusive (≥3 NOMES/OMES) and less inclusive DSM‐5 (≥3 NOMES) definitions. Results Among 153 depressed BD, counting not only NOMES but also OMES yielded a three‐fold higher mixed depression rate (22.9% vs. 7.2%) and important statistically significant clinical correlates for mixed compared to pure depression (more lifetime anxiety disorder comorbidity, more current irritability, and less current antidepressant use), which were not significant using the DSM‐5 threshold. Conclusion To conclude, further studies with larger numbers of patients with DSM‐5 bipolar mixed depression assessing strengths and limitations of more inclusive mixed depression definitions are warranted, including efforts to ascertain whether or not OMES should count toward mixed depression.
ISSN:0001-690X
1600-0447
DOI:10.1111/acps.12580