Affective dimensions as a diagnostic tool for bipolar disorder in first psychotic episodes

被引:14
作者
Arrasate, M. [1 ]
Gonzalez-Ortega, I. [2 ]
Alberich, S. [2 ]
Gutierrez, M. [2 ]
Martinez-Cengotitabengoa, M. [2 ]
Mosquera, F. [3 ]
Cruz, N. [5 ]
Gonzalez-Torres, M. A. [1 ]
Henry, C. [4 ]
Gonzalez-Pinto, A. [2 ]
机构
[1] EHU UPV, Basurto Hosp, Dept Psychiat, Bilbao, Spain
[2] EHU UPV, Araba Univ Hosp Santiago, CIBERSAM, EMBREC,Dept Psychiat, Vitoria, Spain
[3] Araba Mental Hlth, CIBERSAM, Vitoria, Spain
[4] EMBREC, Dept Psychiat, Paris, France
[5] IDIBAPS, Hosp Clin, Inst Neurosci, CIBERSAM,EMBREC,Bipolar Disorders Program, Barcelona, Spain
关键词
Affective; Bipolar; Dimension; First psychosis; Activation; SYMPTOM DIMENSIONS; FUNCTIONAL PSYCHOSES; PRINCIPAL COMPONENTS; DEPRESSIVE DISORDER; SCHIZOPHRENIA; 1ST-EPISODE; PSYCHOPATHOLOGY; ONSET; MODEL; RISK;
D O I
10.1016/j.eurpsy.2013.07.005
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Objective: To examine the predictive diagnostic value of affective symptomatology in a first-episode psychosis (FEP) sample with 5 years' follow-up. Method: Affective dimensions (depressive, manic, activation, dysphoric) were measured at baseline and 5 years in 112 FEP patients based on a factor structure analysis using the Young Mania Rating Scale and Hamilton Depression Rating Scale. Patients were classified as having a diagnosis of bipolar disorder at baseline (BDi), bipolar disorder at 5 years (BDf), or "other psychosis''. The ability of affective dimensions to discriminate between these diagnostic groups and to predict a bipolar disorder diagnosis was analysed. Results: Manic dimension score was higher in BDi vs. BDf, and both groups had higher manic and activation scores vs. "other psychosis''. Activation dimension predicted a bipolar diagnosis at 5 years (odds ratio = 1.383; 95% confidence interval, 1.205-1.587; P = 0.000), and showed high levels of sensitivity (86.2%), specificity (71.7%), positive (57.8%) and negative predictive value (90.5%). Absence of the manic dimension and presence of the depressive dimension were both significant predictors of an early misdiagnosis. Conclusion: The activation dimension is a diagnostic predictor for bipolar disorder in FEP. The manic dimension contributes to a bipolar diagnosis and its absence can lead to early misdiagnosis. (C) 2013 Elsevier Masson SAS. All rights reserved.
引用
收藏
页码:424 / 430
页数:7
相关论文
共 37 条
[1]   Agitated "unipolar" depression re-conceptualized as a depressive mixed state: Implications for the antidepressant-suicide controversy [J].
Akiskal, HS ;
Benazzi, F ;
Perugi, G ;
Rihmer, Z .
JOURNAL OF AFFECTIVE DISORDERS, 2005, 85 (03) :245-258
[2]   Do symptom dimensions or categorical diagnoses best discriminate between known risk factors for psychosis? [J].
Allardyce, Judith ;
McCreadie, Robin G. ;
Morrison, Gary ;
van Os, Jim .
SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY, 2007, 42 (06) :429-437
[3]   Does psychomotor agitation in major depressive episodes indicate bipolarity? [J].
Angst, Jules ;
Gamma, Alex ;
Benazzi, Franco ;
Ajdacic, Vladeta ;
Roessler, Wulf .
EUROPEAN ARCHIVES OF PSYCHIATRY AND CLINICAL NEUROSCIENCE, 2009, 259 (01) :55-63
[4]   The efficacy of 2 different dosages of methylphenidate in treating adults with attention-deficit hyperactivity disorder [J].
Bouffard, R ;
Hechtman, L ;
Minde, K ;
Iaboni-Kassab, F .
CANADIAN JOURNAL OF PSYCHIATRY-REVUE CANADIENNE DE PSYCHIATRIE, 2003, 48 (08) :546-554
[5]   Distribution of symptom dimensions across Kraepelinian divisions [J].
Dikeos, Dimitris G. ;
Wickham, Harvey ;
McDonald, Colm ;
Walshe, Muriel ;
Sigmundsson, Thordur ;
Bramon, Elvira ;
Grech, Anton ;
Toulopoulou, Timothea ;
Murray, Robin ;
Sham, Pak C. .
BRITISH JOURNAL OF PSYCHIATRY, 2006, 189 :346-353
[6]   Remission and relapse in schizophrenia: The Madras longitudinal study [J].
Eaton, WW ;
Thara, R ;
Federman, E ;
Tien, A .
JOURNAL OF NERVOUS AND MENTAL DISEASE, 1998, 186 (06) :357-363
[7]   Risk for bipolar illness in patients initially hospitalized for unipolar depression [J].
Goldberg, JF ;
Harrow, M ;
Whiteside, JE .
AMERICAN JOURNAL OF PSYCHIATRY, 2001, 158 (08) :1265-1270
[8]   Principal components of mania [J].
González-Pinto, A ;
Ballesteros, J ;
Aldama, A ;
de Heredia, JLP ;
Gutierrez, M ;
Mosquera, F ;
González-Pinto, A .
JOURNAL OF AFFECTIVE DISORDERS, 2003, 76 (1-3) :95-102
[9]   Cannabis and First-Episode Psychosis: Different Long-term Outcomes Depending on Continued or Discontinued Use [J].
Gonzalez-Pinto, Ana ;
Alberich, Susana ;
Barbeito, Sara ;
Gutierrez, Miguel ;
Vega, Patricia ;
Ibanez, Berta ;
Haidar, Mahmoud Karim ;
Vieta, Eduard ;
Arango, Celso .
SCHIZOPHRENIA BULLETIN, 2011, 37 (03) :631-639
[10]   A RATING SCALE FOR DEPRESSION [J].
HAMILTON, M .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1960, 23 (01) :56-62