The intensity of depressive symptoms (assessed with Hamilton Depression Rating Scale) and manic symptoms (assessed with Young Mania Rating Scale) in patients with mixed episodes in the course of bipolar disorder

Study aim: The diagnosis of mixed episodes in the course of bipolar affective illness is made on the basis of clinical examination, so it may pose a challenge to clinicians due to the lack of standard assessment tools. The aim of the study was to assess the utility of the Hamilton Depression Rating Scale (HDRS) and Young Mania Rating Scale (YMRS) for the diagnosis of mixed episodes in the course of bipolar disorder. Material and methods: The study included a group of psychiatric inpatients (n=75) diagnosed with bipolar affective disorder (ICD 10 criteria). The patients were being treated for depressive episodes (n=46), manic episodes (n=13) or mixed episodes (n=12). The assessment of the symptoms was made at the beginning of hospitalization using HDRS and YMRS. Results: It was found that during mixed episodes the intensity of depressive and manic symptoms was similar (HDRS 14.4 +/- 7.4 vs. 13.3 +/- 8.2 in YMRS). The intensity of manic symptoms during depressive episodes was mean 9.3 pts. (+/- 10 SD); mainly sleep disturbances and irritability. The intensity of depressive symptoms during manic episodes was mean 7.4 pts. (+/- 4.4 SD); mainly sleep disturbances, agitation and restlessness. Conclusions: The results showed that both HDRS and YMRS may be useful in the diagnosis of mixed episodes. Common symptoms of manic and depressive states do not constitute a significant limitation of these tools.