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Lookup NU author(s): Professor Heinz Grunze
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).
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.
Author(s): Vieta E, Grunze H, Azorin JM, Fagiolini A
Publication type: Article
Publication status: Published
Journal: Journal of Affective Disorders
Year: 2014
Volume: 156
Pages: 206-213
Print publication date: 01/03/2014
Online publication date: 01/01/2014
Acceptance date: 23/12/2013
Date deposited: 16/10/2014
ISSN (print): 0165-0327
ISSN (electronic): 1573-2517
Publisher: Elsevier BV
URL: http://dx.doi.org/10.1016/j.jad.2013.12.031
DOI: 10.1016/j.jad.2013.12.031
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