Evaluating depressive symptoms in mania : a naturalistic study of patients with bipolar disorder
(2015) In Neuropsychiatric Disease and Treatment 11. p.43-1137- Abstract
OBJECTIVE: This study aimed to evaluate patients with bipolar I disorder (BD-I) who have mania with depressive symptoms and who meet the new "with mixed features" specifier of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5).
METHOD: This prospective, multinational, naturalistic study surveyed psychiatrists and their patients with BD-I from October 2013 to March 2014. Eligible patients had BD-I, had a (current) manic episode, and had experienced onset of a manic episode within the previous 3 months. Psychiatrists provided patient information on depressive symptoms (DSM-5 criteria); symptoms of anxiety, irritability, and agitation; suicide attempts; and physician satisfaction with treatment response.... (More)
OBJECTIVE: This study aimed to evaluate patients with bipolar I disorder (BD-I) who have mania with depressive symptoms and who meet the new "with mixed features" specifier of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5).
METHOD: This prospective, multinational, naturalistic study surveyed psychiatrists and their patients with BD-I from October 2013 to March 2014. Eligible patients had BD-I, had a (current) manic episode, and had experienced onset of a manic episode within the previous 3 months. Psychiatrists provided patient information on depressive symptoms (DSM-5 criteria); symptoms of anxiety, irritability, and agitation; suicide attempts; and physician satisfaction with treatment response. Data were stratified according to whether patients met the criteria for the BD-I "with mixed features" specifier of DSM-5 (≥3 depressive symptoms) or not, and characteristics were compared between the two subgroups. Patients also self-reported on depressive symptoms using the Mini-International Neuropsychiatric Interview module questionnaire.
RESULTS: Overall, 34% of 1,035 patients met the criteria for BD-I "with mixed features," exhibiting ≥3 depressive symptoms during their current manic episode. This correlated with the matched patient self-reports of depressive symptoms. During their current manic episode, BD-I patients "with mixed features" had more severe symptoms of anxiety, irritability, and agitation (average composite severity score of 4.1 vs 3.4), a higher incidence of suicide attempts (38% vs 9%), and more physician dissatisfaction with treatment response (22% vs 14%), compared to patients with 0-2 depressive symptoms (all P<0.05).
CONCLUSION: This study found that patients with BD-I "with mixed features" (ie, ≥3 depressive symptoms during a manic episode), suffered, on average, from a greater burden of disease than patients with pure mania. Improved identification of these patients may help to optimize treatment outcomes.
(Less)
- author
- Young, Allan H and Eberhard, Jonas LU
- publishing date
- 2015
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Neuropsychiatric Disease and Treatment
- volume
- 11
- pages
- 43 - 1137
- publisher
- Dove Medical Press Ltd.
- external identifiers
-
- pmid:25995638
- scopus:84929177361
- ISSN
- 1176-6328
- DOI
- 10.2147/NDT.S82532
- language
- English
- LU publication?
- no
- id
- 1f9285fd-b5b5-46eb-a3d6-6a6248566b05
- date added to LUP
- 2017-08-06 13:30:08
- date last changed
- 2024-01-14 01:52:40
@article{1f9285fd-b5b5-46eb-a3d6-6a6248566b05, abstract = {{<p>OBJECTIVE: This study aimed to evaluate patients with bipolar I disorder (BD-I) who have mania with depressive symptoms and who meet the new "with mixed features" specifier of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5).</p><p>METHOD: This prospective, multinational, naturalistic study surveyed psychiatrists and their patients with BD-I from October 2013 to March 2014. Eligible patients had BD-I, had a (current) manic episode, and had experienced onset of a manic episode within the previous 3 months. Psychiatrists provided patient information on depressive symptoms (DSM-5 criteria); symptoms of anxiety, irritability, and agitation; suicide attempts; and physician satisfaction with treatment response. Data were stratified according to whether patients met the criteria for the BD-I "with mixed features" specifier of DSM-5 (≥3 depressive symptoms) or not, and characteristics were compared between the two subgroups. Patients also self-reported on depressive symptoms using the Mini-International Neuropsychiatric Interview module questionnaire.</p><p>RESULTS: Overall, 34% of 1,035 patients met the criteria for BD-I "with mixed features," exhibiting ≥3 depressive symptoms during their current manic episode. This correlated with the matched patient self-reports of depressive symptoms. During their current manic episode, BD-I patients "with mixed features" had more severe symptoms of anxiety, irritability, and agitation (average composite severity score of 4.1 vs 3.4), a higher incidence of suicide attempts (38% vs 9%), and more physician dissatisfaction with treatment response (22% vs 14%), compared to patients with 0-2 depressive symptoms (all P<0.05).</p><p>CONCLUSION: This study found that patients with BD-I "with mixed features" (ie, ≥3 depressive symptoms during a manic episode), suffered, on average, from a greater burden of disease than patients with pure mania. Improved identification of these patients may help to optimize treatment outcomes.</p>}}, author = {{Young, Allan H and Eberhard, Jonas}}, issn = {{1176-6328}}, language = {{eng}}, pages = {{43--1137}}, publisher = {{Dove Medical Press Ltd.}}, series = {{Neuropsychiatric Disease and Treatment}}, title = {{Evaluating depressive symptoms in mania : a naturalistic study of patients with bipolar disorder}}, url = {{http://dx.doi.org/10.2147/NDT.S82532}}, doi = {{10.2147/NDT.S82532}}, volume = {{11}}, year = {{2015}}, }