Making sense of DSM-5 mania with depressive features

Simple item page
dc.contributor.authorReinares, María
dc.contributor.authorBonnin, Caterina del Mar
dc.contributor.authorHidalgo-Mazzei, Diego
dc.contributor.authorUndurraga, Juan
dc.contributor.authorMur, María
dc.contributor.authorNieto, Evaristo
dc.contributor.authorSáez, Cristina
dc.contributor.authorVieta, Eduard
dc.date.accessioned2016-05-31T14:22:03Z
dc.date.available2016-05-31T14:22:03Z
dc.date.issued2015
dc.description.abstractOBJECTIVE: The assessment of the depressive component during mania has become critical for the accurate diagnosis of mixed states, which were defined very narrowly in the past classification systems before Diagnostic and Statistical Manual of Mental Disorders (5th ed.). The aim of this study was to compare socio-demographic, clinical and therapeutic characteristics, as well as clinical and functional outcomes, between manic patients with and without mixed features to validate the relevance of the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) mixed specifier. METHODS: This is a subanalysis of a multicentre naturalistic study MANía Aguda y COnsumo de Recursos (acute mania and health resource consumption [MANACOR]) on the burden of mania in bipolar patients from four hospitals in Catalonia (Spain). The sample consisted of 169 adult patients presenting a manic episode and systematically assessed during a 6-month period. RESULTS: A total of 27% (n = 46/169) of manic patients showed mixed features. Total number of episodes (p = 0.027), particularly depressive and mixed, was greater in manic patients with mixed features, as well as depressive onset (p = 0.018), suicide ideation (p = 0.036), rapid cycling (p = 0.035) and personality disorders (p = 0.071). In contrast, a higher percentage of pure manic subjects were inpatients (p = 0.035), started the illness with mania (p = 0.018) and showed family history of bipolar disorder (p = 0.037), congruent psychotic symptoms (p = 0.001) and cannabis use (p = 0.006). At baseline, pure manic patients received more risperidone (p = 0.028), while mixed patients received more valproate (p = 0.049) and antidepressants (p = 0.005). No differences were found in syndromic recovery at the end of the study. However, depressive change was higher in the mixed group (p = 0.010), while manic change was higher in the pure manic group (p = 0.029). At the end of follow-up, the group with mixed features showed a significant trend towards higher psychosocial dysfunction. CONCLUSION: A total of 27% of manic patients showed mixed features. Groups differed regarding clinical characteristics, course of illness, psychosocial functioning, prescribed treatment and symptom progress. Depressive symptoms in mania should be routinely assessed and considered to guide treatment.
dc.identifier.citationReinares M, Bonnín Cdel M, Hidalgo-Mazzei D, Undurraga J, Mur M, Nieto E, Sáez C, Vieta E. Making sense of DSM-5 mania with depressive features. Aust N Z J Psychiatry. 2015 Jun;49(6):540-9.
dc.identifier.urihttp://hdl.handle.net/11447/346
dc.identifier.urihttp://dx.doi.org/10.1177/0004867415585583
dc.language.isospa
dc.publisherThe Royal Australian and New Zealand College of Psychiatrists
dc.subjectBipolar disorder
dc.subjectDepressive symptoms mania; mixed features
dc.subjectMania
dc.titleMaking sense of DSM-5 mania with depressive features
dc.typeArtículo

Files

Original bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
Making sense of DSM-5 mania with depressive features.pdf
Size:
186.26 KB
Format:
Adobe Portable Document Format
Description:
Texto completo restringido
Download

Collections

Artículos Medicina y Ciencias de la Salud

Implementado por OpenGeek Services