1
|
Xu JJ, Zhu XQ, Liu S, Ding LY, Fu BB, Sun CC, Pan YL, Wang W, Zhang L. Sociodemographic, clinical and treatment characteristics of current rapid-cycling bipolar disorder: a multicenter Chinese study. Int J Bipolar Disord 2024; 12:11. [PMID: 38592605 PMCID: PMC11004094 DOI: 10.1186/s40345-024-00332-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 03/13/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Rapid cycling bipolar disorder (RCBD), characterized by four or more episodes per year, is a complex subtype of bipolar disorder (BD) with poorly understood characteristics. METHOD This multicenter, observational, longitudinal cohort study enrolled 520 BD patients across seven psychiatric institutions in China from January 2013 to January 2014. Participants were divided into RCBD and non-RCBD (NRCBD) groups based on the frequency of mood episodes in the preceding year. Data collection utilized a standardized form, supplemented by a medical record review, focusing on sociodemographic, clinical, and treatment characteristics. Statistical analysis involved independent samples t-tests, Kruskal-Wallis H tests, Chi-square or Fisher's exact tests, with Bonferroni correction applied to account for multiple comparisons, and multivariable logistic regression to identify characteristics associated with RCBD. RESULTS Among the BD cohort, 9.4% were identified as current RCBD. Compared to NRCBD, RCBD patients had a shorter duration from the first psychiatric consultation to the diagnosis of BD, a reduced duration of their longest period of euthymia, a lower proportion of lifetime hospitalization history due to BD, and less use of electroconvulsive therapy (ECT) within the last 12 months. Additionally, they presented higher baseline scores on the Mood Disorder Questionnaire (MDQ) and the Brief 16-item Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR16). However, after applying the Bonferroni correction, these differences were not statistically significant. Multivariable logistic regression analysis identified three factors that were independently associated with RCBD: time from first psychiatric consultation to BD diagnosis (Odds Ratio [OR] = 0.512, P = 0.0416), lifetime hospitalization history due to BD (OR = 0.516, P = 0.0476), and ECT treatment within the past 12 months (OR = 0.293, P = 0.0472). CONCLUSION This study revealed that the duration from first psychiatric consultation to BD diagnosis, lifetime hospitalization history due to BD, and ECT treatment in the past year were associated with RCBD. Recognizing these factors could contribute to enhance the early identification and clinical outcomes of RCBD. Trial Registration Number Registry ClinicalTrials.gov NCT01770704. Date of Registration: First posted on January 18, 2013.
Collapse
Affiliation(s)
- Jin-Jie Xu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China
| | - Xue-Quan Zhu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China
| | - Shuang Liu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China
| | - Lu-Yu Ding
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China
| | - Bing-Bing Fu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China
| | - Cong-Cong Sun
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China
| | - Yan-Li Pan
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China
| | - Wei Wang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China.
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China.
| | - Ling Zhang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China.
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China.
| |
Collapse
|
2
|
Arbona-Lampaya A, Sung H, D’Amico A, Knowles EEM, Besançon EK, Freifeld A, Lacbawan L, Lopes F, Kassem L, Nardi AE, McMahon FJ. Strong Genetic Overlaps Between Dimensional and Categorical Models of Bipolar Disorders in a Family Sample. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2023.06.24.23291169. [PMID: 37425936 PMCID: PMC10327232 DOI: 10.1101/2023.06.24.23291169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Background Bipolar disorder (BD) presents with a wide range of symptoms that vary among relatives, casting doubt on categorical illness models. To address this uncertainly, we investigated the heritability and genetic relationships between categorical and dimensional models of BD in a family sample. Methods Participants in the Amish-Mennonite Bipolar Genetics (AMBiGen) study were assigned categorical mood disorder diagnoses by structured psychiatric interview and completed the Mood Disorder Questionnaire (MDQ), which assesses lifetime history of manic symptoms and associated impairment. Major MDQ dimensions were analyzed by Principal Component Analysis (PCA) in 726 participants. Heritability and genetic overlaps between categorical diagnoses and MDQ-derived dimensions were estimated with SOLAR-ECLIPSE within 432 genotyped participants. Results MDQ scores were significantly higher among individuals diagnosed with BD and related disorders, as expected, but varied widely among relatives. PCA suggested a three-component model for the MDQ. Heritability of the MDQ score was 30% (p<0.001), evenly distributed across its three principal components. Strong and significant genetic correlations were found between categorical diagnoses and most MDQ measures. Limitations Recruitment through probands with BD resulted in increased prevalence of BD in this sample, limiting generalizability. Unavailable genetic data reduced sample size for some analyses. Conclusion heritability and high genetic correlations between categorical diagnoses and MDQ measures support a genetic continuity between dimensional and categorical models of BD.
Collapse
Affiliation(s)
- Alejandro Arbona-Lampaya
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Heejong Sung
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Alexander D’Amico
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Emma E. M. Knowles
- Department of Psychiatry, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Emily K. Besançon
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Ally Freifeld
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Ley Lacbawan
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Fabiana Lopes
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Layla Kassem
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Francis J. McMahon
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| |
Collapse
|
3
|
Liao Y, Han X, Guo L, Wang W, Wang H, Li L, Shen M, Song W, Zhu D, Jiang Y, Teopiz KM, Lu C, McIntyre RS. Evaluation of a novel instrument for detecting bipolar disorders in China: The Rapid Mood Screener (RMS). J Affect Disord 2024; 348:54-61. [PMID: 38110155 DOI: 10.1016/j.jad.2023.12.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 12/01/2023] [Accepted: 12/13/2023] [Indexed: 12/20/2023]
Abstract
OBJECTIVE Bipolar disorder is easily misdiagnosed with major depressive disorder (MDD). The Rapid Mood Screener (RMS) was developed to address this unmet clinical need. This study aims to translate and evaluated the reliability and validity of the RMS in Chinese adults with bipolar I/II disorder (BD-I/II). METHODS Brislin's translation and Delphi method were conducted to formulate the RMS-Chinses version (RMS-C). Patients with MDD (N = 99), BD-I (N = 77) and BD-II (N = 78) were included to assess the validity and reliability of RMS-C. The area under the curve (AUC) was computed to ascertain the ability of the Mood Disorder Questionnaire (MDQ) and RMS-C to distinguish BD-I and BD-II from MDD. The optimal cut-off scores for classification were also calculated by the maximum sensitivity and specificity. RESULTS The intraclass correlation coefficient of the RMS-C was 0.82 (95%CI, 0.71-0.89). The content validity index by six items were 0.71, 0.86, 1.00, 0.86, 1.00, and 1.00 in turn, and by scales was 0.90. The AUCs of the RMS-C in both BD-I/II, BD-I alone and BD-II alone were 0.83 (95 % CI, 0.78-0.89), 0.82 (95 % CI, 0.75-0.89) and 0.85 (95 % CI, 0.79-0.91), respectively, and were comparably to the MDQ. The optimal RMS-C values of the presence of BD-I and BD-II were >4 and 3, respectively. CONCLUSION The RMS-C is a valid, simple self-administer screening tool to help identify BD-I or BD-II in persons experiencing a depressive episode. Validating the impact of screening with the RMS-C on health outcomes and health economics is warranted.
Collapse
Affiliation(s)
- Yuhua Liao
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, People's Republic of China; Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Xue Han
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, People's Republic of China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Hongqiong Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Lingjiang Li
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Manjun Shen
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, People's Republic of China
| | - Weidong Song
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, People's Republic of China
| | - Dongjian Zhu
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, People's Republic of China
| | - Yunbin Jiang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Kayla M Teopiz
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China.
| | - Roger S McIntyre
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Pharmacology, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Canadian Rapid Treatment Center of Excellence, Mississauga, ON, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| |
Collapse
|
4
|
Psychotic-like experiences as a co-occurring psychopathological indicator of multi-dimensional affective symptoms: Findings from a cross-sectional survey among college students. J Affect Disord 2023; 323:33-39. [PMID: 36435396 DOI: 10.1016/j.jad.2022.11.053] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 11/05/2022] [Accepted: 11/19/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although connections between psychotic-like experiences (PLEs) and a series of non-psychotic disorders have been widely explored in previous research, it is unclear whether PLEs could act as a co-occurring psychopathological indicator of multi-dimensional affective symptoms. METHODS A total of 4761 students took part in an online survey which assessed the frequency of PLEs and three types of affective symptoms over lifetime. Binary logistic regression models were used to examine associations between PLEs and each type of affective symptom. Network analysis was conducted to explore the relationship among three subtypes of PLEs - persecutory ideation (PI), bizarre experiences (BEs) and perceptual abnormalities (PAs), and different types of affective symptoms. RESULTS The results showed that compared with the non-PLEs group, the PLEs group suffered significantly higher risk of experiencing three types of affective symptoms, including manic symptoms [adjusted odds ratio (aOR) 11.50, 95 % confidence interval (CI) (4.59-28.81)], depressive symptoms [aOR 7.28, 95 % CI (4.98-10.66)] and anxiety symptoms [aOR 4.47, 95 % CI (3.10-6.43)]. In the network model, bizarre experiences were the most critical central symptom. Both depressive and anxiety symptoms were most strongly associated with persecutory ideation while manic symptoms were most closely related to bizarre experiences. LIMITATIONS Cross-sectional data and self-reported symptoms. CONCLUSIONS These findings suggest that PLEs are a vital co-occurring indicator of multi-dimensional affective symptoms and show its enormous potential as a target for a host of mental health problems. Further investigation may shed light on the aetiology of the relationship between different subtypes of PLEs and affective symptoms.
Collapse
|
5
|
Lou L, Wang Y, Zhang B, Jia Y, Wang W, Ye J. Cerebral processing of emotions in phantom eye pain patients: An event related potential study. ADVANCES IN OPHTHALMOLOGY PRACTICE AND RESEARCH 2022; 2:100075. [PMID: 37846286 PMCID: PMC10577829 DOI: 10.1016/j.aopr.2022.100075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/19/2022] [Accepted: 07/04/2022] [Indexed: 10/18/2023]
Abstract
Purpose Phantom eye pain (PEP) is a major clinical problem after eye removal with no standard treatment protocol to date. As pain is a multidimensional experience associated with emotional and cognitive components, this study aimed to explore the possible neuropsychological mechanisms of PEP in a perspective of emotional cognition, in order to provide a basis for clinical treatment. Methods Visual oddball event-related potentials (ERPs) under different external emotional stimuli (Disgust, Fear, Sadness, Happiness, Erotica and Neutral) were tested in 12 patients and 12 healthy volunteers. Participants' affective states were measured with the Mood Disorder Questionnaire (MDQ), the Hypomania Checklist-32 (HCL-32), and the Plutchik-van Praag Depression Inventory (PVP). The amplitudes and latencies of N1, P2, N2 and P3 components were analyzed by three-way ANOVA, i.e., group (2) × emotion (6) × electrode (3). Multiple comparisons were performed using Bonferroni's test. Results Longer N1 latencies, increased N1 amplitudes; shorter P2 latencies under Disgust and Happiness, decreased P2 amplitudes; shorter N2 latencies under Erotica, increased N2 amplitudes were found in patients compared with controls. There was no main effect of group or interaction effect on P3 latencies and P3 amplitudes. The MDQ and HCL-32 scores were lower, and the N1 latencies under Sadness were negatively correlated with PVP scores in patients. Conclusions PEP patients showed reversed patterns in exogenous attention allocation and enhanced involuntary attention to emotional stimuli compared with controls. This study demonstrated cortical processing of emotions in PEP patients and could provide a basis for developing emotional intervention therapy.
Collapse
Affiliation(s)
- Lixia Lou
- Eye Center, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Yijie Wang
- Eye Center, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Bingren Zhang
- Department of Medical Psychology, College of Clinical Medicine, Hangzhou Normal University, Hangzhou, China
| | - Yanli Jia
- Department of Affective Disorder, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Wei Wang
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Juan Ye
- Eye Center, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| |
Collapse
|
6
|
Hu X, Yu C, Dong T, Yang Z, Fang Y, Jiang Z. Biomarkers and detection methods of bipolar disorder. Biosens Bioelectron 2022; 220:114842. [DOI: 10.1016/j.bios.2022.114842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 09/16/2022] [Accepted: 10/19/2022] [Indexed: 12/01/2022]
|
7
|
Xin LM, Su YA, Yan F, Yang FD, Wang G, Fang YR, Lu Z, Yang HC, Hu J, Chen ZY, Huang Y, Sun J, Wang XP, Li HC, Zhang JB, Li JT, Si TM. Prevalence, clinical features and prescription patterns of psychotropic medications for patients with psychotic depression in China. J Affect Disord 2022; 301:248-252. [PMID: 35038478 DOI: 10.1016/j.jad.2022.01.063] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 01/10/2022] [Accepted: 01/13/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To investigate the prevalence of psychotic depression and the differences in sociodemographic and clinical characteristics and prescription patterns of psychotropic medications between patients with psychotic depression (PD) and patients with nonpsychotic depression (NPD) in China. METHODS We conducted a cross-sectional study in 13 major psychiatric hospitals or the psychiatric units of general hospitals in China from September 1, 2010, to February 28, 2011. PD was defined according to the psychotic disorder section of the Mini International Neuropsychiatric Interview (MINI). The sociodemographic and clinical characteristics and the prescription patterns of psychotropic medications were compared between the PD and NPD groups. Multivariate logistic regression analysis was used to investigate factors associated with an increased likelihood of PD. RESULTS Among 1172 MDD patients, the prevalence of psychotic features was 9.2% in the present study. The logistic regression analysis indicated that unmarried (OR = 2.08, p < 0.001), frequent depressive episodes (OR = 2.10, p = 0.020), depressive episodes with suicidal ideation and attempts (OR = 1.91, p = 0.004), and patients who were prescribed any antipsychotics (OR = 2.94, p < 0.001) were associated with psychotic features in patients with MDD. LIMITATIONS Cross-sectional design, retrospective recall of some data CONCLUSION: The prevalence of PD is high in China, and there were some differences in demographic and clinical characteristics between patients with PD and patients with NPD. Clinicians should regularly assess psychotic symptoms and consider intensive treatment and close monitoring when treating subjects with PD.
Collapse
Affiliation(s)
- Li-Min Xin
- Beijing Huilongguan Hospital, Beijing, China
| | - Yun-Ai Su
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China.
| | - Feng Yan
- Beijing Huilongguan Hospital, Beijing, China
| | - Fu-De Yang
- Beijing Huilongguan Hospital, Beijing, China
| | - Gang Wang
- Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yi-Ru Fang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zheng Lu
- Shanghai Tongji Hospital, Tongji University Medical School, Shanghai, China
| | - Hai-Chen Yang
- Division of Mood Disorders, Shenzhen Mental Health Centre, Shenzhen, Guangdong Province, China
| | - Jian Hu
- The First Hospital of Harbin Medical University, Harbin, China
| | - Zhi-Yu Chen
- Hangzhou Seventh People's Hospital, Hangzhou, China
| | - Yi Huang
- West China Hospital, Sichuan University, Chengdu, China
| | - Jing Sun
- The Affiliated Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Xiao-Ping Wang
- The Second Xiangya Hospital, Mental Health Institute, Central South University, Changsha, China
| | - Hui-Chun Li
- The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jin-Bei Zhang
- The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Ji-Tao Li
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
| | - Tian-Mei Si
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China.
| |
Collapse
|
8
|
Assessment Tool of Bipolar Disorder for Primary Health Care: The SAEBD. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168318. [PMID: 34444069 PMCID: PMC8392302 DOI: 10.3390/ijerph18168318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/28/2021] [Accepted: 08/02/2021] [Indexed: 12/03/2022]
Abstract
Mixed states are highly prevalent in patients with bipolar disorder and require comprehensive scales. Considering this, the current study aims to develop a measure to assess the full spectrum of clinical manifestations of bipolar disorder. A sample of 88 patients was evaluated; the Hamilton Depression Scale (HAM-D), Montgomery-Asberg Depression Scale (MADRS), and the Young Mania Rating Scale (YMRS) were applied, together with the preliminary version of the Scale for the Assessment of Episodes in Bipolar Disorder (SAEBD). After analyzing the appropriateness and statistical properties of the items, discriminant analysis and analysis of diagnostic capacity were performed. The discriminant functions correctly classified 100% of the cases in euthymia, predominant depressive symptoms or mixed symptoms, as well as 92.3% of the cases with predominant manic symptoms. Overall, the functions correctly classified 98.9% of the cases. The area under the curve (0.935) showed high capacity to discriminate between clinical and non-clinical cases (i.e., in euthymia). The SAEBD sensitivity was 0.95, specificity was 0.71, the Positive Predictive Value (PPV) was 0.88, the Negative Predictive Value (NPV) was 0.87, the Positive Likelihood Ratio (+LR) was 3.33, and the Negative Likelihood Ratio (−LR) was 0.07. In conclusion, the SAEBD is a promising scale that shows high reliability and validity, as well as diagnostic utility as a screening tool for use in diverse health care settings.
Collapse
|
9
|
Ouali U, Jouini L, Zgueb Y, Jomli R, Omrani A, Nacef F, Preti A, Carta MG. The Factor Structure of the Mood Disorder Questionnaire in Tunisian Patients. Clin Pract Epidemiol Ment Health 2020; 16:82-92. [PMID: 33029185 PMCID: PMC7536729 DOI: 10.2174/1745017902016010082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 05/02/2019] [Accepted: 05/08/2019] [Indexed: 11/28/2022]
Abstract
Background: The Mood Disorder Questionnaire (MDQ) is a frequently used screening tool for the early detection of Bipolar Disorder (BD), which is often unrecognized or misdiagnosed at its onset. In this study, data from Tunisia has been used to evaluate the psychometric properties of the Arabic MDQ. Methods: The sample included 151 patients with a current major depressive episode. The Arabic adapted version of the Structured Clinical Interview for DSM-IV-TR was used to formulate a diagnosis, yielding 62 patients with BD and 89 with unipolar Major Depressive Disorder (MDD). Principal component analysis with parallel analysis was used to establish the spontaneous distribution of the 13 core items of the MDQ. Confirmatory Factor Analysis (CFA) was used to check the available factor models. Receiver Operating Characteristic (ROC) analysis was used to assess the capacity of the MDQ to distinguish patients with BD from those with MDD. Results: Cronbach’s α in the sample was 0.80 (95%CI: 0.75 to 0.85). Ordinal α was 0.88. Parallel analysis suggested two main components, which explained 59% of variance in the data. CFA found a good fit for the existing unidimensional, the two-factor, and the three-factor models. ROC analysis showed that at a threshold of 7, the MDQ was able to distinguish patients with BD from those with MDD with extraordinary negative predictive value (0.92) and a positive diagnostic likelihood ratio of 3.8. Conclusion: The Arabic version of the MDQ showed good measurement properties in terms of reliability, factorial validity and discriminative properties.
Collapse
|
10
|
Wang HR, Bahk WM, Yoon BH, Kim MD, Jung YE, Min KJ, Hong J, Woo YS. The Influence of Current Mood States on Screening Accuracy of the Mood Disorder Questionnaire. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE : THE OFFICIAL SCIENTIFIC JOURNAL OF THE KOREAN COLLEGE OF NEUROPSYCHOPHARMACOLOGY 2020; 18:25-31. [PMID: 31958902 PMCID: PMC7006979 DOI: 10.9758/cpn.2020.18.1.25] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 11/01/2018] [Accepted: 11/14/2018] [Indexed: 11/30/2022]
Abstract
Objective In this study we investigated whether current mood states of patients with bipolar disorder have an influence on the screening accuracy of the Mood Disorder Questionnaire (MDQ). Methods A total of 452 patients with mood disorder (including 192 with major depressive disorder and 260 with bipolar disorder completed the Korean version of the MDQ. Patients with bipolar disorder were subdivided into three groups (bipolar depressed only, bipolar euthymic only, bipolar manic/hypomanic only) according to current mood states. The screening accuracy of the MDQ including sensitivity, specificity and area under the curve (AUC) of receiver operating characteristic (ROC) curves were evaluated according to current mood states. Results The optimal cutoff of MDQ was 5 in this study sample. Sensitivity and specificity were not significantly different according to current mood states. Significant differences in AUCs of four independent ROC curves were not found (ROC 1st curve included all bipolar patients; ROC 2nd curve included only bipolar depressed patients; ROC 3rd curve included only bipolar manic/hypomanic patients; ROC 4th curve included only bipolar euthymic patients). Conclusion The study results showed that current mood states (either euthymic state, depressed or manic/hypomanic) did not significantly influence the screening accuracy of the MDQ suggesting that the MDQ could be a useful screening instrument for detecting bipolar disorder in clinical practice regardless of the current mood symptoms of subjects.
Collapse
Affiliation(s)
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Bo-Hyun Yoon
- Department of Psychiatry, Naju National Hospital, Naju, Korea
| | - Moon-Doo Kim
- Department of Psychiatry, Jeju National University Hospital, Jeju, Korea
| | - Young-Eun Jung
- Department of Psychiatry, Jeju National University Hospital, Jeju, Korea
| | - Kyung Joon Min
- Department of Psychiatry, Chung-Ang University, Seoul, Korea
| | - Jeongwan Hong
- Department of Psychiatry, Iksan Hospital, Iksan, Korea
| | - Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| |
Collapse
|
11
|
Zhang B, Jia Y, Wang C, Shao X, Wang W. Visual event-related potentials in external emotional conditions in bipolar disorders I and II. Neurophysiol Clin 2019; 49:359-369. [PMID: 31718912 DOI: 10.1016/j.neucli.2019.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 09/24/2019] [Accepted: 09/24/2019] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES Mutual influences of cognitive and emotional functions occur in bipolar disorder, but specific alterations in relation to external emotional stimuli in bipolar I (BD I) and II (BD II) subtypes remain unknown. This study aimed to explore the effects of external emotional stimuli on cerebral attentional function in BD I and BD II. METHODS We tested visual oddball event-related potentials (ERPs) during various external emotional stimuli (Disgust, Fear, Erotica, Happiness, Neutral and Sadness) in 31 patients with BD I, 19 BD II and 47 healthy volunteers. Participants' concurrent affective states were also evaluated. RESULTS The ERP N2 latencies during Fear and Happiness were prolonged, P3 amplitudes during Disgust and Erotica were decreased in BD I; P3 amplitudes during Disgust, Erotica, Happiness and Neutral conditions were decreased in BD II. Increased frontal and parietal and decreased temporal and occipital activations were found in BD I, while increased occipital and parietal and decreased frontal and limbic activations in BD II in relation to different external emotions. ERP components were not correlated with concurrent affective states in patients. CONCLUSIONS Automatic attention during Happiness and Fear, and voluntary attention during Disgust and Erotica conditions were impaired in BD I; and voluntary attention during Disgust, Happiness, Erotica and Neutral conditions was impaired in BD II. Our study illustrates different patterns of visual attentional deficits associated with different external emotional stimuli in BD I and BD II.
Collapse
Affiliation(s)
- Bingren Zhang
- Department of Clinical Psychology and Psychiatry, School of Public Health, Zhejiang University College of Medicine, Hangzhou, China
| | - Yanli Jia
- Department of Clinical Psychology and Psychiatry, School of Public Health, Zhejiang University College of Medicine, Hangzhou, China
| | - Chu Wang
- Department of Clinical Psychology and Psychiatry, School of Public Health, Zhejiang University College of Medicine, Hangzhou, China
| | - Xu Shao
- Department of Clinical Psychology and Psychiatry, School of Public Health, Zhejiang University College of Medicine, Hangzhou, China
| | - Wei Wang
- Department of Clinical Psychology and Psychiatry, School of Public Health, Zhejiang University College of Medicine, Hangzhou, China.
| |
Collapse
|
12
|
Shabani A, Mirzaei Khoshalani M, Mahdavi S, Ahmadzad-Asl M. Screening bipolar disorders in a general hospital: Psychometric findings for the Persian version of mood disorder questionnaire and bipolar spectrum diagnostic scale. Med J Islam Repub Iran 2019; 33:48. [PMID: 31456972 PMCID: PMC6708087 DOI: 10.34171/mjiri.33.48] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Indexed: 01/04/2023] Open
Abstract
Background: Mood Disorder Questionnaire (MDQ) and Bipolar Spectrum Diagnostic Scale (BSDS) are used to screen patients with bipolar disorders and have been examined in some psychiatric settings. The present study aimed to assess the validity and reliability of these 2 tools on inpatients in a general hospital.
Methods: In a cross-sectional study in 2011, a total of 207 inpatients admitted to different wards of Rasoul Akram hospital, Tehran, were selected by systematic random sampling. Demographic questionnaire, MDQ, and BSDS were completed. Also, Structured Clinical Interview for DSM-IV axis I disorders (SCID-I) was performed for all participants within 72 hours. The SCID-I was used as the gold standard of psychiatric diagnoses to identify the predictive validity of the 2 screening tests. Sensitivity and specificity indices were identified using Roc curve. The 2 screening tools were recompleted by 20% of the patients (n=43) after 3-7 days to measure test-retest reliability using paired t test and correlation between measures in 2 separate occasions.
Results: In this study, 101 female and 106 male (m=36.9±15.5 yrs.) patients were entered the study, of them 56 (32 males) had bipolar disorder according to SCID-I. The most common bipolar disorder was bipolar disorder type II (9.7%). Pearson’s test showed a high test-retest reliability for both MDQ (r=0.72, p<0.001) and BSDS (r=0.77, p<0.001). For MDQ, the scores 5 (sensitivity=0.60; specificity=0.73) and 6 (sensitivity=0.56; specificity=0.77) were the best cutoff points. Positive and negative predictive values for the mentioned cutoff points were 0.45 and 0.83 (for the score 5) and 0.48 and 0.82 (for the score 6), respectively. The best cutoff point for BSDS was 11 with the sensitivity, specificity, and positive and negative predictive values of 0.74, 0.69, 0.47, and 0.87.
Conclusion: The Persian versions of MDQ and BSDS have acceptable validity and reliability to screen Persian patients with bipolar spectrum disorders in a general hospital.
Collapse
Affiliation(s)
- Amir Shabani
- Mental Health Research Center, Mood Disorders Research Group, Iran University of Medical Sciences, Tehran, Iran
| | - Mosleh Mirzaei Khoshalani
- Tehran Institute of Psychiatry, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
| | - Seyedreza Mahdavi
- Tehran Institute of Psychiatry, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
| | - Masoud Ahmadzad-Asl
- Mental Health Research Center, Bipolar Disorders Research Group, Tehran Institute of Psychiatry, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
13
|
Xin LM, Chen L, Su YA, Yang FD, Wang G, Fang YR, Lu Z, Yang HC, Hu J, Chen ZY, Huang Y, Sun J, Wang XP, Li HC, Zhang JB, Osser DN, Si TM. Prevalence and clinical features of atypical depression among patients with major depressive disorder in China. J Affect Disord 2019; 246:285-289. [PMID: 30594041 DOI: 10.1016/j.jad.2018.12.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 12/06/2018] [Accepted: 12/15/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Little is known about the demographic and clinical features of the atypical subtype of major depressive disorder (MDD) patients in China. This study set out to investigate the prevalence of atypical depression in MDD patients in China, and identify its demographic and clinical features. METHODS The study was conducted in 13 major psychiatric hospitals or in the psychiatric units of general hospitals in China, and recruited a sample of 1172 patients diagnosed with MDD. The patients' demographic and clinical features and prescriptions of psychotropic drugs were collected using a standardized questionnaire designed for the study. RESULTS The prevalence of atypical depression was 15.3%. In multiple logistic regression analyses, compared to the non-atypical depression patients, the atypical depression patients were more likely to have depressive episodes with suicide ideation and attempts (OR = 1.49, 95% CI = 1.06, 2.10, P = 0.023), depressive episodes with psychotic features (OR = 2.15, 95% CI = 1.43, 3.22, P < 0.001), seasonal depressive episodes (OR = 1.77, 95% CI = 1.12, 2.78, P = 0.014), an earlier age of onset (OR = 0.98, 95% CI = 0.96, 0.99, P = 0.001), and lifetime depressive episodes (OR = 1.07, 95% CI = 1.01, 1.13, P = 0.020). LIMITATIONS The assessment of atypical features was not based on a validated rating scale. CONCLUSION Our results indicate that atypical depression is common in Chinese patients with MDD. MDD with atypical features may be more severe and debilitating than patients with non-atypical features.
Collapse
Affiliation(s)
- Li-Min Xin
- Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital and Peking University Institute of Mental Health, Beijing 100191, China; Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China
| | - Lin Chen
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China
| | - Yun-Ai Su
- Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital and Peking University Institute of Mental Health, Beijing 100191, China.
| | - Fu-De Yang
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China
| | - Gang Wang
- Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yi-Ru Fang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zheng Lu
- Shanghai Tongji Hospital, Tongji University Medical School, Shanghai, China
| | - Hai-Chen Yang
- Division of Mood Disorders, Shenzhen Mental Health Centre, Shenzhen, Guangdong Province, China
| | - Jian Hu
- The First Hospital of Harbin Medical University, Harbin, China
| | - Zhi-Yu Chen
- Hangzhou Seventh People's Hospital, Hangzhou, China
| | - Yi Huang
- West China Hospital, Sichuan University, Chengdu, China
| | - Jing Sun
- The Affiliated Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Xiao-Ping Wang
- Mental Health Institute, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Hui-Chun Li
- The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jin-Bei Zhang
- The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - David N Osser
- Harvard Medical School Department of Psychiatry and VA Boston Healthcare System, Boston, MA, United States
| | - Tian-Mei Si
- Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital and Peking University Institute of Mental Health, Beijing 100191, China.
| |
Collapse
|
14
|
Pan B, Zhang Q, Tsai H, Zhang B, Wang W. Hypochondriac concerns and correlates of personality styles and affective states in bipolar I and II disorders. BMC Psychiatry 2018; 18:398. [PMID: 30577769 PMCID: PMC6303968 DOI: 10.1186/s12888-018-1988-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 12/13/2018] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Hypochondriac concerns are associated with the treatment-difficulty of bipolar disorder, which might be due to the personality styles and affective states. METHODS We invited outpatients with bipolar I disorder (BD I, n = 87), bipolar II disorder (BD II, n = 92) and healthy volunteers (n = 129) to undergo the Illness Attitude Scales and Parker Personality Measure tests, and measurements of concurrent affective states. RESULTS Compared to healthy volunteers, BD I and BD II patients scored significantly higher on mania, hypomania and depression. BD I and BD II patients also scored significantly higher on Symptom Effect and Treatment Seeking, and BD II patients scored higher on Patho-thanatophobia and Hypochondriacal Belief. BD II in addition scored higher on Patho-thanatophobia than BD I did. In controls, the Dependent style predicted Patho-thanatophobia and Symptom Effect, Schizoid with Hypochondriacal Belief; in BD I, Narcissistic (-) with Hypochondriacal Belief, Histrionic with Patho-thanatophobia and Hypochondriacal Belief, depression with Hypochondriacal Belief, and hypomania with Symptom Effect and Hypochondriacal Belief; in BD II, depression with Symptom Effect and Hypochondriacal Belief, mania with Symptom Effect. CONCLUSIONS Bipolar disorder, especially BD II, is associated with greater hypochondriac concerns, which relates to personality disorder functioning styles and concurrent affective states.
Collapse
Affiliation(s)
- Bing Pan
- Department of Psychiatry, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, China
- Department of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Zhejiang, 310058 Hangzhou China
| | - Qing Zhang
- Department of Psychiatry, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, China
| | - Huitzong Tsai
- Department of Psychiatry, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, China
| | - Bingren Zhang
- Department of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Zhejiang, 310058 Hangzhou China
| | - Wei Wang
- Department of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Zhejiang, 310058 Hangzhou China
| |
Collapse
|
15
|
Zimmerman M, Holst CG. Screening for psychiatric disorders with self-administered questionnaires. Psychiatry Res 2018; 270:1068-1073. [PMID: 29908784 DOI: 10.1016/j.psychres.2018.05.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 05/06/2018] [Accepted: 05/09/2018] [Indexed: 11/25/2022]
Abstract
Given the time demands of clinical practice it is not surprising that diagnoses are sometimes missed. To improve diagnostic recognition, self-administered screening scales have been recommended. A problem with much of the research effort on screening scales is the confusion between diagnostic testing and screening. It is important for a screening test to have high sensitivity because the more time intensive/expensive follow-up diagnostic inquiry will presumably only occur in patients who are positive on the initial screen. Investigators vary in how they analyze their data in determining the recommended cutoff score on a self-administered screening questionnaire. To illustrate this, in the present report we examined how often each of the different approaches towards determining a cutoff score on bipolar disorder screening scales were used. We reviewed 68 reports of the performance of the 3 most commonly researched bipolar disorder screening scales to determine how the recommended cutoff on the scale was derived. Most studies recommended a cutoff point on the screening scale that optimized the level of agreement with the diagnostic gold standard. Only 11 (16.2%) studies recommended a cutoff that prioritized the scale's sensitivity. It is important for clinicians to understand the difference between screening and diagnostic tests. The results of the present study indicate that most studies of the performance of the 3 most commonly studied bipolar disorder screening measures have taken the wrong approach in deriving the cutoff score on the scale for the purpose of screening.
Collapse
Affiliation(s)
- Mark Zimmerman
- Department of Psychiatry and Human Behavior, Brown Medical School, USA; Department of Psychiatry, Rhode Island Hospital, Providence, RI, USA.
| | - Carolina Guzman Holst
- Department of Psychiatry and Human Behavior, Brown Medical School, USA; Department of Psychiatry, Rhode Island Hospital, Providence, RI, USA
| |
Collapse
|
16
|
Zhang B, Wang C, Ma G, Fan H, Wang J, Wang W. Cerebral processing of facial emotions in bipolar I and II disorders: An event-related potential study. J Affect Disord 2018; 236:37-44. [PMID: 29709719 DOI: 10.1016/j.jad.2018.04.098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 03/13/2018] [Accepted: 04/08/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Behavioral results have shown that bipolar disorder patients have impaired recognition of facial emotions, but the detailed information processing of facial emotions in patients with bipolar I (BD I) and II (BD II) disorders remain unknown. METHODS We tested the cerebral event-related potentials to the static facial expressions of Neutral, Happiness, Anger and Sadness in 39 adult patients with BD I, 22 BD II, and 54 healthy volunteers. Participants' affective states were measured with the Mood Disorder Questionnaire, the Hypomania Checklist-32, and the Plutchik-van Praag Depression Inventory. RESULTS Over-processed right occipitotemporal cortex during N1 time window to Neutral and Happiness, and during P3b window to Sadness were found in BD I; prolonged N1 latencies to Neutral and Happiness, declined P3b amplitude to Sadness, negative correlation between P3b latency to Sadness and depression, and attenuated superior frontal activity during P3b window to Sadness were found in BD II; and the right-side dominance during facial emotion processing were found in both BD I and BD II. LIMITATIONS We didn't record the personality traits or medication used in patients, nor included other facial emotions such as fear and disgust. CONCLUSIONS When responding to facial emotions, both BD I and BD II showed a right-side processing dominance; BD I displayed enhanced processing in the right occipitotemporal cortex during structural encoding and categorical processing of facial emotions; while BD II displayed generalized impairments, less involvement of superior frontal cortex to negative emotions, and reduced ability to process negative emotions which was associated with depression.
Collapse
Affiliation(s)
- Bingren Zhang
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, Zhejiang 310058 China
| | - Chu Wang
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, Zhejiang 310058 China
| | - Guorong Ma
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, Zhejiang 310058 China
| | - Hongying Fan
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, Zhejiang 310058 China
| | - Jiawei Wang
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, Zhejiang 310058 China
| | - Wei Wang
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, Zhejiang 310058 China.
| |
Collapse
|
17
|
Electrocardiographic and Electrooculographic Responses to External Emotions and Their Transitions in Bipolar I and II Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15050884. [PMID: 29710812 PMCID: PMC5981923 DOI: 10.3390/ijerph15050884] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 04/11/2018] [Accepted: 04/27/2018] [Indexed: 12/26/2022]
Abstract
Bipolar disorder has two main types, bipolar I (BD I) and II (BD II), which present different affective states and personality characteristics, they might present different modes of emotional regulation. We hypothesized that the electrocardiogram and electrooculogram to external emotions are different in BD I and BD II. We asked 69 BD I and 54 BD II patients, and 139 healthy volunteers to undergo these tests in response to disgust, erotica, fear, happiness, neutral, and sadness, and their transitions. Their affective states were also measured. The heart rate in BD I was significantly higher under background fear after target neutral. The eyeball movement was quicker in BD I under target happiness after background disgust; in BD I under target sadness after background disgust; and in BD I under background disgust after target neutral. Some electrocardiographic and electrooculographic changes were correlated with affective states in patients. BD I and BD II had different physiological responses to external emotions and their transitions, indicating different pathophysiologies and suggesting different emotional-therapies for BD I and BD II.
Collapse
|
18
|
Zhu Q, Wang J, Fan H, Ma G, Zhang B, Shen C, Wang W. Blink reflex under external emotional-stimuli in bipolar I and II disorders. Psychiatry Res 2018; 259:520-525. [PMID: 29156424 DOI: 10.1016/j.psychres.2017.11.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 11/02/2017] [Accepted: 11/04/2017] [Indexed: 11/17/2022]
Abstract
Bipolar disorder types I (BD I) and II (BD II) might present different cortico-brainstem circuit dysfunctions under external emotions, which might be reflected by the blink reflex. We therefore invited 32 BD I and 23 BD II patients, and 46 healthy volunteers to answer the Mood Disorder Questionnaire, the Hypomania Checklist-32, and the Plutchik - van Praag Depression inventory, and to undergo the blink reflex test under external emotions (emotional pictures plus sounds) of Disgust, Erotica, Fear, Happiness, and Sadness. Compared to healthy controls, BD I showed prolonged R2/R2' latencies under most emotions, and their PVP scores were negatively correlated with the areas under curve (AUCs) of R2 and R2' under Erotica; and BD II showed reduced R2/R2' AUCs under all emotions. Moreover, R2' AUCs under Disgust, Fear, and Happiness were significantly reduced in BD II than those in BD I. Our results have shown that, irrespective of patients' on-going affective states, the R2/R2' components were delayed in BD I but suppressed in BD II under most external emotions. Our study provides some hints to distinguish the two types of bipolar disorder, referring to the cortico-brainstem circuit dysfunctions under external emotions.
Collapse
Affiliation(s)
- Qisha Zhu
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China
| | - Jiawei Wang
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China
| | - Hongying Fan
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China
| | - Guorong Ma
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China
| | - Bingren Zhang
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China
| | - Chanchan Shen
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China
| | - Wei Wang
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China.
| |
Collapse
|
19
|
Zhang B, Wang J, Zhu Q, Ma G, Shen C, Fan H, Wang W. Hypnotic susceptibility and affective states in bipolar I and II disorders. BMC Psychiatry 2017; 17:362. [PMID: 29121879 PMCID: PMC5679347 DOI: 10.1186/s12888-017-1529-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 10/31/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Highly hypnotizable individuals have impaired executive function, elevated motor impulsivity and increased emotional sensitivity, which are sometimes found in bipolar disorder patients. It is then reasonable to assume that certain aspects of hypnotic susceptibility differ with the types of bipolar disorder. METHODS The Stanford Hypnotic Susceptibility Scale: Form C (SHSS:C) test, the Mood Disorder Questionnaire (MDQ), the Hypomanic Checklist-32 (HCL-32) and the Plutchick-van Praag Depression Inventory (PVP) were applied to 62 patients with bipolar I disorder, 33 bipolar II disorder, and 120 healthy volunteers. RESULTS The passing rate of the SHSS:C 'Moving hands apart' item was higher in bipolar I patients than in controls, whereas for 'Mosquito hallucination' the rate was lower. Bipolar I and II patients scored significantly higher on MDQ, HCL-32 and PVP scales than controls. The passing rates of 'Mosquito hallucination' in controls, 'Arm rigidity' in bipolar I, and 'Age regression' in bipolar II predicted the respective MDQ scores. CONCLUSION In contrast to cognitive suggestions, bipolar I patients followed motor suggestions more often under hypnosis. Furthermore, both bipolar disorder patients and healthy volunteers demonstrated associations between mania levels and certain hypnotic susceptibility features. Our study aids in better understanding the altered conscious states in bipolar disorders, and encourages the use of related psychotherapy for these patients.
Collapse
Affiliation(s)
- Bingren Zhang
- 0000 0000 8744 8924grid.268505.cDepartment of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Hangzhou, Zhejiang 310058 China
| | - Jiawei Wang
- 0000 0000 8744 8924grid.268505.cDepartment of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Hangzhou, Zhejiang 310058 China
| | - Qisha Zhu
- 0000 0000 8744 8924grid.268505.cDepartment of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Hangzhou, Zhejiang 310058 China
| | - Guorong Ma
- 0000 0000 8744 8924grid.268505.cDepartment of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Hangzhou, Zhejiang 310058 China
| | - Chanchan Shen
- 0000 0000 8744 8924grid.268505.cDepartment of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Hangzhou, Zhejiang 310058 China
| | - Hongying Fan
- 0000 0000 8744 8924grid.268505.cDepartment of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Hangzhou, Zhejiang 310058 China
| | - Wei Wang
- Department of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Hangzhou, Zhejiang, 310058, China.
| |
Collapse
|
20
|
Zimmerman M. Screening for bipolar disorder with self-administered questionnaires: A critique of the concept and a call to stop publishing studies of their performance in psychiatric samples. Depress Anxiety 2017; 34:779-785. [PMID: 28872771 DOI: 10.1002/da.22644] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 02/21/2017] [Accepted: 04/18/2017] [Indexed: 11/09/2022] Open
Affiliation(s)
- Mark Zimmerman
- Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI, USA.,Department of Psychiatry, Rhode Island Hospital, Providence, RI, USA
| |
Collapse
|
21
|
Zhu Q, Wang J, Shen C, Fan H, Zhang B, Ma G, Lu Y, Wang W. Inhibitory brainstem reflexes under external emotional-stimuli in bipolar I and II disorders. BMC Psychiatry 2017; 17:224. [PMID: 28629452 PMCID: PMC5477268 DOI: 10.1186/s12888-017-1390-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Bipolar disorder types I (BD I) and II (BD II) might present different dysfunctions of the cortex and brainstem, as reflected by the second exteroceptive suppression period of temporalis muscle activity (ES2) under different stimuli of external emotions. METHODS This study included 30 BD I and 20 BD II patients, and 40 healthy volunteers. All participants were invited to answer the Mood Disorder Questionnaire, the Hypomania Checklist-32, and the Plutchik-van Praag Depression inventory, as well as to undergo the ES2 test under external emotional-stimuli (emotional pictures plus sounds) of Disgust, Erotica, Fear, Happiness, and Sadness. RESULTS The scale scores were elevated in both patient groups, but were not correlated with ES2 parameters. Compared to healthy controls, BD I showed prolonged ES2 latency under Erotica, and their perceived happiness and sadness intensities were negatively correlated with the respective ES2 durations, while BD II showed prolonged ES2 latencies under Disgust and Happiness, and shortened ES2 durations under Disgust, Happiness and Sadness. Moreover, ES2 duration under Sadness was significantly shorter in BD II than that in BD I. CONCLUSIONS The cortico-brainstem inhibitory dysfunctions in BD I and BD II was different, and this difference was independent of the patient's ongoing emotions. Our study thus provides some hints to distinguish the two types of bipolar disorders.
Collapse
Affiliation(s)
- Qisha Zhu
- 0000 0000 8744 8924grid.268505.cDepartment of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Yuhangtang Road 866, Hangzhou, Zhejiang 310058 China
| | - Jiawei Wang
- 0000 0000 8744 8924grid.268505.cDepartment of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Yuhangtang Road 866, Hangzhou, Zhejiang 310058 China
| | - Chanchan Shen
- 0000 0000 8744 8924grid.268505.cDepartment of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Yuhangtang Road 866, Hangzhou, Zhejiang 310058 China
| | - Hongying Fan
- 0000 0000 8744 8924grid.268505.cDepartment of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Yuhangtang Road 866, Hangzhou, Zhejiang 310058 China
| | - Bingren Zhang
- 0000 0000 8744 8924grid.268505.cDepartment of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Yuhangtang Road 866, Hangzhou, Zhejiang 310058 China
| | - Guorong Ma
- 0000 0000 8744 8924grid.268505.cDepartment of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Yuhangtang Road 866, Hangzhou, Zhejiang 310058 China
| | - Yanxia Lu
- 0000 0000 8744 8924grid.268505.cDepartment of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Yuhangtang Road 866, Hangzhou, Zhejiang 310058 China
| | - Wei Wang
- Department of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Yuhangtang Road 866, Hangzhou, Zhejiang, 310058, China.
| |
Collapse
|
22
|
Yeh TC, Wang SC, Chang YT, Yeh CB. Predictors of Nicotine Dependence in Adolescents: Symptoms of Bipolar Disorder and Attention-Deficit/Hyperactivity Disorder. J Child Adolesc Psychopharmacol 2017; 27:366-373. [PMID: 28146638 DOI: 10.1089/cap.2016.0099] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Bipolar disorder (BD) and attention-deficit/hyperactivity disorder (ADHD) have been associated with the use of cigarettes, but little is known about the impact of the subthreshold symptoms of BD or ADHD on the course of nicotine dependence. Identifying the links is essential for elucidating the pathway and supporting the development of nicotine prevention strategies for adolescents. METHODS Participants (n = 3322) aged 15-17 years completed the Chinese version of the ADHD Self-Report Scale and the Mood Disorder Questionnaire. The modified Fagerström Tolerance Questionnaire was completed to measure their nicotine use or dependence. Mediation analyses were performed to explore the relationship of two predictors. RESULTS The prevalence rates of cigarette smoking and nicotine dependence in this study were 14.4% and 2.3%, respectively. Male gender (odds ratio [OR] 2.30; 95% confidence interval [CI] 1.60-3.30), subclinical symptoms of ADHD (OR 1.34; 95% CI 1.04-1.71), clinical symptoms of ADHD (OR 1.69; 95% CI 1.08-2.66), and symptoms of BD (OR 1.59; 95% CI1.09 to 2.32) were associated with nicotine use. Male gender (OR 4.60; 95% CI 1.41-14.98) and symptoms of BD (OR 6.14; 95% CI 3.37-11.18), but not symptoms of ADHD, were associated with nicotine dependence. In mediation analyses, we found that the effect of ADHD symptoms was no longer significant after controlling for symptoms of BD, and the mediation ratio (PM) was 0.39. CONCLUSIONS Our findings suggest that mood disturbances other than symptoms of ADHD are more likely to be a key predictor of nicotine dependence among adolescents. The conclusions may improve our understanding of the course of nicotine dependence and help to promote potential health policy for nicotine control among youths.
Collapse
Affiliation(s)
- Ta-Chuan Yeh
- 1 Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Sheng-Chiang Wang
- 2 Department of Psychiatry, Tri-Service General Hospital Song-Shan Branch, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Yu-Tien Chang
- 3 School of Public Health, National Defense Medical Center , Taipei, Taiwan, Republic of China
| | - Chin-Bin Yeh
- 1 Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
| |
Collapse
|
23
|
Massidda D, Giovanni Carta M, Altoè G. Integrating Different Factorial Solutions of a Psychometric Tool Via Social Network Analysis. METHODOLOGY-EUROPEAN JOURNAL OF RESEARCH METHODS FOR THE BEHAVIORAL AND SOCIAL SCIENCES 2016. [DOI: 10.1027/1614-2241/a000113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Abstract. Evaluating the factorial structure of a psychometric test is crucial to capture the complexity of a psychological phenomenon. Indeed, for the same test, several studies may find different factorial solutions which, in turn, may be explained by within and/or between sample variability. In this paper we introduce a novel quantitative approach to combine different factorial solutions of the same test. We propose to use a method based on Social Network Analysis to create and statistically evaluate an integrated factorial structure based on the information provided by previous researches. We present an application to the Mood Disorder Questionnaire by considering different factorial structures reported in the literature. The integrated factorial solution indicates the presence of three factors supporting the multidimensionality of the test. The role of single items in the composition of factors is also evaluated and discussed in terms of differences and similarities between the five original studies and the new integrated model. From an applied perspective, our approach may be useful to assist researchers in summarizing different factorial solutions for the same test efficiently. Furthermore, the resulting integrated factor solution could serve as baseline model to validate the structure of the test by applying confirmatory factor techniques to new data.
Collapse
Affiliation(s)
- Davide Massidda
- Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, Italy
| | - Mauro Giovanni Carta
- Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, Italy
| | - Gianmarco Altoè
- Department of Developmental and Socialization Psychology, University of Padua, Italy
| |
Collapse
|
24
|
Wang HR, Woo YS, Ahn HS, Ahn IM, Kim HJ, Bahk WM. THE VALIDITY OF THE MOOD DISORDER QUESTIONNAIRE FOR SCREENING BIPOLAR DISORDER: A META-ANALYSIS. Depress Anxiety 2015; 32:527-38. [PMID: 26010478 DOI: 10.1002/da.22374] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Revised: 03/23/2015] [Accepted: 03/28/2015] [Indexed: 11/07/2022] Open
Abstract
We conducted a meta-analysis to review the diagnostic accuracy of the Mood Disorder Questionnaire (MDQ) among patients with mood disorders. We used a bivariate random effects model to calculate summary sensitivity and specificity. Twenty-one studies were included. At the standard or modified cutoff value of 7, summary sensitivity was .62 and summary specificity was .85. When we pooled 11 studies including both patients with bipolar disorder (BD) and those with unipolar depression, the summary sensitivity was .76 and summary specificity was .81. However, among the six studies that excluded patients with known BD, the summary sensitivity was significantly reduced to .37 and summary specificity was .88. There were no significant differences on the diagnostic accuracy of the MDQ between studies from Eastern and Western countries after adjusting for various clinical correlates. The overall diagnostic accuracy of the MDQ was relatively good. However, when the MDQ is applied among patients with depression without previous diagnoses of BD, its sensitivity was significantly reduced. This suggests that when the MDQ is applied among this population, its optimal cutoff value should be adjusted to enhance its sensitivity.
Collapse
Affiliation(s)
- Hee Ryung Wang
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyeong Sik Ahn
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Il Min Ahn
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea.,Department of Literary Arts, Brown University, Providence, Rhode Island
| | - Hyun Jung Kim
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| |
Collapse
|
25
|
Xu S, Gao Q, Ma L, Fan H, Mao H, Liu J, Wang W. The Zuckerman-Kuhlman personality questionnaire in bipolar I and II disorders: a preliminary report. Psychiatry Res 2015; 226:357-60. [PMID: 25660665 DOI: 10.1016/j.psychres.2015.01.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 12/04/2014] [Accepted: 01/19/2015] [Indexed: 10/24/2022]
Abstract
Patients with bipolar disorder have tendencies of higher impulsivity and sensation seeking, they might contribute differently to the emotional states of bipolar I (BD I) and II (BD II). We administered the Zuckerman-Kuhlman Personality Questionnaire (ZKPQ), the Plutchik-van Praag Depression Inventory (PVP), the Mood Disorder Questionnaire (MDQ), and the Hypomania Checklist (HCL-32) in 23 patients with BD I, 22 BD II, and 64 healthy volunteers. Both BD I and II scored higher on ZKPQ Impulsive sensation seeking (and its Impulsivity facet), Neuroticism-anxiety and Aggression-hostility, and on PVP and HCL-32 scales than controls did; BD I scored higher on MDQ and General sensation seeking facet than controls did. Compared to BD II, BD I scored higher on Impulsive sensation seeking (and General sensation seeking) and on MDQ. Moreover, General sensation seeking predicted MDQ, and Activity predicted HCL-32 in BD I. Aggression-hostility predicted HCL-32 in BD II. General sensation seeking predicted MDQ and HCL-32, and together with Neuroticism-anxiety, predicted PVP in controls. Our study suggests that Impulsive sensation seeking, and its General sensation seeking facet might help to delineate the two types of bipolar disorder.
Collapse
Affiliation(s)
- Shaofang Xu
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China
| | - Qianqian Gao
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China
| | - Liji Ma
- Department of Psychology, Zhejiang Police Vocational Academy, Hangzhou, China
| | - Hongying Fan
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China
| | - Hongjing Mao
- Department of Clinical Psychology, Affiliated Psychiatric Hospital, Zhejiang University College of Medicine, Hangzhou, China
| | - Jian Liu
- Department of Clinical Psychology, Affiliated Psychiatric Hospital, Zhejiang University College of Medicine, Hangzhou, China
| | - Wei Wang
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China; Department of Clinical Psychology, Affiliated Psychiatric Hospital, Zhejiang University College of Medicine, Hangzhou, China.
| |
Collapse
|
26
|
Relationship between personality disorder functioning styles and the emotional states in bipolar I and II disorders. PLoS One 2015; 10:e0117353. [PMID: 25625553 PMCID: PMC4307975 DOI: 10.1371/journal.pone.0117353] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 12/23/2014] [Indexed: 11/20/2022] Open
Abstract
Background Bipolar disorder types I (BD I) and II (BD II) behave differently in clinical manifestations, normal personality traits, responses to pharmacotherapies, biochemical backgrounds and neuroimaging activations. How the varied emotional states of BD I and II are related to the comorbid personality disorders remains to be settled. Methods We therefore administered the Plutchick – van Praag Depression Inventory (PVP), the Mood Disorder Questionnaire (MDQ), the Hypomanic Checklist-32 (HCL-32), and the Parker Personality Measure (PERM) in 37 patients with BD I, 34 BD II, and in 76 healthy volunteers. Results Compared to the healthy volunteers, patients with BD I and II scored higher on some PERM styles, PVP, MDQ and HCL-32 scales. In BD I, the PERM Borderline style predicted the PVP scale; and Antisocial predicted HCL-32. In BD II, Borderline, Dependant, Paranoid (-) and Schizoid (-) predicted PVP; Borderline predicted MDQ; Passive-Aggressive and Schizoid (-) predicted HCL-32. In controls, Borderline and Narcissistic (-) predicted PVP; Borderline and Dependant (-) predicted MDQ. Conclusion Besides confirming the different predictability of the 11 functioning styles of personality disorder to BD I and II, we found that the prediction was more common in BD II, which might underlie its higher risk of suicide and poorer treatment outcome.
Collapse
|
27
|
Demographic and clinical differences between early- and late-onset major depressions in thirteen psychiatric institutions in China. J Affect Disord 2015; 170:266-9. [PMID: 25265534 DOI: 10.1016/j.jad.2014.09.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Revised: 09/04/2014] [Accepted: 09/05/2014] [Indexed: 11/20/2022]
Abstract
BACKGROUND Little is known about the demographic and clinical differences between early- and late-onset depressions (EOD and LOD, respectively) in Chinese patients. This study examined the demographic and clinical profile of EOD (<=25 years) compared to LOD (>25 years) in China. METHODS A consecutively recruited sample of 1178 patients with MDD was assessed in 13 psychiatric hospitals or psychiatric units of general hospitals in China nationwide. The cross-sectional data of patients' demographic and clinical characteristics and prescriptions of psychotropic drugs including antidepressants, mood stabilizers, antipsychotics and benzodiazepines were recorded using a standardized protocol and data collection procedure. RESULTS Two hundred and seventy five (23.3%) of the 1178 patients fulfilled criteria for EOD. In multiple logistic regression analyses, compared to LOD patients their EOD counterparts were more likely to be unmarried and unemployed, had more atypical and psychotic depressive episodes, had bipolar features, while they had more lifetime depressive episodes. CONCLUSIONS The demographic and more severe clinical features of EOD in Chinese patients were basically consistent with those found in Western populations. The association between socio-cultural factors and development of EOD warrants further studies.
Collapse
|
28
|
He H, Xu G, Sun B, Ouyang H, Dang Y, Guo Y, Miao G, Rios C, Akiskal HS, Lin K. The use of 15-point hypomanic checklist in differentiating bipolar I and bipolar II disorder from major depressive disorder. Gen Hosp Psychiatry 2014; 36:347-51. [PMID: 24461731 DOI: 10.1016/j.genhosppsych.2013.12.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Revised: 12/11/2013] [Accepted: 12/13/2013] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Individuals with bipolar disorder (BP) are often misdiagnosed with major depressive disorder (MDD). In this study, we developed a Chinese version of 15-point hypomania scale (HCL-15) in order to determine its sensitivity and specificity in the diagnosis of BP and BP-II in particular. METHODS A total of 623 individuals suffering a major depressive episode (MDE) were systematically interviewed with both Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Patient Edition, and HCL-15. A cutoff score of 8 or more in HCL-15 was suggested for BP. RESULTS Of the 623 depressed patients, 115 (18.5%) actually required a diagnosis of BP-I, and another 159 (25.5%) could be more appropriately diagnosed with BP-II, according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria. The sensitivity of 15-HCL in detection of BP-II was 0.78 and 0.46 for BP-I; the specificity was 0.9 and 0.69, respectively. The specificity of HCL-15 for BP versus MDD was as high as 0.93. Approximately 60%-80% of all questions in the HCL-15 questionnaire revealed positive responses from patients, while items 11 and 12, measuring the consumption of alcohol, coffee and cigarettes, demonstrated a low positive response rate. CONCLUSIONS The HCL-15 assessment scale was fairly sensitive and highly specific for a BP-II diagnosis but not for a BP-I diagnosis. Some items in the HCL-15 symptom list need to be further modified to better fit Chinese culture and customs. The HCL-15 scale could be a useful tool in clinical practice for screening individuals with BP-II in order to avoid a misdiagnosis of MDD.
Collapse
Affiliation(s)
- Hongbo He
- Psychiatric Neuroscience Research Institute, Guangzhou Brain Hospital, Affiliated hospital of Guangzhou Medical University
| | - Guiyun Xu
- Psychiatric Neuroscience Research Institute, Guangzhou Brain Hospital, Affiliated hospital of Guangzhou Medical University; Department of Affective Disorder, Guangzhou Brain Hospital, Affiliated Hospital of Guangzhou Medical University.
| | - Bin Sun
- Psychiatric Neuroscience Research Institute, Guangzhou Brain Hospital, Affiliated hospital of Guangzhou Medical University
| | - Huiyi Ouyang
- Psychiatric Neuroscience Research Institute, Guangzhou Brain Hospital, Affiliated hospital of Guangzhou Medical University
| | - Yamei Dang
- Department of Affective Disorder, Guangzhou Brain Hospital, Affiliated Hospital of Guangzhou Medical University
| | - Yangbo Guo
- Psychiatric Neuroscience Research Institute, Guangzhou Brain Hospital, Affiliated hospital of Guangzhou Medical University; Department of Affective Disorder, Guangzhou Brain Hospital, Affiliated Hospital of Guangzhou Medical University
| | - Guodong Miao
- Department of Affective Disorder, Guangzhou Brain Hospital, Affiliated Hospital of Guangzhou Medical University
| | - Catherine Rios
- International Mood Center, University of California, San Diego, La Jolla, CA, USA
| | - Hagop S Akiskal
- International Mood Center, University of California, San Diego, La Jolla, CA, USA
| | - Kangguang Lin
- Department of Affective Disorder, Guangzhou Brain Hospital, Affiliated Hospital of Guangzhou Medical University; Laboratory of Neuropsychology, The University of Hong Kong, Hong Kong; Laboratory of Cognitive Affective Neuroscience, The University of Hong Kong, Hong Kong.
| |
Collapse
|
29
|
Yang HC, Liu TB, Rong H, Bi JQ, Ji EN, Peng HJ, Wang XP, Fang YR, Yuan CM, Si TM, Lu Z, Hu J, Chen ZY, Huang Y, Sun J, Li HC, Hu C, Zhang JB, Li LJ. Evaluation of Mood Disorder Questionnaire (MDQ) in patients with mood disorders: a multicenter trial across China. PLoS One 2014; 9:e91895. [PMID: 24705393 PMCID: PMC3976254 DOI: 10.1371/journal.pone.0091895] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 02/16/2014] [Indexed: 02/05/2023] Open
Abstract
Background The aim of this study was to test the ability of the Chinese version of the Mood Disorder Questionnaire (MDQ) to identify Bipolar Disorders (BD) in patients diagnosed with Major Depressive Disorder (MDD) or Unipolar Disorder (UD) in the clinical setting. Methods 1,487 being treated for MDD or UD at 12 mental health centers across China, completed the MDQ and subsequently examined by the Mini International Neuropsychiatric Interview (MINI). Receiver Operating Characteristic(ROC) curves were used to determine the ability of the MDQ to differentiate between BD (BD, BD-I and BD-II) and MDD or UD and patients with BD-I from patients with BD-II. Results Of the 1,487 patients, 309 (20.8%) satisfied the DSM-IV criteria for BD: 118 (7.9%) for BD-I and 191 (12.8%) for BD-II. When only part one of the MDQ was used, the best cutoff was 7 between BD and UD (sensitivity 0.66, specificity 0.88, positive predictive value 0.59, negative predictive value 0.91), 6 between BD-II and UD, and 10 between BD-I and BD-II. If all three parts of the MDQ were used, the MDQ could not distinguish between BD and UD at a cutoff of 7 (or 6), and the sensitivity was only 0.22 (or 0.24). Conclusion The Chinese version of the MDQ had good psychometric features in screening bipolar disorders from depressive patients with mood disorders when part two and part three of the MDQ were ignored.
Collapse
Affiliation(s)
- Hai-Chen Yang
- Division of Mood Disorders, Shenzhen Mental Health Centre, Shenzhen Key Lab for Psychological Healthcare, Guangdong, China
| | - Tie-Bang Liu
- Division of Mood Disorders, Shenzhen Mental Health Centre, Shenzhen Key Lab for Psychological Healthcare, Guangdong, China
- * E-mail: (TBL); (LJL)
| | - Han Rong
- Division of Mood Disorders, Shenzhen Mental Health Centre, Shenzhen Key Lab for Psychological Healthcare, Guangdong, China
| | - Jian-Qiang Bi
- Division of Mood Disorders, Shenzhen Mental Health Centre, Shenzhen Key Lab for Psychological Healthcare, Guangdong, China
| | - Er-Ni Ji
- Division of Mood Disorders, Shenzhen Mental Health Centre, Shenzhen Key Lab for Psychological Healthcare, Guangdong, China
| | - Hong-Jun Peng
- Mental Health Institute, The Second Xiangya Hospital, Central South University, Hunan, China
| | - Xiao-Ping Wang
- Mental Health Institute, The Second Xiangya Hospital, Central South University, Hunan, China
| | - Yi-Ru Fang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Cheng-Mei Yuan
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Tian-Mei Si
- Peking University Institute of Mental Health, Beijing, China
| | - Zheng Lu
- Shanghai Tongji Hospital, Tongji University Medical School, Shanghai, China
| | - Jian Hu
- The First Hospital of Harbin Medical University, Heilongjiang, China
| | - Zhi-Yu Chen
- Hangzhou Seventh People's Hospital, Zhejiang, China
| | - Yi Huang
- West China Hospital, Sichuan University, Sichuan, China
| | - Jing Sun
- The Affiliated Brain Hospital, Nanjing Medical University, Jiangsu, China
| | - Hui-Chun Li
- The Second Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, China
| | - Chen Hu
- Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Jin-Bei Zhang
- The Third Affiliated Hospital of Sun Yat-Sen University, Guangdong, China
| | - Ling-Jiang Li
- Mental Health Institute, The Second Xiangya Hospital, Central South University, Hunan, China
- * E-mail: (TBL); (LJL)
| |
Collapse
|
30
|
Carta MG, Massidda D, Moro MF, Aguglia E, Balestrieri M, Caraci F, Dell'Osso L, Di Sciascio G, Drago F, Faravelli C, Hardoy MC, Calò S, Pollice R, Fortezzo A, Akiskal H. Comparing factor structure of the Mood Disorder Questionnaire (MDQ): In Italy sexual behavior is euphoric but in Asia mysterious and forbidden. J Affect Disord 2014; 155:96-103. [PMID: 24238869 DOI: 10.1016/j.jad.2013.10.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2013] [Revised: 10/20/2013] [Accepted: 10/21/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND The introduction of screening questionnaires, such as the Mood Disorder Questionnaire (MDQ), has stimulated clinical and epidemiological studies on bipolar disorders. In this work, we studied the item response pattern of the MDQ in the Italian population and compared the results with those of the validation of the MDQ in Asian studies (Chinese and Korean), analyzing similarities and differences among the populations studied. METHODS The sample was made up of 2278 participants, distributed as follows: 56.6% females, 50.8% living in the north-central Italy, and 33.7% living in rural areas. The factor analysis was run on the matrix of tetrachoric correlations. The psychometric properties of the MDQ were also studied using the Rasch logistic model. RESULTS The parallel analysis found two significant components. The first includes symptoms referring to acceleration, danger and irritability as risky behaviors, social interaction problems and mental flow. The second includes symptoms referring to self-confidence and energy. With respect to the Korean/Chinese results, the Italian sample, item 11 ("much more sex"), appears related to self-confidence and energy, while in Asia it is connected with items expressing risky behaviors and irritability. LIMITATIONS Differences in the frequency of comorbid disorders in Asian and Italian populations should be considered. The results should be confirmed and compared with those of other populations. CONCLUSIONS Cultural differences appear to be associated with a different symptomatic expression of bipolar spectrum disorders. Future research will investigate the role of gene-environment interaction in the genesis of these differences.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Audrey Fortezzo
- International Mood Center, University of California, San Diego, USA
| | - Hagop Akiskal
- International Mood Center, University of California, San Diego, USA
| |
Collapse
|
31
|
Waleeprakhon P, Ittasakul P, Lotrakul M, Wisajun P, Jullagate S, Ketter TA. Development and validation of a screening instrument for bipolar spectrum disorder: The Mood Disorder Questionnaire Thai version. Neuropsychiatr Dis Treat 2014; 10:1497-502. [PMID: 25170269 PMCID: PMC4144938 DOI: 10.2147/ndt.s67842] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The Mood Disorder Questionnaire (MDQ) has been translated to many languages and has been used in many countries as a screening instrument for bipolar disorder. The main objective of this study was to evaluate validity of the Thai version of the MDQ as a screening instrument for bipolar disorder in a psychiatric outpatient sample, and to determine its optimum question #1 item threshold value for bipolar disorder. METHODS The English language Mood Disorder Questionnaire (MDQ) was translated into Thai. The process involved back-translation, cross-cultural adaptation, field testing of the prefinal version, as well as final adjustments. Two hundred and fifty major depressive disorder outpatients were further assessed by the Thai version of the MDQ and the Thai version of the Mini International Neuropsychiatric Interview (MINI). During the assessment, reliability and validity analyses, and receiver operating characteristic curve (ROC) analysis were performed. RESULTS The Thai version of the MDQ screening had adequate internal consistency (Cronbach's alpha =0.791, omega total =0.68, and omega hierarchical =0.69). The optimal question #1 item threshold value was at least five positive items, which yielded adequate sensitivity (76.5%), specificity (72.7%), positive predictive value (74.3%), and negative predictive value (75.0%). The ROC area under the curve (AUC) for this study was 0.82 (95% confidence interval: 0.70 to 0.90). CONCLUSION The Thai version of the MDQ had some useful psychometric properties for screening for bipolar disorder in a mood disorder clinic setting, with a recommended question #1 item threshold value of at least five positive items.
Collapse
Affiliation(s)
- Punjaporn Waleeprakhon
- Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Pichai Ittasakul
- Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Manote Lotrakul
- Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Pattarabhorn Wisajun
- Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sudawan Jullagate
- Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Terence A Ketter
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| |
Collapse
|
32
|
Hu C, Xiang YT, Wang G, Ungvari GS, Dickerson FB, Kilbourne AM, Lai KYC, Si TM, Fang YR, Lu Z, Yang HC, Hu J, Chen ZY, Huang Y, Sun J, Wang XP, Li HC, Zhang JB, Chiu HFK. Screening for bipolar disorder with the Mood Disorders Questionnaire in patients diagnosed as major depressive disorder - the experience in China. J Affect Disord 2012; 141:40-6. [PMID: 22436092 DOI: 10.1016/j.jad.2012.02.035] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Revised: 02/22/2012] [Accepted: 02/22/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Bipolar disorder (BD) is often misdiagnosed as a major depressive disorder (MDD). This study aimed to test the usefulness of the screening tool, the Mood Disorders Questionnaire (MDQ), to identify BD patients misdiagnosed as MDD in Chinese clinical settings. METHODS A total of 1487 patients treated for MDD were consecutively examined in 13 mental health centers in China. The patients' socio-demographic and clinical characteristics were recorded using a standardized protocol and data collection procedure. The MDQ was completed by patients to identify symptoms characteristic of BD. DSM-IV diagnoses were established using the Mini International Neuropsychiatric Interview (MINI). RESULTS Three hundred-nine of the 1487 patients (20.8%) satisfied DSM-IV criteria for BD; 118 (7.9%) for BD-I and 191 (12.8%) for BD-II on the MINI. The optimal cut-off point on the MDQ to differentiate BD from MDD was 3, while cut-off points of 5 and 3 differentiated BD-I and BD-II from MDD, respectively. The maximum sensitivity was 0.31, 0.45 and 0.22 for differentiating BD, BD-I and BD-II from MDD, respectively. CONCLUSIONS The optimal cutoff points of the MDQ for screening BD in Chinese patients originally diagnosed as MDD were considerably lower than those in earlier studies. The routine clinical use of the MDQ as a screening scale for BD in Chinese patients treated for MDD does not seem to be justified.
Collapse
Affiliation(s)
- Chen Hu
- Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, China
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Gan Z, Han Z, Li K, Diao F, Wu X, Guan N, Zhang J. Validation of the Chinese version of the "Mood Disorder Questionnaire" for screening bipolar disorder among patients with a current depressive episode. BMC Psychiatry 2012; 12:8. [PMID: 22293033 PMCID: PMC3299660 DOI: 10.1186/1471-244x-12-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2011] [Accepted: 01/31/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Mood Disorder Questionnaire (MDQ) is a well-recognized screening tool for bipolar disorder, but its Chinese version needs further validation. This study aims to measure the accuracy of the Chinese version of the MDQ as a screening instrument for bipolar disorder (BPD) in a group of patients with a current major depressive episode. METHODS 142 consecutive patients with an initial DSM-IV-TR diagnosis of a major depressive episode were screened for BPD using the Chinese translation of the MDQ and followed up for one year. The final diagnosis, determined by a special committee consisting of three trained senior psychiatrists, was used as a 'gold standard' and ROC was plotted to evaluate the performance of the MDQ. The optimal cut-off was chosen by maximizing the Younden's index. RESULTS Of the 142 patients, 122 (85.9%) finished the one year follow-up. On the basis of a semi-structured clinical interview 48.4% (59/122) received a diagnosis of unipolar depression (UPD), 36.9% (45/122) BPDII and 14.8% (18/122) BPDI. At the end of the one year follow-up,9 moved from UPD to BPD, 2 from BPDII to UPD, 1 from BPDII to BPDI, the overall rate of initial misdiagnosis was 16.4%. MDQ showed a good accuracy for BPD: the optimal cut-off was 4, with a sensitivity of 0.72 and a specificity of 0.73. When BPDII and BPDI were calculated independently, the optimal cut-off for BPDII was 4, with a sensitivity of 0.70 and a specificity of 0.73; while the optimal cut-off for BPDI was 5, with a sensitivity of 0.67 and a specificity of 0.86. CONCLUSIONS Our results show that the Chinese version of MDQ is a valid tool for screening BPD in a group of patients with current depressive episode on the Chinese mainland.
Collapse
Affiliation(s)
- Zhaoyu Gan
- Psychiatry Department, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China
| | - Zili Han
- Psychiatry Department, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China
| | - Kanglai Li
- VIP Department, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China
| | - Feici Diao
- Psychiatry Department, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China
| | - Xiaoli Wu
- Psychiatry Department, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China
| | - Nianhong Guan
- Psychiatry Department, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China
| | - Jinbei Zhang
- Psychiatry Department, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China
| |
Collapse
|