Evaluating depressive symptoms in mania: a naturalistic study of patients with bipolar disorder

Allan H Young,1 Jonas Eberhard1,21Institute of Psychiatry, King’s College London, London, UK; 2Corporate Medical Affairs, H. Lundbeck A/S, Copenhagen, DenmarkObjective: This study aimed to evaluate patients with bipolar I disorder (BD-I) who have mania with depressive symptoms and who meet...

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Autores principales:	Young AH, Eberhard J
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/d36f6dca47f94c92bdd9db531f11a0d0
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spelling	oai:doaj.org-article:d36f6dca47f94c92bdd9db531f11a0d02021-12-02T06:10:51ZEvaluating depressive symptoms in mania: a naturalistic study of patients with bipolar disorder1178-2021https://doaj.org/article/d36f6dca47f94c92bdd9db531f11a0d02015-04-01T00:00:00Zhttp://www.dovepress.com/evaluating-depressive-symptoms-in-mania-a-naturalistic-study-of-patien-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Allan H Young,1 Jonas Eberhard1,21Institute of Psychiatry, King’s College London, London, UK; 2Corporate Medical Affairs, H. Lundbeck A/S, Copenhagen, DenmarkObjective: This study aimed to evaluate patients with bipolar I disorder (BD-I) who have mania with depressive symptoms and who meet the new “with mixed features” specifier of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5).Method: This prospective, multinational, naturalistic study surveyed psychiatrists and their patients with BD-I from October 2013 to March 2014. Eligible patients had BD-I, had a (current) manic episode, and had experienced onset of a manic episode within the previous 3 months. Psychiatrists provided patient information on depressive symptoms (DSM-5 criteria); symptoms of anxiety, irritability, and agitation; suicide attempts; and physician satisfaction with treatment response. Data were stratified according to whether patients met the criteria for the BD-I “with mixed features” specifier of DSM-5 (≥3 depressive symptoms) or not, and characteristics were compared between the two subgroups. Patients also self-reported on depressive symptoms using the Mini-International Neuropsychiatric Interview module questionnaire.Results: Overall, 34% of 1,035 patients met the criteria for BD-I “with mixed features,” exhibiting ≥3 depressive symptoms during their current manic episode. This correlated with the matched patient self-reports of depressive symptoms. During their current manic episode, BD-I patients “with mixed features” had more severe symptoms of anxiety, irritability, and agitation (average composite severity score of 4.1 vs 3.4), a higher incidence of suicide attempts (38% vs 9%), and more physician dissatisfaction with treatment response (22% vs 14%), compared to patients with 0–2 depressive symptoms (all P<0.05).Conclusion: This study found that patients with BD-I “with mixed features” (ie, ≥3 depressive symptoms during a manic episode), suffered, on average, from a greater burden of disease than patients with pure mania. Improved identification of these patients may help to optimize treatment outcomes.Keywords: bipolar disorder, mania with depressive symptoms, mixed features, DSM-5Young AHEberhard JDove Medical PressarticleNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2015, Iss default, Pp 1137-1143 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Young AH Eberhard J Evaluating depressive symptoms in mania: a naturalistic study of patients with bipolar disorder
description	Allan H Young,1 Jonas Eberhard1,21Institute of Psychiatry, King’s College London, London, UK; 2Corporate Medical Affairs, H. Lundbeck A/S, Copenhagen, DenmarkObjective: This study aimed to evaluate patients with bipolar I disorder (BD-I) who have mania with depressive symptoms and who meet the new “with mixed features” specifier of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5).Method: This prospective, multinational, naturalistic study surveyed psychiatrists and their patients with BD-I from October 2013 to March 2014. Eligible patients had BD-I, had a (current) manic episode, and had experienced onset of a manic episode within the previous 3 months. Psychiatrists provided patient information on depressive symptoms (DSM-5 criteria); symptoms of anxiety, irritability, and agitation; suicide attempts; and physician satisfaction with treatment response. Data were stratified according to whether patients met the criteria for the BD-I “with mixed features” specifier of DSM-5 (≥3 depressive symptoms) or not, and characteristics were compared between the two subgroups. Patients also self-reported on depressive symptoms using the Mini-International Neuropsychiatric Interview module questionnaire.Results: Overall, 34% of 1,035 patients met the criteria for BD-I “with mixed features,” exhibiting ≥3 depressive symptoms during their current manic episode. This correlated with the matched patient self-reports of depressive symptoms. During their current manic episode, BD-I patients “with mixed features” had more severe symptoms of anxiety, irritability, and agitation (average composite severity score of 4.1 vs 3.4), a higher incidence of suicide attempts (38% vs 9%), and more physician dissatisfaction with treatment response (22% vs 14%), compared to patients with 0–2 depressive symptoms (all P<0.05).Conclusion: This study found that patients with BD-I “with mixed features” (ie, ≥3 depressive symptoms during a manic episode), suffered, on average, from a greater burden of disease than patients with pure mania. Improved identification of these patients may help to optimize treatment outcomes.Keywords: bipolar disorder, mania with depressive symptoms, mixed features, DSM-5
format	article
author	Young AH Eberhard J
author_facet	Young AH Eberhard J
author_sort	Young AH
title	Evaluating depressive symptoms in mania: a naturalistic study of patients with bipolar disorder
title_short	Evaluating depressive symptoms in mania: a naturalistic study of patients with bipolar disorder
title_full	Evaluating depressive symptoms in mania: a naturalistic study of patients with bipolar disorder
title_fullStr	Evaluating depressive symptoms in mania: a naturalistic study of patients with bipolar disorder
title_full_unstemmed	Evaluating depressive symptoms in mania: a naturalistic study of patients with bipolar disorder
title_sort	evaluating depressive symptoms in mania: a naturalistic study of patients with bipolar disorder
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/d36f6dca47f94c92bdd9db531f11a0d0
work_keys_str_mv	AT youngah evaluatingdepressivesymptomsinmaniaanaturalisticstudyofpatientswithbipolardisorder AT eberhardj evaluatingdepressivesymptomsinmaniaanaturalisticstudyofpatientswithbipolardisorder
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Evaluating depressive symptoms in mania: a naturalistic study of patients with bipolar disorder

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