A prospective study of the transition rates of subthreshold (hypo)mania and depression in the general population

Regeer, Eline J.; Krabbendam, Lydia; Graaf, Ron de; Have, Margreet ten; Nolen, Willem A.; Os, Jim van

doi:10.1017/s0033291705006823

Cited by 63 publications

(66 citation statements)

References 26 publications

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“…Thus, the clinical relevance of these findings remains uncertain. Nevertheless, as has been described for sub-threshold psychosis symptoms , research suggests that expressions of mania outside the realm of clinical disorder have a distribution in the general population (Akiskal, 2003, Krabbendam et al, 2004 and that sub-threshold expressions of mania show continuity with clinical diagnoses of mania and thus bipolar disorder (Regeer et al, 2006, Thomas, 2004.…”

Section: Does Cannabis Use Induce Mania Symptoms Specifically?mentioning

confidence: 94%

Cannabis use and mania symptoms: A systematic review and meta-analysis

Gibbs

Winsper

Marwaha

et al. 2015

Journal of Affective Disorders

175

121

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(2015) Cannabis use and mania symptoms : a systematic review and meta-analysis. Journal of Affective Disorders, Volume 171 . pp. 39-47. Permanent WRAP url:http://wrap.warwick.ac.uk/64733 Copyright and reuse:The Warwick Research Archive Portal (WRAP) makes this work of researchers of the University of Warwick available open access under the following conditions. Copyright © and all moral rights to the version of the paper presented here belong to the individual author(s) and/or other copyright owners. To the extent reasonable and practicable the material made available in WRAP has been checked for eligibility before being made available.Copies of full items can be used for personal research or study, educational, or not-forprofit purposes without prior permission or charge. Provided that the authors, title and full bibliographic details are credited, a hyperlink and/or URL is given for the original metadata page and the content is not changed in any way. Publisher statement: NOTICE: this is the author's version of a work that was accepted for publication in Journal of Affective Disorders. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in http://dx.doi.org/10.1016/j.jad.2014.09.016 A note on versions:The version presented here may differ from the published version or, version of record, if you wish to cite this item you are advised to consult the publisher's version. Please see the 'permanent WRAP url' above for details on accessing the published version and note that access may require a subscription. 2 Background: Whilst cannabis use appears to be a causal risk factor for the development of schizophrenia-related psychosis, associations with mania remain relatively unknown. This review aimed to examine the impact of cannabis use on the incidence of manic symptoms and on their occurrence in those with pre-existing bipolar disorder Methods: A systematic review of the scientific literature using the PRISMA guidelines.PsychINFO, Cochrane, Scopus, Embase and MEDLINE databases were searched for prospective studies.Results: Six articles met inclusion criteria. These sampled 2,391 individuals who had experienced mania symptoms. The mean length of follow up was 3.9 years.Studies support an association between cannabis use and the exacerbation of manic symptoms in those with previously diagnosed bipolar disorder. Furthermore, a meta-analysis of two studies suggests that cannabis use is associated with an approximately 3-fold (Odds Ratio: 2.97; 95% CI: 1.80 to 4.90) increased risk for the new onset of manic symptoms. Limitations:We were only able to identify a small number of studies of variable quality, thus our conclusions remain preliminary. Conclusions:Our findings whilst tentative, suggest that cannabis use may worsen the occurrence of manic symptoms i...

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Section: Does Cannabis Use Induce Mania Symptoms Specifically?mentioning

confidence: 94%

Cannabis use and mania symptoms: A systematic review and meta-analysis

Gibbs

Winsper

Marwaha

et al. 2015

Journal of Affective Disorders

175

121

View full text Add to dashboard Cite

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“…Both binary and continuous affective variables were constructed as described previously [34][35][36] : i) ''Binary (hypo)mania'' and ''binary depression'': An a priori binary (hypo)mania variable was defined as at least 2 DIA-X/M-CIDI mania symptoms and a binary depression variable as at least 3 DIA-X/M-CIDI depression symptoms. ii) In addition, guided by previous work, 34-36 a continuous ''(Hypo)mania Score'' and a continuous ''Depression Score'' variable were constructed.…”

Section: Binary and Continuous Affective Variablesmentioning

confidence: 99%

Affective Dysregulation and Reality Distortion: A 10-Year Prospective Study of Their Association and Clinical Relevance

Rossum

Dominguez

Lieb

et al. 2009

Schizophrenia Bulletin

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142

137

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Evidence from clinical patient populations indicates that affective dysregulation is strongly associated with reality distortion, suggesting that a process of misassignment of emotional salience may underlie this connection. To examine this in more detail without clinical confounds, affective regulation-reality distortion relationships, and their clinical relevance, were examined in a German prospective cohort community study. A cohort of 2524 adolescents and young adults aged 14-24 years at baseline was examined by experienced psychologists. Presence of psychotic experiences and (hypo)manic and depressive symptoms was assessed at 2 time points (3.5 and up to 10 years after baseline) using the Munich-Composite International Diagnostic Interview. Associations were tested between level of affective dysregulation on the one hand and incidence of psychotic experiences, persistence of these experiences, and psychotic Impairment on the other. Most psychotic experiences occurred in a context of affective dysregulation, and bidirectional dose-response was apparent with greater level of both affective dysregulation and psychotic experiences. Persistence of psychotic experiences was progressively more likely with greater level of (hypo)manic symptoms (odds ratio [OR] trend 5 1.51, P < .001) and depressive symptoms (OR trend 5 1.15, P 5 .012). Similarly, psychotic experiences of clinical relevance were progressively more likely to occur with greater level of affective dysregulation (depressive symptoms: OR trend 5 1.28, P 5 .002; (hypo)manic symptoms: OR trend 5 1.37, P 5 .036). Correlated genetic liabilities underlying affective and nonaffective psychotic syndromes may be expressed as correlated dimensions in the general population. Also, affective dysregulation may contribute causally to the persistence and clinical relevance of reality distortion, possibly by facilitating a mechanism of aberrant salience attribution.

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“…These items were rated yes (1) or no (0) and were only rated if : (a) at least one of the core symptoms ' unusual happiness or excitement ' or ' unusual irritability ' was present ; (b) core symptoms were either noticed by others or caused participants problems ; (c) symptoms were present for at least four successive days ; (d) symptoms were not a result of alcohol/drugs use. Guided by previous work (Regeer et al 2006), a sum score of symptom ratings was formed (range 0-11 symptoms). Five progressively stricter and overlapping subcategories of this sum score were created (I, no symptoms ; II, o1 symptom ; III, o4 symptoms ; IV, o7 symptoms ; V, o10 symptoms), which represented the underlying continuous score of (hypo)manic symptoms.…”

Section: Mania Categories Based On Dsm-iv Algorithmsmentioning

confidence: 99%

Evidence that bipolar disorder is the poor outcome fraction of a common developmental phenotype: an 8-year cohort study in young people

Tijssen

Wittchen

et al. 2009

Psychol. Med.

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Background. Reported rates of bipolar syndromes are highly variable between studies because of age differences, differences in diagnostic criteria, or restriction of sampling to clinical contacts.Method. In 1395 adolescents aged 14-17 years, DSM-IV (hypo)manic episodes (manic and hypomanic episodes combined), use of mental health care, and five ordinal subcategories representing the underlying continuous score of (hypo)manic symptoms (' mania symptom scale ') were measured at baseline and approximately 1.5, 4 and 10 years later using the Munich-Composite International Diagnostic Interview (DIA-X/M-CIDI).Results. Incidence rates (IRs) of both (hypo)manic episodes and (hypo)manic symptoms (at least one DSM-IV core symptom) were far higher (714/105 person-years and 1720/10 5 person-years respectively) than traditional estimates. In addition, the risk of developing (hypo)manic episodes was very low after the age of 21 years [hazard ratio (HR) 0.031, 95 % confidence interval (CI) 0.0050-0.19], independent of childhood disorders such as attention deficit hyperactivity disorder (ADHD). Most individuals with hypomanic and manic episodes were never in care (87 % and 62 % respectively) and not presenting co-morbid depressive episodes (69 % and 60 % respectively). The probability of mental health care increased linearly with the number of symptoms on the mania symptom scale. The incidence of the bipolar categories, in particular at the level of clinical morbidity, was strongly associated with previous childhood disorders and male sex.Conclusions. This study showed, for the first time, that experiencing (hypo)manic symptoms is a common adolescent phenomenon that infrequently predicts mental health care use. The findings suggest that the onset of bipolar disorder can be elucidated by studying the pathway from non-pathological behavioural expression to dysfunction and need for care.

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A prospective study of the transition rates of subthreshold (hypo)mania and depression in the general population

Cited by 63 publications

References 26 publications

Cannabis use and mania symptoms: A systematic review and meta-analysis

Cannabis use and mania symptoms: A systematic review and meta-analysis

Affective Dysregulation and Reality Distortion: A 10-Year Prospective Study of Their Association and Clinical Relevance

Evidence that bipolar disorder is the poor outcome fraction of a common developmental phenotype: an 8-year cohort study in young people

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