Bipolar Disorders in DSM-IV: Impact of Inclusion of Rapid Cycling as a Course Modifier

Dünner, David L.

doi:10.1016/s0893-133x(98)00024-4

Cited by 15 publications

(11 citation statements)

References 17 publications

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“…We also performed the TDT considering BP I and BP II triads separately, as some data suggest different vulnerability factors in these two diagnostic sub-groups (Dunner 1998). In our sample there were 107 BP I informative triads for the analysis of the G861C polymorphism, which showed no biases in the transmission of either alleles (chi-square ϭ 1.829, df ϭ 1, p ϭ .176), and four BP I informative triads for the T371G (Phe-124-Cys) polymorphism that were the ones represented in the analysis on the total sample ( see above ).…”

Section: Resultsmentioning

confidence: 99%

The 5HT1Dβ Receptor Gene in Bipolar Disorder A Family-based Association Study

Mundo

Zai

Lee

et al. 2001

Neuropsychopharmacology

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Section: Resultsmentioning

confidence: 99%

The 5HT1Dβ Receptor Gene in Bipolar Disorder A Family-based Association Study

Mundo

Zai

Lee

et al. 2001

Neuropsychopharmacology

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“…Moreover, evidence from the literature on adults (Angst et al 2003) suggests that short episodes (1–3 days) of mania-like symptoms do not differ significantly from episodes of typical duration (>4 days) on a number of external validators. Indeed, it has been pointed out (Dunner 1998) that in the DSM-IV “the duration of a hypomanic episode was arbitrarily (added italics) set at 4 days or longer” (page 190). Another potentially relevant finding from the work of Angst and colleagues (Angst et al 2003), is that their group of “pure hypomania” (which does not conform to typical DSM-IV criteria for BP), showed the highest rates of conduct problems across all subgroups of mood disorders.…”

Section: Discussionmentioning

confidence: 99%

Dimensions and Latent Classes of Episodic Mania-Like Symptoms in Youth: An Empirical Enquiry

Stringaris

Ståhl

Santosh

et al. 2011

J Abnorm Child Psychol

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The dramatic increase in diagnostic rates of bipolar disorder in children and adolescents in the USA has led to an intense interest in the phenomenology of the disorder. Here we present data from a newly-developed instrument to assess episodic mania-like symptoms in youth in a large population-based sample (N=5326) using parentand self-report. We found that a substantial proportion of children screened positive for having episodes of "going high" and were at an increased risk for morbidity and impairment. Using factor analysis, we identified that episodic mania-like symptoms comprised two dimensions: An under-controlled dimension that was associated with significant impairment, and a low-risk exuberant dimension. Using latent class analysis, we identified a small group of children scoring high on a range of manic symptoms and suffering from severe psychosocial impairment and morbidity. Our results carry implications for the nosology and psychosocial impairment associated with episodic mood changes in young people.

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“…The DSM has taken a conservative approach to the inclusion of disorders in the bipolar spectrum; bipolar II was introduced only in the latest edition, and with an arbitrary and perhaps overly stringent 4‐day duration criterion for hypomanias (18–20). Although bipolar II can be diagnosed reliably using Research Diagnostic Criteria (21) for hypomania with duration as little as 2 days (22) and there is little doubt that it exists as a distinct clinical entity (18, 23), there is reason to believe that the diagnosis can be made reliably only by expert clinicians (24).…”

Section: How Useful Is the Bipolar Spectrum?mentioning

confidence: 99%

Affective instability as rapid cycling: theoretical and clinical implications for borderline personality and bipolar spectrum disorders

2006

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Objectives: The Diagnostic and Statistical Manual of Mental Disorders guidelines provide only a partial solution to the nosology and treatment of bipolar disorder in that disorders with common symptoms and biological correlates may be categorized separately because of superficial differences related to behavior, life history, and temperament. The relationship is explored between extremely rapid switching forms of bipolar disorder, in which manic and depressive symptoms are either mixed or switch rapidly, and forms of borderline personality disorder in which affective lability is a prominent symptom. Methods: A MedLine search was conducted of articles that focused on rapid cycling in bipolar disorder, emphasizing recent publications (2001–2004). Results: Studies examined here suggest a number of points of phenomenological and biological overlap between the affective lability criterion of borderline personality disorder and the extremely rapid cycling bipolar disorders. We propose a model for the development of ‘borderline’ behaviors on the basis of unstable mood states that sheds light on how the psychological and somatic interventions may be aimed at ‘breaking the cycle’ of borderline personality disorder development. A review of pharmacologic studies suggests that anticonvulsants may have similar stabilizing effects in both borderline personality disorder and rapid cycling bipolar disorder. Conclusions: The same mechanism may drive both the rapid mood switching in some forms of bipolar disorder and the affective instability of borderline personality disorder and may even be rooted in the same genetic etiology. While continued clinical investigation of the use of anticonvulsants in borderline personality disorder is needed, anticonvulsants may be useful in the treatment of this condition, combined with appropriate psychotherapy.

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Bipolar Disorders in DSM-IV: Impact of Inclusion of Rapid Cycling as a Course Modifier

Cited by 15 publications

References 17 publications

The 5HT1Dβ Receptor Gene in Bipolar Disorder A Family-based Association Study

The 5HT1Dβ Receptor Gene in Bipolar Disorder A Family-based Association Study

Dimensions and Latent Classes of Episodic Mania-Like Symptoms in Youth: An Empirical Enquiry

Affective instability as rapid cycling: theoretical and clinical implications for borderline personality and bipolar spectrum disorders

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