Evidence for three distinct classes of ‘typical’, ‘psychotic’ and ‘dual’ mania: results from the EMBLEM study

Haro, Josep María; Os, Jim van; Vieta, Eduard; Reed, Catherine; Lorenzo, M; Goetz, Iris

doi:10.1111/j.1600-0447.2005.00692.x

Cited by 73 publications

(69 citation statements)

References 38 publications

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“…Data were collected by the investigators or their designees. The study design and baseline characteristics of the study population have been reported previously [18,23] . Patients (inpatients or outpatients) were enrolled in the study if the treating physician decided to initiate or change oral medication (antipsychotics, anticonvulsants and / or lithium) for a manic or mixed episode within the normal course of their bipolar I disorder.…”

Section: Patients and Methods ▼ Study Design And Patientsmentioning

confidence: 99%

Assessment of Medication Adherence in a Cohort of Patients with Bipolar Disorder

González-Pinto

Reed²,

Novick³

et al. 2010

Pharmacopsychiatry

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Section: Patients and Methods ▼ Study Design And Patientsmentioning

confidence: 99%

Assessment of Medication Adherence in a Cohort of Patients with Bipolar Disorder

González-Pinto

Reed²,

Novick³

et al. 2010

Pharmacopsychiatry

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“…It has also been shown that patients with a history of psychosis, regardless of a diagnosis, are impaired on a variety of cognitive measures, such as executive functioning, verbal learning and memory, verbal fluency, control inference (Glahn et al, 2007;Martinez-Aran et al, 2008;Simonsen et al, 2011;Udal et al, 2012) and additionally, psychotic features in mood disorders have validity in terms of prognosis, treatment response and family history for psychiatric illness (Mazzarini et al, 2010;Souery et al, 2011;Schultze-Lutter et al, 2012). It has also been shown that psychotic symptoms in mood disorders are associated with higher number of hospitalizations (Jager et al, 2005), poorer response to medications (Coryell et al, 1984), increased recurrence (Tohen et al, 2003), greater symptom severity worse short-and long-term outcome (Coryell et al, 2001), longer duration of recovery (Geller et al, 2002) and overall greater functional impairment (Haro et al, 2006). Moreover, executive dysfunction in BPD patients was reported to be related to a history of psychosis in their families (Tabares-Seisdedos et al, 2003).…”

Section: Comparison Of Cognitive Performance Between Bpd(+) and Bpd(−mentioning

confidence: 99%

Impairments of Working Memory in Schizophrenia and Bipolar Disorder: the Effect of History of Psychotic Symptoms and Different Aspects of Cognitive Task Demands

Hewedi

Frydecka

Moustafa

2015

European Psychiatry

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Comparisons of cognitive impairments between schizophrenia (SZ) and bipolar disorder (BPD) have produced mixed results. We applied different working memory (WM) measures (Digit Span Forward and Backward, Short-delay and Long-delay CPT-AX, N-back) to patients with SZ (n = 23), psychotic BPD (n = 19) and non-psychotic BPD (n = 24), as well as to healthy controls (HC) (n = 18) in order to compare the level of WM impairments across the groups. With respect to the less demanding WM measures (Digit Span Forward and Backward, Short-delay CPT-AX), there were no between group differences in cognitive performance; however, with respect to the more demanding WM measures (Long-delay CPT-AX, N-back), we observed that the groups with psychosis (SZ, psychotic BPD) did not differ from one another, but performed poorer than the group without a history of psychosis (non-psychotic BPD). A history of psychotic symptoms may influence cognitive performance with respect to WM delay and load effects as measured by Long-delay CPT-AX and N-back tests, respectively. We observed a positive correlation of WM performance with antipsychotic treatment and a negative correlation with depressive symptoms in BPD and with negative symptoms in SZ subgroup. Our study suggests that WM dysfunctions are more closely related to a history of psychosis than to the diagnostic categories of SZ and BPD described by psychiatric classification systems.

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“…A recently published study (EMBLEM; abbreviated EM) [24] , which was a prospective, observational study on the outcomes of patients treated for mania, conducted across 14 European countries identified, using a latent class analysis, 3 groups of patients at baseline on a sample of 3,536 subjects: typical mania, psychotic mania with severer mania and presence of psychotic symptoms and 'dual mania' with a high proportion of substance abuse.…”

Section: Discussionmentioning

confidence: 99%

Validation of a Severity Threshold for the Mania Rating Scale: A Receiver-Operating Characteristic Analysis

Azorin

Kaladjian

Akiskal³

et al. 2007

Psychopathology

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Background: The aim of this study was to determine a cutoff score on the Mania Rating Scale (MRS), which easily allows identification of severe mania in a population of manic patients to be included in clinical trials of antimanic drugs. Method: 1,090 hospitalized patients meeting DSM-IV criteria for a manic episode were subtyped according to the specifier for severity and assessed for demographic characteristics, illness course and clinical symptomatology. Using receiver-operating characteristic (ROC) analysis, the optimal threshold for severity was determined on the MRS. Results: In a French national clinical sample (n = 1,090), 851 cases were specified as severe and 239 as nonsevere (mild + moderate) mania according to DSM-IV criteria (307 without psychotic features, 544 with psychotic features). Patients with severe mania scored higher on the MRS but showed the same levels of scores on the Montgomery Asberg Depression Rating Scale compared to nonsevere cases. Many characteristics of the whole sample and of the psychotic group were found to be comparable, respectively, to those reported in recent epidemiological studies, which was particularly true for age, gender, age at onset, number of mood episodes and suicide attempts. The optimal ROC solution for separating severe from nonsevere mania was a cutoff score of 39 on the MRS. This cutoff score displayed a positive predictive value of 0.91. Conclusion: A cutoff score of 39 is proposed as a severity threshold for mania on the MRS by virtue of its ROC validation in a large representative sample of severe versus nonsevere manic patients whose severity was assessed according to DSM-IV subtyping.

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Evidence for three distinct classes of ‘typical’, ‘psychotic’ and ‘dual’ mania: results from the EMBLEM study

Abstract: Dual mania represents a distinct and not infrequent subgroup of patients with mania. The exclusion of patients with comorbid substance problems from clinical trials creates a gap in our knowledge on treatment effectiveness.

Cited by 73 publications

References 38 publications

Assessment of Medication Adherence in a Cohort of Patients with Bipolar Disorder

Assessment of Medication Adherence in a Cohort of Patients with Bipolar Disorder

Impairments of Working Memory in Schizophrenia and Bipolar Disorder: the Effect of History of Psychotic Symptoms and Different Aspects of Cognitive Task Demands

Validation of a Severity Threshold for the Mania Rating Scale: A Receiver-Operating Characteristic Analysis

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