Faut-il annoncer un diagnostic de trouble bipolaire à un patient qui n’a jamais connu la dépression ? Une revue systématique actualisée sur la manie récurrente

Dondé, Clément; Lepetit, Alexis; Lavigne, Benjamin

doi:10.1016/j.lpm.2018.06.020

Cited by 2 publications

(3 citation statements)

References 28 publications

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“…We carried out an additional, post hoc, non-systematic search on Google Scholar to check whether additional studies were retrievable. We performed also a manual search of the reference lists of four relevant reviews (Angst, 2015 ; Angst & Grobler, 2015 ; Dondé, Lepetit, & Lavigne, 2019 ; Yazıcı, 2014 ). We completed the preliminary screening based on titles and abstracts.…”

Section: Methodsmentioning

confidence: 99%

Characterizing the clinical profile of mania without major depressive episodes: a systematic review and meta-analysis of factors associated with unipolar mania

et al. 2023

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Background The diagnostic concept of unipolar mania (UM), i.e. the lifetime occurrence of mania without major depressive episodes, remains a topic of debate despite the evidence accumulated in the last few years. We carried out a systematic review and meta-analysis of observational studies testing factors associated with UM as compared to bipolar disorder with a manic-depressive course (md-BD). Methods Studies indexed up to July 2022 in main electronic databases were searched. Random-effects meta-analyses of the association between UM and relevant correlates yielded odds ratio (OR) or standardized mean difference (SMD), with 95% confidence intervals (CIs). Results Based on data from 21 studies, factors positively or negatively associated with UM, as compared to md-BD, were: male gender (OR 1.47; 95% CI 1.11–1.94); age at onset (SMD −0.25; 95% CI −0.46 to −0.04); number of hospitalizations (SMD 0.53; 95% CI 0.21–0.84); family history of depression (OR 0.55; 95% CI 0.36–0.85); suicide attempts (OR 0.25; 95% CI 0.19–0.34); comorbid anxiety disorders (OR 0.35; 95% CI 0.26–0.49); psychotic features (OR 2.16; 95% CI 1.55–3.00); hyperthymic temperament (OR 1.99; 95% CI 1.17–3.40). The quality of evidence for the association with previous suicide attempts was high, moderate for anxiety disorders and psychotic features, and low or very low for other correlates. Conclusions Despite the heterogeneous quality of evidence, this work supports the hypothesis that UM might represent a distinctive diagnostic construct, with peculiar clinical correlates. Additional research is needed to better differentiate UM in the context of affective disorders, favouring personalized care approaches.

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Section: Methodsmentioning

confidence: 99%

Characterizing the clinical profile of mania without major depressive episodes: a systematic review and meta-analysis of factors associated with unipolar mania

et al. 2023

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“…An increasing number of scientific papers, however, argue that unipolar mania (UM), i.e., mania without depression, as opposed to bipolar disorder with both depression and mania (DM), warrants a separate diagnosis. The most recent comprehensive reviews argue strongly that UM is substantially different from DM and should be seen as an entity of its own [ 7 – 9 ]. A study by Merikangas [ 10 ] suggests a possible independent familial transmission of mania and depression, thus questioning the bipolar unity, while a recent study using UK biobank data found “key differences” between UM and DM [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…The definition of UM remains debated, but there is a call for consensus regarding needed number of manic episodes and follow-up time [ 9 ]. One review recommends using the definition of at least two manic episodes as “possible UM” and at least four manic episodes as “probable UM” [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and characteristics of unipolar mania in a low-income country setting: population-based data from the Butajira cohort, rural Ethiopia

Wikström

Zeberg

Mayston

et al. 2022

Soc Psychiatry Psychiatr Epidemiol

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Purpose Previous research suggests unipolar mania, i.e., bipolar disorder without depression, to be more common in low-income countries. However, longitudinal population-based studies on unipolar mania from low-income countries are lacking. This study therefore examined unipolar mania, in Butajira, Ethiopia, and associations with possible determinants. Methods Key informants and 68,378 screenings with the Composite International Diagnostic Interviews (CIDI 2.1) identified suspected cases of bipolar disorder. Diagnosis was confirmed using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN 2.1) (n = 2,285). 315 participants with bipolar disorder were recruited and followed up for an average of 2.5 years. Unipolar mania was defined when illness episodes consisted of at least two manic relapses. 240 cases had sufficient data to ascertain course of disorder. Results 41.7% (100 of 240 cases) of participants had unipolar mania. Unipolar mania was associated with less suicidal ideation (0% vs. 26.4%, p < 0.001), less suicidal thoughts (occasionally/often: 1%/3% vs. 19.6%/21%, p < 0.001), and less history of suicide attempt (2% vs. 11.6%, p = 0.01). The participants with unipolar mania tended to have better social functioning (OR = 2.05, p = 0.07) and less alcohol use (20.8% vs. 31.4%, p = 0.07). The study was partly based on retrospective data liable to recall bias. Some cases defined as unipolar mania in our study may later develop depression. Conclusion Previous cross-sectional studies finding high proportions of unipolar mania in low-income countries appear supported. Unipolar mania trended towards better social functioning and was associated with lower suicidality. Future unipolar mania specifications could inform treatment and prognostic estimates of bipolar disorder.

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Faut-il annoncer un diagnostic de trouble bipolaire à un patient qui n’a jamais connu la dépression ? Une revue systématique actualisée sur la manie récurrente

Cited by 2 publications

References 28 publications

Characterizing the clinical profile of mania without major depressive episodes: a systematic review and meta-analysis of factors associated with unipolar mania

Characterizing the clinical profile of mania without major depressive episodes: a systematic review and meta-analysis of factors associated with unipolar mania

Prevalence and characteristics of unipolar mania in a low-income country setting: population-based data from the Butajira cohort, rural Ethiopia

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