Gender, temperament, and the clinical picture in dysphoric mixed mania: findings from a French national study (EPIMAN)

Akiskal, Hagop S.; Hantouche, Elie G.; Bourgeois, M; Azorin, Jean‐Michel; Sechter, D.; Allilaire, Jean‐François; Lancrenon, S.; Fraud, Jean-Philippe; Châtenet-Duchêne, L.

doi:10.1016/s0165-0327(98)00113-x

Cited by 254 publications

(155 citation statements)

References 35 publications

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“…Depressive mood and insomnia were the two most common depressive symptoms in mixed episodes, differently from the report from Akiskal et al, 13 who observed a higher occurrence of depressive mood and suicide ideation. Irritability was equally present in both groups, differing from some authors' findings who reported irritability to be more frequent in mixed episodes.…”

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confidence: 78%

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A clinical study comparing manic and mixed episodes in patients with bipolar disorder

Schwartzmann

Amaral

Issler

et al. 2007

Rev. Bras. Psiquiatr.

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A clinical study comparing manic and mixed episodes in patients with bipolar disorder Estudo clínico comparativo entre episódios de mania e mistos em pacientes com transtorno bipolar A b s t r a c t Objective: Mixed episodes have been described as more severe than manic episodes, especially due to their longer duration and their association with higher rates of suicide attempts, hospitalization and psychotic symptoms. The purpose of this study was to compare the severity between mixed and pure manic episodes according to DSM-IV criteria, through the evaluation of sociodemographic data and clinical characteristics. Method: Twenty-nine bipolar I patients presenting acute mixed episodes were compared to 20 bipolar I patients with acute manic episodes according to DSM-IV criteria. We analyzed (cross-sectionally) episode length, presence of psychotic symptoms, frequency of suicide attempts and hospitalization, Young Mania Rating Scale scores, Hamilton Depression Rating Scale scores and the Clinical Global Assessment Scale scores. Results: Young Mania Rating Scale scores were higher in manic episodes than in mixed episodes. There were no differences in gender frequency, CGI scores and rates of hospitalization, suicide attempts and psychotic symptoms, when mixed and manic episodes where compared.Patients with mixed episodes were younger. Conclusion: In our sample, mixed states occurred at an earlier age than manic episodes. Contrary to previous reports, we did not find significant differences between manic and mixed episodes regarding severity of symptomatology, except for manic symptoms ratings, which were higher in acute manic patients. In part, this may be explained by the different criteria adopted on previous studies.Descriptors: Comparative study; Psychotic disorders; Bipolar disorder; Suicide, attempt; Hospitalization Resumo Objetivo: Estados mistos têm sido descritos como mais graves que episódios de mania, especialmente pela maior duração dos episódios, maiores taxas de suicídio, hospitalização e sintomas psicóticos. O objetivo deste estudo foi comparar a severidade entre episódios mistos e mania pura definidos segundo critérios do DSM-IV, avaliando-se características clínicas e sociodemográficas dos pacientes. Método: Vinte e nove pacientes bipolares do tipo I em estado misto foram comparados a 20 pacientes bipolares do tipo I em episódio de mania aguda de acordo com os critérios do DSM-IV. Analisou-se transversalmente a duração dos episódios, presença de sintomas psicóticos, tentativa de suicídio, hospitalização, escores da Escala de Sintomas de Mania de Young, escores da Escala de Depressão de Hamilton e Escala de Avaliação Clínica Global. Resultados: As pontuações na escala de avaliação de mania de Young foram maiores nos episódios de mania quando comparadas às de episódios mistos. Não houve diferença estatisticamente significativa na freqüência de gêneros, nas pontuações da CGI, nas taxas de hospitalização, tentativa de suicídio e sintomas psicóticos entre episódios mistos e de mania. Pacientes com episód...

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contrasting

confidence: 78%

“…Using broad criteria for mixed states, Akiskal et al 13 reported that suicidal ideation and depressive mood are more frequent in mixed episodes when compared to manic episodes. Irritability has been found to be more frequent than depressive mood in mixed episodes.…”

Section: 12mentioning

confidence: 99%

A clinical study comparing manic and mixed episodes in patients with bipolar disorder

Schwartzmann

Amaral

Issler

et al. 2007

Rev. Bras. Psiquiatr.

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“…13,[17][18][19] Family history: The mixed pattern of mania is associated with family history of depression, besides bipolar disorder (BD), suggesting a double inheritance in MS. 19 These data are not consensual in the literature. As to the disease's onset, it does not change when there is occurrence of MS or pure mania in the patients' history.…”

Section: Source: Dsm-iv Adaptedmentioning

confidence: 99%

“…13,[19][20][24][25][26] They also describe worse recovery from episodes, longer duration of the disease, higher presence of psychotic symptoms, higher number of hospitalizations, worse treatment outcomes, higher comorbidity rates with disorders such as obsessive-compulsive disorder and panic disorder, altered basic mood, substance abuse, use of antidepressants and precedent stressor. 13,17,19,24,31,38 It seems that some bipolar patients show a predominantly mixed pattern: onset of disease with mixed episode predicts a course with predominance of this type of phenomenology. [19][20]24,[27][28][29] Psychotic symptoms and irritability seem to be constantly present in episodes with mixed symptomatology.…”

Section: Source: Dsm-iv Adaptedmentioning

confidence: 99%

“…MD is associated with hyperthymic mood, 17 predominance of bipolar II disorder, 15 atypical symptoms of depression, 15,41 predominance of females 41 and use of antidepressants. 14 14 considers that mixed depression is an MS for showing characteristics common to mixed mania, such as treatment response, symptoms instability, great incidence on females.…”

Section: Mixed Depression (Md) Mixed Depression (Md) Mixed Depressionmentioning

confidence: 99%

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Diagnóstico e tratamento dos estados mistos

Schwartzmann

Lafer

2004

Rev. Bras. Psiquiatr.

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Mixed Hypomania in 908 Patients With Bipolar Disorder Evaluated Prospectively in the Stanley Foundation Bipolar Treatment Network

Suppes¹,

Mintz²,

McElroy³

et al. 2005

Arch Gen Psychiatry

179

120

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Gender, temperament, and the clinical picture in dysphoric mixed mania: findings from a French national study (EPIMAN)

Cited by 254 publications

References 35 publications

A clinical study comparing manic and mixed episodes in patients with bipolar disorder

A clinical study comparing manic and mixed episodes in patients with bipolar disorder

Diagnóstico e tratamento dos estados mistos

Mixed Hypomania in 908 Patients With Bipolar Disorder Evaluated Prospectively in the Stanley Foundation Bipolar Treatment Network

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