Prevalence of mixed mania using 3 definitions

Vieta, Eduard; Morralla, C.

doi:10.1016/j.jad.2009.12.019

Cited by 45 publications

(20 citation statements)

References 24 publications

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“…These results indicate that depression and mania have limited overlap, at least at a single point in time, and is confirmed clinically, as depressive and manic symptoms often co-occur, but true mixed states as defined by DSM IV-TR are uncommon. 20,21 The CAT-MANIA correlated minimally with the CAT-DI (r=.38), and with the CAT-ANX (r=.47). In terms of its relationship with current DSM IV-TR bipolar diagnoses (bipolar I disorder, bipolar II disorder, bipolar, not otherwise specified), the CAT-MANIA had an OR = 2.89 (1.47, 5.71), p<.002.…”

Section: Resultsmentioning

confidence: 96%

Validation of Computerized Adaptive Testing in an Outpatient Nonacademic Setting: The VOCATIONS Trial

Achtyes¹,

Halstead²,

Smart³

et al. 2015

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Objective Computerized adaptive tests (CAT) provide an alternative to fixed-length assessments for diagnostic screening and severity measurement of psychiatric disorders. We sought to cross-sectionally validate a suite of computerized adaptive tests for mental health (CAT-MH) in a community psychiatric sample. Methods 145 adult psychiatric outpatients and controls were prospectively evaluated with CAT for depression, mania and anxiety symptoms, compared to gold-standard psychiatric assessments including: Structured Clinical Interview for DSM IV-TR (SCID), Hamilton Rating Scale for Depression (HAM-D25), Patient Health Questionnaire (PHQ-9), Center for Epidemiologic Studies Depression Scale (CES-D), and Global Assessment of Functioning (GAF). Results Sensitivity and specificity for the computerized adaptive diagnostic test for depression (CAD-MDD) were .96 and .64, respectively (.96 and 1.00 for major depression versus controls). CAT for depression severity (CAT-DI) correlated well to standard depression scales HAM-D25 (r=.79), PHQ-9 (r=.90), CES-D (r=.90) and had OR=27.88 for current SCID major depressive disorder diagnosis across its range. CAT for anxiety severity (CAT-ANX) correlated to HAM-D25 (r=.73), PHQ-9 (r=.78), CES-D (r=.81), and had OR=11.52 for current SCID generalized anxiety disorder diagnosis across its range. CAT for mania severity (CAT-MANIA) did not correlate well to HAM-D25 (r=.31), PHQ-9 (r=.37), CES-D (r=.39), but had an OR=11.56 for a current SCID bipolar diagnosis across its range. Participants found the CAT-MH suite of tests acceptable and easy to use, averaging 51.7 items and 9.4 minutes to complete the full battery. Conclusions Compared to current gold-standard diagnostic and assessment measures, CAT-MH provides an effective, rapidly-administered assessment of psychiatric symptoms.

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Section: Resultsmentioning

confidence: 96%

Validation of Computerized Adaptive Testing in an Outpatient Nonacademic Setting: The VOCATIONS Trial

Achtyes¹,

Halstead²,

Smart³

et al. 2015

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“…Depressive symptoms co‐occur alongside mania in 10%‐30% of cases,200, 201 with studies suggesting mixed features are indicative of a more severe and disabling course, as well as a higher rate of suicide 201, 202. Evidence supports the preferential use of atypical antipsychotics and divalproex in these cases, with combination therapy frequently required 195, 203.…”

Section: Acute Management Of Bipolar Maniamentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

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The Canadian Network for Mood and Anxiety Treatments (CANMAT) previously published treatment guidelines for bipolar disorder in 2005, along with international commentaries and subsequent updates in 2007, 2009, and 2013. The last two updates were published in collaboration with the International Society for Bipolar Disorders (ISBD). These 2018 CANMAT and ISBD Bipolar Treatment Guidelines represent the significant advances in the field since the last full edition was published in 2005, including updates to diagnosis and management as well as new research into pharmacological and psychological treatments. These advances have been translated into clear and easy to use recommendations for first, second, and third‐ line treatments, with consideration given to levels of evidence for efficacy, clinical support based on experience, and consensus ratings of safety, tolerability, and treatment‐emergent switch risk. New to these guidelines, hierarchical rankings were created for first and second‐ line treatments recommended for acute mania, acute depression, and maintenance treatment in bipolar I disorder. Created by considering the impact of each treatment across all phases of illness, this hierarchy will further assist clinicians in making evidence‐based treatment decisions. Lithium, quetiapine, divalproex, asenapine, aripiprazole, paliperidone, risperidone, and cariprazine alone or in combination are recommended as first‐line treatments for acute mania. First‐line options for bipolar I depression include quetiapine, lurasidone plus lithium or divalproex, lithium, lamotrigine, lurasidone, or adjunctive lamotrigine. While medications that have been shown to be effective for the acute phase should generally be continued for the maintenance phase in bipolar I disorder, there are some exceptions (such as with antidepressants); and available data suggest that lithium, quetiapine, divalproex, lamotrigine, asenapine, and aripiprazole monotherapy or combination treatments should be considered first‐line for those initiating or switching treatment during the maintenance phase. In addition to addressing issues in bipolar I disorder, these guidelines also provide an overview of, and recommendations for, clinical management of bipolar II disorder, as well as advice on specific populations, such as women at various stages of the reproductive cycle, children and adolescents, and older adults. There are also discussions on the impact of specific psychiatric and medical comorbidities such as substance use, anxiety, and metabolic disorders. Finally, an overview of issues related to safety and monitoring is provided. The CANMAT and ISBD groups hope that these guidelines become a valuable tool for practitioners across the globe.

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“…Unfortunately, psychotic disorders significantly impair the ability of the affected individual to communicate effectively, have clear mentation, and behave in a socially appropriate and consistent manner, which negatively impacts the ability to conduct a normal lifestyle. SZ-related disorders affect approximately 2.4 million people, or 1.1% of the USA population >18 years old each year (Gejman et al, 2010; Regier et al, 1993) while the spectrum of BP affect approximately 5.7 million people, or 2.6% of the USA population >18 years old each year (Kessler et al, 2005a, 2005b; Vieta and Morralla, 2010). These disorders place a profound emotional, financial, and social burden on the individual, their families, and society at large.…”

Section: Neuropsychiatric Disorder Overviewmentioning

confidence: 99%

Expression profiling in neuropsychiatric disorders: Emphasis on glutamate receptors in bipolar disorder

Ginsberg

Hemby

Smiley

2012

Pharmacology Biochemistry and Behavior

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Functional genomics and proteomics approaches are being employed to evaluate gene and encoded protein expression changes with the tacit goal to find novel targets for drug discovery. Genome-wide association studies (GWAS) have attempted to identify valid candidate genes through single nucleotide polymorphism (SNP) analysis. Furthermore, microarray analysis of gene expression in brain regions and discrete cell populations has enabled the simultaneous quantitative assessment of relevant genes. The ability to associate gene expression changes with neuropsychiatric disorders, including bipolar disorder (BP), and their response to therapeutic drugs provides a novel means for pharmacotherapeutic interventions. This review summarizes gene and pathway targets that have been identified in GWAS studies and expression profiling of human postmortem brain in BP, with an emphasis on glutamate receptors (GluRs). Although functional genomic assessment of BP is in its infancy, results to date point towards a dysregulation of GluRs that bear some similarity to schizophrenia (SZ), although the pattern is complex, and likely to be more complementary than overlapping. The importance of single population expression profiling of specific neurons and intrinsic circuits is emphasized, as this approach provides informative gene expression profile data that may be underappreciated in regional studies with admixed neuronal and non-neuronal cell types.

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Prevalence of mixed mania using 3 definitions

Cited by 45 publications

References 24 publications

Validation of Computerized Adaptive Testing in an Outpatient Nonacademic Setting: The VOCATIONS Trial

Validation of Computerized Adaptive Testing in an Outpatient Nonacademic Setting: The VOCATIONS Trial

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

Expression profiling in neuropsychiatric disorders: Emphasis on glutamate receptors in bipolar disorder

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