An evaluation of the DSM-5 rules defining mania and hypomania with identical symptom criteria

作者：Parker Gordon B^*; Graham Rebecca K

来源：Journal of Affective Disorders, 2015, 170: 91-94.

DOI：10.1016/j.jad.2014.08.051

• Bipolar disorder
• Hypomania
• Mania
• DSM

Background: DSM-IV and DSM-5 provide identical symptom criteria and cut-off scores in defining mania and hypomania, a model seemingly counter-intuitive for classificatory differentiation. We designed a study to examine the impact of such DSM criteria and propose alternative models.
Methods: Prevalence and severity of hypo/manic symptoms as measured by the Mood Swings Questionnaire (MSQ) were compared in age and gender-matched bipolar I and II patients. Use of the MSQ allowed both DSM and additional items to be evaluated in terms of their capacity to differentiate the two bipolar conditions.
Results: In comparison to bipolar II participants, the bipolar I participants reported higher prevalence scores on six MSQ symptoms, severity scores on twelve MSQ symptoms and total MSQ scores. While bipolar I and If participants reported similar prevalence rates of DSM-5 symptoms, bipolar I participants returned higher prevalence rates on five (non-DSM) MSQ items.
Limitations: Bipolar sub-type was not formally assessed by a structured diagnostic interview. The degree to which assigned MSQ items corresponded with DSM items might not necessarily have high equivalence. The study would have been enriched by evaluating a number of other symptom constructs.
Conclusions: Findings suggest several optional approaches to differentiating mania and hypomania. The model we favor is one with a core set of features integral to mania and hypomania that is complemented by certain differentiating features. Psychotic features and over-valued ideas might provide the domain for such differentiation.

• 出版日期2015-1-1