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Reevaluation of Patients With Bipolar Disorder on Manic Episode : Improving the Diagnosing of Mixed Episode

Authors
 Kyung Ran Kim  ;  Hyun-Sang Cho  ;  Se Joo Kim  ;  Jeong-Ho Seok  ;  Eun Lee  ;  Duk-In Jon 
Citation
 JOURNAL OF NERVOUS AND MENTAL DISEASE, Vol.201(8) : 686-690, 2013 
Journal Title
JOURNAL OF NERVOUS AND MENTAL DISEASE
ISSN
 0022-3018 
Issue Date
2013
MeSH
Adult ; Bipolar Disorder/classification ; Bipolar Disorder/diagnosis* ; Depression/diagnosis* ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Predictive Value of Tests ; Psychiatric Status Rating Scales ; Retrospective Studies
Keywords
Bipolar disorder ; Cincinnati criteria ; mixed episode ; underdiagnosis
Abstract
Abstract: Mixed manic/depressive episodes in patients with bipolar disorder are underdiagnosed because of restrictive diagnostic criteria. Using the broader definition of a mixed episode represented by the Cincinnati criteria, we reevaluated the medical records of patients with bipolar disorder hospitalized for a manic episode. We also examined the predictive power of previously unrecognized depressive symptoms. Of 520 inpatients with mania, we retrospectively diagnosed 59 (11.3%) as having a probable mixed episode. Compared with the patients with pure mania, the patients with mixed episodes were more likely to have a family history of psychiatric illness, comorbid personality disorder, and a history of suicide attempts. Binary logistic regression revealed that loss of interest, loss of energy, feelings of worthlessness, and feelings of helplessness had good positive predictive value (>0.7) for mixed episodes. Accurate diagnosis of mixed episodes may require a broadening of diagnostic criteria and emphasis on symptoms such as loss of interest, loss of energy, and feelings of worthlessness and helplessness.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00005053-201308000-00007&LSLINK=80&D=ovft
DOI
10.1097/NMD.0b013e31829c505a
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Psychiatry (정신과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Ran(김경란) ORCID logo https://orcid.org/0000-0001-8375-1851
Kim, Se Joo(김세주) ORCID logo https://orcid.org/0000-0002-5438-8210
Seok, Jeong Ho(석정호) ORCID logo https://orcid.org/0000-0002-9402-7591
Lee, Eun(이은) ORCID logo https://orcid.org/0000-0002-7462-0144
Cho, Hyun Sang(조현상) ORCID logo https://orcid.org/0000-0003-1019-9941
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87374
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