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Rodríguez DG, Zapata-Ospina JP, Uribe MM, Suarez D, Tabares LF, Ahunca LF, Aguirre DC, Holguín JC, Valencia JG. Spanish validation of the short version of the racing and crowded thoughts questionnaire (RCTQ-13). BMC Psychiatry 2024; 24:214. [PMID: 38504212 PMCID: PMC10953190 DOI: 10.1186/s12888-024-05618-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 02/15/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND The Racing and Crowded Thoughts Questionnaire (RCTQ-13) is the most widely used specific scale for the measurement of racing thoughts, but there is currently no Spanish version that allow the evaluation in Spanish-speaking patients. The objective of this study is to translate, adapt, and validate the RCTQ-13 in a Colombian population with affective disorders. METHODS The questionnaire was translated and back-translated, and corrections were implemented following a pilot test to improve comprehensibility. We included patients with Bipolar I Disorder and with Major depressive disorder seen in three centers in the city of Medellín, Colombia. We evaluate structural validity with confirmatory factor analysis, internal consistency, and test-retest reliability. Construct validity was also assessed with the comparison between euthymic, maniac, and depressive episodes and the correlation with worry, rumination, and mania scales. Responsiveness was measured 1 month after the first evaluation. Based on item response theory (IRT), we also estimated item difficulty, discrimination, and fit using a generalized partial credit model. RESULTS Two hundred fifty subjects were included. Confirmatory factor analysis revealed that the three-factor structure of the scale was appropriate. Internal consistency was adequate for the entire scale (Cronbach's alpha = 0.95, 95% CI: 0.94-0.96) and for each factor. Test-retest reliability was good (intraclass correlation coefficient = 0.82, 95%IC: 0.70-0.88). For construct validity, we observed differences between patients with different types of affective episodes, a moderate positive correlation with the Penn State Worry Scale (r = 0.55) and the Ruminative Response Scale (r = 0.42), and a low negative correlation with the Young Mania Rating Scale (r = - 0.10). Responsiveness was proved to be adequate. Under IRT, the response thresholds for the response options are organized for all items. The infit was adequate for all items and the outfit was acceptable. CONCLUSIONS The Spanish version of the RCTQ-13 is a reliable, valid, and responsive scale and can be used for the clinical assessment of the construct of racing and crowded thoughts in patients with the spectrum of affective disorders in whom this experience can be expressed with different nuances. Further research is needed to expand the relationship with rumination and worry.
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Affiliation(s)
| | | | | | - Diana Suarez
- Hospital Alma Máter de Antioquia, Medellin, Colombia
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Chakrabarti S. Bipolar disorder in the International Classification of Diseases-Eleventh version: A review of the changes, their basis, and usefulness. World J Psychiatry 2022; 12:1335-1355. [PMID: 36579354 PMCID: PMC9791613 DOI: 10.5498/wjp.v12.i12.1335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 10/07/2022] [Accepted: 11/22/2022] [Indexed: 12/16/2022] Open
Abstract
The World Health Organization’s 11th revision of the International Classification of Diseases (ICD-11) including the chapter on mental disorders has come into effect this year. This review focuses on the “Bipolar or Related Disorders” section of the ICD-11 draft. It describes the benchmarks for the new version, particularly the foremost principle of clinical utility. The alterations made to the diagnosis of bipolar disorder (BD) are evaluated on their scientific basis and clinical utility. The change in the diagnostic requirements for manic and hypomanic episodes has been much debated. Whether the current criteria have achieved an optimum balance between sensitivity and specificity is still not clear. The ICD-11 definition of depressive episodes is substantially different, but the lack of empirical support for the changes has meant that the reliability and utility of bipolar depression are relatively low. Unlike the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), the ICD-11 has retained the category of mixed episodes. Although the concept of mixed episodes in the ICD-11 is not perfect, it appears to be more inclusive than the DSM-5 approach. Additionally, there are some uncertainties about the guidelines for the subtypes of BD and cyclothymic disorder. The initial results on the reliability and clinical utility of BD are promising, but the newly created diagnostic categories also appear to have some limitations. Although further improvement and research are needed, the focus should now be on facing the challenges of implementation, dissemination, and education and training in the use of these guidelines.
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Affiliation(s)
- Subho Chakrabarti
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, UT, India
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3
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Naifar M, Maalej Bouali M, Guidara W, Ellouze AS, Jmal K, Omri S, Messedi M, Zouari L, Elleuch A, Maalej M, Chaabouni K, Charfi N, Turki M, Jihène BT, Ayadi F. [Bipolar disorder vulnerability: The vitamin D path]. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2020; 65:184-192. [PMID: 31434497 PMCID: PMC7019462 DOI: 10.1177/0706743719870513] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Bipolar disorder (BD) etiopathogenesis is still not well elucidated. It has recently been proven that 25-hydroxy vitamin D (25OHD) has an anti-inflammatory and neuroprotective role. Our objectives were to measure 25OHD plasma levels in patients with BD in acute decompensation and compare them with patients with schizophrenia (SCZ) or schizoaffective disorder (SAD) and with healthy controls. METHODS This is a cross-sectional case-control study including male inpatients with a decompensation of their disease who were diagnosed with BD, SCZ or SAD according to DSM-5 criterias. The control group was constituted by unrelated healthy subjects, age-and-sex matched. RESULTS The 25OHD level was significantly higher only in patients with BD compared to controls. 25OHD was also positively correlated to the PANSS scale (r = 0.282, p < 0.001) and to different MOCA scores (r = 0.326, p = 0.006) as well as aspects related to abstraction, attention and memory capacity. Multivariate analysis found that BD acute decompensation was independently related to the rise in plasma 25OHD (p = 0.012; OR =1.157, [1.032 -1.297]). CONCLUSION Our study shows that BD acute decompensation is associated with the rise in plasma 25OHD synthesis. However, the vitamin D dosage relevance as a biomarker of this disease warrants a verification in other studies.
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Affiliation(s)
- Manel Naifar
- UR 12ES17 « Bases moléculaires de la pathologie humaine », Faculté de Médecine de Sfax, Université de Sfax, Sfax, Tunisie.,Laboratoire de Biochimie, CHU Habib Bourguiba, Sfax, Tunisie
| | | | - Wassim Guidara
- UR 12ES17 « Bases moléculaires de la pathologie humaine », Faculté de Médecine de Sfax, Université de Sfax, Sfax, Tunisie
| | | | - Khalil Jmal
- UR 12ES17 « Bases moléculaires de la pathologie humaine », Faculté de Médecine de Sfax, Université de Sfax, Sfax, Tunisie.,Laboratoire de Biochimie, CHU Habib Bourguiba, Sfax, Tunisie
| | - Sana Omri
- Service de Psychiatrie « C », CHU Hédi Chaker, Sfax, Tunisie
| | - Meriam Messedi
- UR 12ES17 « Bases moléculaires de la pathologie humaine », Faculté de Médecine de Sfax, Université de Sfax, Sfax, Tunisie
| | - Lobna Zouari
- Service de Psychiatrie « C », CHU Hédi Chaker, Sfax, Tunisie
| | - Aida Elleuch
- UR 12ES17 « Bases moléculaires de la pathologie humaine », Faculté de Médecine de Sfax, Université de Sfax, Sfax, Tunisie.,Laboratoire de Biochimie, CHU Habib Bourguiba, Sfax, Tunisie
| | - Mohamed Maalej
- Service de Psychiatrie « C », CHU Hédi Chaker, Sfax, Tunisie
| | - Khansa Chaabouni
- UR 12ES17 « Bases moléculaires de la pathologie humaine », Faculté de Médecine de Sfax, Université de Sfax, Sfax, Tunisie.,Laboratoire de Biochimie, CHU Habib Bourguiba, Sfax, Tunisie
| | - Nada Charfi
- Service de Psychiatrie « C », CHU Hédi Chaker, Sfax, Tunisie
| | - Mouna Turki
- UR 12ES17 « Bases moléculaires de la pathologie humaine », Faculté de Médecine de Sfax, Université de Sfax, Sfax, Tunisie.,Laboratoire de Biochimie, CHU Habib Bourguiba, Sfax, Tunisie
| | | | - Fatma Ayadi
- UR 12ES17 « Bases moléculaires de la pathologie humaine », Faculté de Médecine de Sfax, Université de Sfax, Sfax, Tunisie.,Laboratoire de Biochimie, CHU Habib Bourguiba, Sfax, Tunisie
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4
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Jauhar S, Ratheesh A, Davey C, Yatham LN, McGorry PD, McGuire P, Berk M, Young AH. The case for improved care and provision of treatment for people with first-episode mania. Lancet Psychiatry 2019; 6:869-876. [PMID: 31248840 DOI: 10.1016/s2215-0366(19)30082-3] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 02/19/2019] [Accepted: 02/19/2019] [Indexed: 11/19/2022]
Abstract
The care of people with first-episode mania has been overlooked in comparison with the care of patients with other non-affective psychoses, despite evidence suggesting targeted treatments might be of benefit for this patient group. In this Personal View, we outline the general epidemiology of first-episode mania in the context of bipolar disorder, the natural history of mania (with an emphasis on its recurrent nature), current evidence for pharmacological, psychological, and service-level interventions, current guidelines for the treatment of first-episode mania, and provide a patient's point of view of the care pathway (appendix). We note the paucity of high-quality evidence for interventions in first-episode mania and the lack of agreement among treatment guidelines in relation to treatment, especially maintenance treatment. We suggest that, based on high morbidity and clinical need, research evidence to inform guideline development is necessary, and in the interim, clearer guidance on treatment and diagnosis should be given; specifically, we have suggested that patients should be cared for within a first-episode psychosis service, when such a service exists.
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Affiliation(s)
- Sameer Jauhar
- Department of Psychological Medicine, Psychology and Neuroscience, King's College London, London; Early intervention Pathway, Psychosis Clinical Academic Group, South London and Maudsley National Health Service Foundation Trust, London.
| | - Aswin Ratheesh
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia; Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Christopher Davey
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
| | - Lakshmi N Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Patrick D McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia; Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Phillip McGuire
- Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London; Early intervention Pathway, Psychosis Clinical Academic Group, South London and Maudsley National Health Service Foundation Trust, London
| | - Michael Berk
- The Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia; IMPACT Strategic Research Centre, School of Medicine and Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Allan H Young
- Department of Psychological Medicine, Psychology and Neuroscience, King's College London, London
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5
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Blackburn TP. Depressive disorders: Treatment failures and poor prognosis over the last 50 years. Pharmacol Res Perspect 2019; 7:e00472. [PMID: 31065377 PMCID: PMC6498411 DOI: 10.1002/prp2.472] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 02/11/2019] [Accepted: 03/18/2019] [Indexed: 12/12/2022] Open
Abstract
Depression like many diseases is pleiotropic but unlike cancer and Alzheimer's disease for example, is still largely stigmatized and falls into the dark shadows of human illness. The failure of depression to be in the spotlight for successful treatment options is inherent in the complexity of the disease(s), flawed clinical diagnosis, overgeneralization of the illness, inadequate and biased clinical trial design, restrictive and biased inclusion/exclusion criteria, lack of approved/robust biomarkers, expensive imaging technology along with few advances in neurobiological hypotheses in decades. Clinical trial studies summitted to the regulatory agencies (FDA/EMA) for approval, have continually failed to show significant differences between active and placebo. For decades, we have acknowledged this failure, despite vigorous debated by all stakeholders to provide adequate answers to this escalating problem, with only a few new antidepressants approved in the last 20 years with equivocal efficacy, little improvement in side effects or onset of efficacy. It is also clear that funding and initiatives for mental illness lags far behind other life-treating diseases. Thus, it is no surprise we have not achieved much success in the last 50 years in treating depression, but we are accountable for the many failures and suboptimal treatment. This review will therefore critically address where we have failed and how future advances in medical science offers a glimmer of light for the patient and aid our future understanding of the neurobiology and pathophysiology of the disease, enabling transformative therapies for the treatment of depressive disorders.
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6
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Salagre E, Dodd S, Aedo A, Rosa A, Amoretti S, Pinzon J, Reinares M, Berk M, Kapczinski FP, Vieta E, Grande I. Toward Precision Psychiatry in Bipolar Disorder: Staging 2.0. Front Psychiatry 2018; 9:641. [PMID: 30555363 PMCID: PMC6282906 DOI: 10.3389/fpsyt.2018.00641] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 11/13/2018] [Indexed: 12/23/2022] Open
Abstract
Personalized treatment is defined as choosing the "right treatment for the right person at the right time." Although psychiatry has not yet reached this level of precision, we are on the way thanks to recent technological developments that may aid to detect plausible molecular and genetic markers. At the moment there are some models that are contributing to precision psychiatry through the concept of staging. While staging was initially presented as a way to categorize patients according to clinical presentation, course, and illness severity, current staging models integrate multiple levels of information that can help to define each patient's characteristics, severity, and prognosis in a more precise and individualized way. Moreover, staging might serve as the foundation to create a clinical decision-making algorithm on the basis of the patient's stage. In this review we will summarize the evolution of the bipolar disorder staging model in relation to the new discoveries on the neurobiology of bipolar disorder. Furthermore, we will discuss how the latest and future progress in psychiatry might transform current staging models into precision staging models.
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Affiliation(s)
- Estela Salagre
- Barcelona Bipolar Disorders Program, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Seetal Dodd
- IMPACT Strategic Research Centre, Barwon Health, Deakin University, Geelong, VIC, Australia.,Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
| | - Alberto Aedo
- Barcelona Bipolar Disorders Program, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain.,Bipolar Disorders Unit, Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Adriane Rosa
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Postgraduate Program: Psychiatry and Behavioral Science, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Department of Pharmacology and Postgraduate Program: Pharmacology and Therapeutics, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Silvia Amoretti
- Barcelona Clínic Schizophrenia Unit, Hospital Clinic de Barcelona, CIBERSAM, Barcelona, Spain
| | - Justo Pinzon
- Barcelona Bipolar Disorders Program, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Maria Reinares
- Barcelona Bipolar Disorders Program, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Michael Berk
- IMPACT Strategic Research Centre, Barwon Health, Deakin University, Geelong, VIC, Australia.,Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Florey Institute for Neuroscience and Mental Health, Parkville, VIC, Australia
| | | | - Eduard Vieta
- Barcelona Bipolar Disorders Program, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Iria Grande
- Barcelona Bipolar Disorders Program, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
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7
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Montejo ÁL, Arango C, Bernardo M, Carrasco JL, Crespo-Facorro B, Cruz JJ, Del Pino-Montes J, García-Escudero MA, García-Rizo C, González-Pinto A, Hernández AI, Martín-Carrasco M, Mayoral-Cleries F, Mayoral-van Son J, Mories MT, Pachiarotti I, Pérez J, Ros S, Vieta E. Multidisciplinary consensus on the therapeutic recommendations for iatrogenic hyperprolactinemia secondary to antipsychotics. Front Neuroendocrinol 2017; 45:25-34. [PMID: 28235557 DOI: 10.1016/j.yfrne.2017.02.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 02/15/2017] [Accepted: 02/17/2017] [Indexed: 01/08/2023]
Abstract
Hyperprolactinemia is an underappreciated/unknown adverse effects of antipsychotics. The consequences of hyperprolactinemia compromise therapeutic adherence and can be serious. We present the consensus recommendations made by a group of experts regarding the management of antipsychotic-induced hyperprolactinemia. The current consensus was developed in 3 phases: 1, review of the scientific literature; 2, subsequent round table discussion to attempt to reach a consensus among the experts; and 3, review by all of the authors of the final conclusions until reaching a complete consensus. We include recommendations on the appropriate time to act after hyperprolactinemia detection and discuss the evidence on available options: decreasing the dose of the antipsychotic drug, switching antipsychotics, adding aripiprazole, adding dopaminergic agonists, and other type of treatment. The consensus also included recommendations for some specific populations such as patients with a first psychotic episode and the pediatric-youth population, bipolar disorder, personality disorders and the elderly population.
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Affiliation(s)
- Ángel L Montejo
- Neurosciences Area, Instituto de Biomedicina de Salamanca (IBSAL), University of Salamanca, Psychiatry Department, University Hospital of Salamanca, Salamanca, Spain.
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), IiSGM, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Miquel Bernardo
- Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic of Barcelona, Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - José L Carrasco
- Instituto de Investigación Sanitaria, Hospital Clínico San Carlos, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Benidicto Crespo-Facorro
- Department of Medicine & Psychiatry, University Hospital Marqués de Valdecilla, IDIVAL, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Santander, Spain
| | - Juan J Cruz
- Department of Medical Oncology, Instituto de Biomedicina de Salamanca (IBSAL), University of Salamanca, University Hospital of Salamanca, Salamanca, Spain
| | | | | | - Clemente García-Rizo
- Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic of Barcelona, Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Ana González-Pinto
- International Mood Disorders Research Centre, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Hospital Santiago Apóstol, University of the Basque Country, Vitoria, Spain
| | - Ana I Hernández
- FEA Psiquiatría, Red de Salud Mental de Guipúzcoa, San Sebastián, Spain
| | - Manuel Martín-Carrasco
- Institute of Psychiatric Research, Mª Josefa Recio Foundation, Bilbao, Spain; Psychiatry Clinic Padre Menni, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Pamplona, Spain
| | - Fermín Mayoral-Cleries
- University Regional Hospital of Malaga, Biomedical Research Institute (IBIMA), Malaga, Spain
| | | | - M Teresa Mories
- Endocrinology and Nutrition Department, University Hospital of Salamanca, Salamanca, Spain
| | - Isabella Pachiarotti
- Bipolar Disorders Program, Psychiatry Department, Hospital Clinic, University of Barcelona, IDIBAPS, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Jesús Pérez
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Salvador Ros
- International Institute of Applied Neurosciences, Barcelona, Spain
| | - Eduard Vieta
- Bipolar Disorders Program, Psychiatry Department, Hospital Clinic, University of Barcelona, IDIBAPS, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
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Abstract
Bipolar disorders are a group of psychiatric disorders with profound negative impact on affected patients. Even if their symptomatology has long been recognized, diagnostic criteria have changed over time and diagnosis often remains difficult. The Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), issued in May 2013, comprises several changes regarding the diagnosis of bipolar disorders compared to the previous edition. Diagnostic categories and criteria for bipolar disorders show some concordance with the internationally also widely used Tenth Edition of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). However, there are also major differences that are worth highlighting. The aim of the following text is to depict and discuss those.
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Calvó-Perxas L, Garre-Olmo J, Vilalta-Franch J. Prevalence and sociodemographic correlates of depressive and bipolar disorders in Catalonia (Spain) using DSM-5 criteria. J Affect Disord 2015; 184:97-103. [PMID: 26074018 DOI: 10.1016/j.jad.2015.05.048] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 05/21/2015] [Accepted: 05/22/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND This study aims to determine the prevalence and sociodemographic correlates of major depression disorders (MDD) and bipolar disorders (BPDs) in a population-based sample in Catalonia (NE Spain). METHODS Cross sectional study nested in the Regicor Survey. We used a population-based sample of participants 45 years and older (n = 5068). The Patient Health Questionnaire-9 (PHQ-9), and the Mini International Neuropsychiatric Interview (MINI) were used to apply DSM-5 criteria to diagnose MDD and BPDs. RESULTS The lifetime prevalence of Single MDD was 4.2% (95% CI = 3.7-4.8), while Recurrent MDD was 24.1% (95% CI = 22.9-25.3). Other depressive disorders were detected in 0.4% (95% CI = 0.2-0.5) of the sample. The lifetime prevalence of a bipolar disorder (BPD) was set to 3.0% (95% CI = 2.5-3.4), with 0.3% (95% CI = 0.2-0.5) BPD Type I, 0.9% (95% CI = 0.6-1.2) BPD type II, and 1.8% (95% CI = 1.4-2.1) other BPD. MDD was more frequent in women, unmarried people, and those with low education. BPD rates were higher in young and unmarried people. LIMITATIONS Only participants of 45 years and older were included in this study. The length of the depressive episodes was not recorded. Our results may be biased by a reluctance of patients with a mental illness to participate. CONCLUSIONS This is the first population-based study reporting DSM-5 estimated prevalences of depressive and bipolar disorders in our country. The prevalence of mood disorders is high in our community, with almost 25% of the population presenting with at least one depressive disorder throughout life.
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Affiliation(s)
- Laia Calvó-Perxas
- Girona Biomedical Research Institute (IdIBGI), IAS Research Unit, Salt, Catalonia, Spain
| | - Josep Garre-Olmo
- Girona Biomedical Research Institute (IdIBGI), IAS Research Unit, Salt, Catalonia, Spain; Department of Medical Sciences, University of Girona, Girona, Catalonia, Spain.
| | - Joan Vilalta-Franch
- Girona Biomedical Research Institute (IdIBGI), IAS Research Unit, Salt, Catalonia, Spain; Department of Medical Sciences, University of Girona, Girona, Catalonia, Spain; Memory and Dementia Assessment Unit, Institut d'Assistència Sanitària, Salt, Catalonia, Spain
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10
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The State of the Art of the DSM-5 "with Mixed Features" Specifier. ScientificWorldJournal 2015; 2015:757258. [PMID: 26380368 PMCID: PMC4562096 DOI: 10.1155/2015/757258] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 04/10/2015] [Indexed: 11/30/2022] Open
Abstract
The new DSM-5 “with mixed features” specifier (MFS) has renewed the interest of the scientific community in mixed states, leading not only to new clinical studies but also to new criticisms of the current nosology. Consequently, in our paper we have reviewed the latest literature, trying to understand the reactions of psychiatrists to the new nosology and its epidemiological, prognostic, and clinical consequences. It seems that the most widespread major criticism is the exclusion from the DSM-5 MFS of overlapping symptoms (such as psychomotor agitation, irritability, and distractibility), with a consequent reduction in diagnostic power. On the other hand, undoubtedly the new DSM-5 classification has helped to identify more patients suffering from a mixed state by broadening the narrow DSM-IV-TR criteria. As for the clinical presentation, the epidemiological data, and the therapeutic outcomes, the latest literature does not point out a univocal point of view and further research is needed to fully assess the implications of the new DSM-5 MFS. It is our view that a diagnostic category should be preferred to a specifier and mixed states should be better considered as a spectrum of states, according to what was stated many years ago by Kraepelin.
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12
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Vieta E. [Personalised medicine applied to mental health: Precision psychiatry]. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2015; 8:117-8. [PMID: 25959401 DOI: 10.1016/j.rpsm.2015.03.003] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 03/26/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Eduard Vieta
- Instituto de Neurociencias, Hospital Clínic, Universidad de Barcelona, Barcelona, España; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, España.
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