Impact of modification to DSM-5 criterion A for hypomania/mania in newly diagnosed bipolar patients: findings from the prospective BIO study
Abstract Background DSM-IV states that criterion A for diagnosing hypomania/mania is mood change. The revised DSM-5 now states that increased energy or activity must be present alongside mood changes to diagnose hypomania/mania, thus raising energy/activity to criterion A. We set out to investigate...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2021-05-01
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| Series: | International Journal of Bipolar Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40345-020-00219-9 |
| _version_ | 1818451526803259392 |
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| author | Mette U. Fredskild Sharleny Stanislaus Klara Coello Sigurd A. Melbye Hanne Lie Kjærstad Kimie Stefanie Ormstrup Sletved Trisha Suppes Maj Vinberg Lars Vedel Kessing |
| author_facet | Mette U. Fredskild Sharleny Stanislaus Klara Coello Sigurd A. Melbye Hanne Lie Kjærstad Kimie Stefanie Ormstrup Sletved Trisha Suppes Maj Vinberg Lars Vedel Kessing |
| author_sort | Mette U. Fredskild |
| collection | DOAJ |
| description | Abstract Background DSM-IV states that criterion A for diagnosing hypomania/mania is mood change. The revised DSM-5 now states that increased energy or activity must be present alongside mood changes to diagnose hypomania/mania, thus raising energy/activity to criterion A. We set out to investigate how the change in criterion A affects the diagnosis of hypomanic/manic visits in patients with a newly diagnosed bipolar disorder. Results In this prospective cohort study, 373 patients were included (median age = 32; IQR, 27–40). Women constituted 66% (n = 245) of the cohort and 68% of the cohort (n = 253) met criteria for bipolar type II, the remaining patients were diagnosed bipolar type I. Median number of contributed visits was 2 per subject (IQR, 1–3) and median follow-up time was 3 years (IQR, 2–4). During follow-up, 127 patients had at least one visit with fulfilled DSM-IV criterion A. Applying DSM-5 criterion A reduced the number of patients experiencing a hypomanic/manic visit by 62% at baseline and by 50% during longitudinal follow-up, compared with DSM-IV criterion A. Fulfilling DSM-5 criterion A during follow-up was associated with higher modified young mania rating scale score (OR = 1.51, CL [1.34, 1.71], p < 0.0001) and increased number of visits contributed (OR = 1.86, CL [1.52, 2.29], p < 0.0001). Conclusion Applying the stricter DSM-5 criterion A in a cohort of newly diagnosed bipolar patients reduced the number of patients experiencing a hypomanic/manic visit substantially, and was associated with higher overall young mania rating scale scores, compared with DSM-IV criterion A. Consequently, fewer hypomanic/manic visits may be detected in newly diagnosed bipolar patients with applied DSM-5 criterion A, and the upcoming ICD-11, which may possibly result in longer diagnostic delay of BD as compared with the DSM-IV. |
| first_indexed | 2024-12-14T21:08:36Z |
| format | Article |
| id | doaj.art-95af91c97cc94680b4fb72ee84f13433 |
| institution | Directory Open Access Journal |
| issn | 2194-7511 |
| language | English |
| last_indexed | 2024-12-14T21:08:36Z |
| publishDate | 2021-05-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | International Journal of Bipolar Disorders |
| spelling | doaj.art-95af91c97cc94680b4fb72ee84f134332022-12-21T22:47:20ZengSpringerOpenInternational Journal of Bipolar Disorders2194-75112021-05-019111010.1186/s40345-020-00219-9Impact of modification to DSM-5 criterion A for hypomania/mania in newly diagnosed bipolar patients: findings from the prospective BIO studyMette U. Fredskild0Sharleny Stanislaus1Klara Coello2Sigurd A. Melbye3Hanne Lie Kjærstad4Kimie Stefanie Ormstrup Sletved5Trisha Suppes6Maj Vinberg7Lars Vedel Kessing8Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Centre Copenhagen, Department O, 6233, RigshospitaletCopenhagen Affective Disorders Research Centre (CADIC), Psychiatric Centre Copenhagen, Department O, 6233, RigshospitaletCopenhagen Affective Disorders Research Centre (CADIC), Psychiatric Centre Copenhagen, Department O, 6233, RigshospitaletCopenhagen Affective Disorders Research Centre (CADIC), Psychiatric Centre Copenhagen, Department O, 6233, RigshospitaletCopenhagen Affective Disorders Research Centre (CADIC), Psychiatric Centre Copenhagen, Department O, 6233, RigshospitaletCopenhagen Affective Disorders Research Centre (CADIC), Psychiatric Centre Copenhagen, Department O, 6233, RigshospitaletDepartment of Psychiatry & Behavioral Sciences, Stanford University School of MedicineCopenhagen Affective Disorders Research Centre (CADIC), Psychiatric Centre Copenhagen, Department O, 6233, RigshospitaletCopenhagen Affective Disorders Research Centre (CADIC), Psychiatric Centre Copenhagen, Department O, 6233, RigshospitaletAbstract Background DSM-IV states that criterion A for diagnosing hypomania/mania is mood change. The revised DSM-5 now states that increased energy or activity must be present alongside mood changes to diagnose hypomania/mania, thus raising energy/activity to criterion A. We set out to investigate how the change in criterion A affects the diagnosis of hypomanic/manic visits in patients with a newly diagnosed bipolar disorder. Results In this prospective cohort study, 373 patients were included (median age = 32; IQR, 27–40). Women constituted 66% (n = 245) of the cohort and 68% of the cohort (n = 253) met criteria for bipolar type II, the remaining patients were diagnosed bipolar type I. Median number of contributed visits was 2 per subject (IQR, 1–3) and median follow-up time was 3 years (IQR, 2–4). During follow-up, 127 patients had at least one visit with fulfilled DSM-IV criterion A. Applying DSM-5 criterion A reduced the number of patients experiencing a hypomanic/manic visit by 62% at baseline and by 50% during longitudinal follow-up, compared with DSM-IV criterion A. Fulfilling DSM-5 criterion A during follow-up was associated with higher modified young mania rating scale score (OR = 1.51, CL [1.34, 1.71], p < 0.0001) and increased number of visits contributed (OR = 1.86, CL [1.52, 2.29], p < 0.0001). Conclusion Applying the stricter DSM-5 criterion A in a cohort of newly diagnosed bipolar patients reduced the number of patients experiencing a hypomanic/manic visit substantially, and was associated with higher overall young mania rating scale scores, compared with DSM-IV criterion A. Consequently, fewer hypomanic/manic visits may be detected in newly diagnosed bipolar patients with applied DSM-5 criterion A, and the upcoming ICD-11, which may possibly result in longer diagnostic delay of BD as compared with the DSM-IV.https://doi.org/10.1186/s40345-020-00219-9Bipolar disorderDiagnostic and Statistical Manual of Mental Disorders Version IV (DSM-IV)Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5)MoodIrritabilityEnergy |
| spellingShingle | Mette U. Fredskild Sharleny Stanislaus Klara Coello Sigurd A. Melbye Hanne Lie Kjærstad Kimie Stefanie Ormstrup Sletved Trisha Suppes Maj Vinberg Lars Vedel Kessing Impact of modification to DSM-5 criterion A for hypomania/mania in newly diagnosed bipolar patients: findings from the prospective BIO study International Journal of Bipolar Disorders Bipolar disorder Diagnostic and Statistical Manual of Mental Disorders Version IV (DSM-IV) Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) Mood Irritability Energy |
| title | Impact of modification to DSM-5 criterion A for hypomania/mania in newly diagnosed bipolar patients: findings from the prospective BIO study |
| title_full | Impact of modification to DSM-5 criterion A for hypomania/mania in newly diagnosed bipolar patients: findings from the prospective BIO study |
| title_fullStr | Impact of modification to DSM-5 criterion A for hypomania/mania in newly diagnosed bipolar patients: findings from the prospective BIO study |
| title_full_unstemmed | Impact of modification to DSM-5 criterion A for hypomania/mania in newly diagnosed bipolar patients: findings from the prospective BIO study |
| title_short | Impact of modification to DSM-5 criterion A for hypomania/mania in newly diagnosed bipolar patients: findings from the prospective BIO study |
| title_sort | impact of modification to dsm 5 criterion a for hypomania mania in newly diagnosed bipolar patients findings from the prospective bio study |
| topic | Bipolar disorder Diagnostic and Statistical Manual of Mental Disorders Version IV (DSM-IV) Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) Mood Irritability Energy |
| url | https://doi.org/10.1186/s40345-020-00219-9 |
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