Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-24T19:55:22.240Z Has data issue: false hasContentIssue false
  • English
  • Français

Dimensions of mania: differences between mixed and pure episodes

Published online by Cambridge University Press:  16 April 2020

Ana González-Pinto ,
Ana Aldama ,
Asunción González Pinto ,
Fernando Mosquera ,
José Luis Pérez de Heredia ,
Javier Ballesteros  and
Miguel Gutiérrez
Ana González-Pinto*
Affiliation:
Hospital Santiago Psychiatric Department Vitoria, Spain
Ana Aldama
Affiliation:
Hospital Santiago Psychiatric Department Vitoria, Spain
Asunción González Pinto
Affiliation:
University of the Basque Country, Vizcaya, Spain
Fernando Mosquera
Affiliation:
Hospital Santiago Psychiatric Department Vitoria, Spain
José Luis Pérez de Heredia
Affiliation:
University of the Basque Country, Vizcaya, Spain
Javier Ballesteros
Affiliation:
University of the Basque Country, Vizcaya, Spain
Miguel Gutiérrez
Affiliation:
University of the Basque Country, Vizcaya, Spain
*
*Corresponding author. E-mail address: [email protected] (A. González-Pinto).
Get access

Abstract

Objective

The presence of at least five dimensions in mania has recently been established. This study extends previous findings by comparing the dimensions of pure vs. mixed mania.

Materials and method

One hundred and three inpatients with bipolar I disorder, manic or mixed (DSM IV), were assessed with SCID-I, YMRS and HDRS-21. The five-factor solution found after applying factorial analysis with Varimax rotation was compared between manic and mixed patients.

Results

There were differences between pure mania and mixed states on factor 1 (depression) and factor 3 (hedonism). There was a tendency to present higher values on factor 5 (activation) in the pure manic group. No differences were found in factor 2 (dysphoria) and factor 4 (psychosis).

Discussion

Hedonism and activation dimensions are present to a lesser degree in mixed states. Although the principal difference between mixed and pure bipolar disorder is the existence of depressive symptoms, the depressive dimension is strongly present in patients with pure mania.

Conclusions

There is need to search for core depressive symptoms in all patients suffering from mania and to evaluate their outcome in clinical trials.

Keywords

Bipolar disorderMixed maniaFactorial analysisDimensions of mania
Type
Short communication
Information
European Psychiatry , Volume 19 , Issue 5 , August 2004 , pp. 307 - 310
Copyright
Copyright © 2004 European Psychiatric Association

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Akiskal, HSHantouche, EGBourgeois, MLAzorin, JMSechter, DAllilaire, JFet al.Gender, temperament, and the clinical picture in dysphoric mixed mania: findings from a French national study (EPIMAN). J Affect Disord 1998;50:176–86.CrossRefGoogle ScholarPubMed
Akiskal, HSAzorin, JMHantouche, EG.Proposed multidimensional structure of mania: beyond the euphoric–dysphoric dichotomy. J Affect Disord 2003;73:7–18.CrossRefGoogle ScholarPubMed
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington (DC): APA; 1994.Google Scholar
Cassidy, FMurry, EForest, KCarroll, BJ.The performance of DSM-III-R criteria in the diagnosis of bipolar mixed states. J Affect Disord 1997;46:79–81.CrossRefGoogle Scholar
Cassidy, FForest, KMurry, ECarrol, BJ.A factor analysis of the signs and symptoms of mania. Arch Gen Psychiatry 1998;55:27–32.CrossRefGoogle ScholarPubMed
Cassidy, FMurry, EForest, KCarroll, BJ.Signs and symptoms of mania in pure and mixed episodes. J Affect Disord 1998;50:187–201.CrossRefGoogle ScholarPubMed
Cassidy, FAhearn, EMurry, EForest, KCarroll, BJ.Diagnostic depressive symptoms of the mixed bipolar episode. Psychol Med 2000;30:403–11.CrossRefGoogle ScholarPubMed
Cassidy, FCarroll, BJ.Frequencies of sings and symptoms in mixed and pure episodes of mania: implications for the study of manic episodes. Prog Neuropsychopharmacol Biol Psychiatry 2001;25(3):659–65.CrossRefGoogle Scholar
Dell’Osso, LPini, STundo, ASarno, NMusetti, LCasano, GB.Clinical characteristics of mania, mixed mania, and bipolar depression with psychotic features. Compr Psychiatry 2000;41(4):242–7.CrossRefGoogle ScholarPubMed
Dilsaver, SCChen, YRShoaib, AMSusan, AC.Phenomenology of mania: evidence for distinct depressed, dysphoric and euphoric presentations. Am J Psychiatry 1999;156:426–30.Google ScholarPubMed
Goldberg, JFGarno, JLPortera, LLeon, ACKocsis, H.Qualitative differences in manic symptoms during mixed versus pure mania. Compr Psychiatry 2000;41(4):237–41.CrossRefGoogle ScholarPubMed
González-Pinto, ABallesteros, JAldama, APérez de Heredia, JLGutiérrez, MMosquera, Fet al.Principal components of mania. J Affect Disord 2003;76:95–102.CrossRefGoogle ScholarPubMed
Hamilton, M.A rating scale for depression. J Neurol Neurosurg Psychiatry 1960;23:56–62.CrossRefGoogle ScholarPubMed
Hantouche, EGAllialaire, JPBourgeois, MLAzorin, JMSechter, LChatenêt-Duchêne, Let al.The feasibility of self-assessment of dys-phoric mania in the French national EPIMAN study. J Affect Disord 2001;67:97–103.CrossRefGoogle ScholarPubMed
McElroy, SLStrakowski, SMKeck, PETugrul, KLWest, SALonczak, HS.Differences and similarities in mixed and pure mania. Compr Psychiatry 1995;36(3):187–94.CrossRefGoogle ScholarPubMed
Perugi, GAkiskal, HSMicheli, CMuseti, LPaiano, AQuilici, Cet al.Clinical subtypes of bipolar mixed states: validating a broader European definition in 143 cases. J Affect Disord 1997;43:169–80.CrossRefGoogle ScholarPubMed
Rossi, ADaneluzzo, EArduini, LDi Domenico, MPollice Petruzzi, C.A factor analysis of signs and symptoms of the manic episode with Bech-Rafaelsen mania and melancholia scales. J Affect Disord 2001; 64(2–3):267–70.CrossRefGoogle ScholarPubMed
Sato, TBottlender, RKleindienst, NTanabe, AMöller, HJ.The boundary between mixed and manic episodes in the ICD-10 classification. Acta Psychiatr Scand 2002;106:109–16.CrossRefGoogle ScholarPubMed
Sato, TBottlender, RKleindienst, NMöller, HJ.Syndromes and phenomenological subtypes of underlying acute mania: a factor analytic study of 576 manic patients. Am J Psychiatry 2002;159:968–74.CrossRefGoogle ScholarPubMed
Spitzer, RLWilliams, JBWGibbon, MFirst, MBSCID I. Version 2.0 for DSM IV. Indiana: Lilly Research Laboratories; 1996.Google Scholar
Swann, ACJanicak, PLCalabrese, JRBowden, CLDilsaver, SCMorris, DDet al.Structure of mania: depressive, irritable, and psychotic clusters with different retrospectively-assessed course patterns of illness in randomized clinical trial participants. J Affect Disord 2001;67:123–32.CrossRefGoogle ScholarPubMed
World Health Organization. The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. Geneva: WHO; 1992.Google Scholar
Young, RCBiggs, TZiegler, EMeyer, DAA rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry 1978;133:429–35.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.