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Affective dimensions as a diagnostic tool for bipolar disorder in first psychotic episodes

Published online by Cambridge University Press:  15 April 2020

M. Arrasate ,
I. González-Ortega ,
S. Alberich ,
M. Gutierrez ,
M. Martínez-Cengotitabengoa ,
F. Mosquera ,
N. Cruz ,
M.A. González-Torres ,
C. Henry  and
A. González-Pinto
M. Arrasate
Affiliation:
Department of Psychiatry, Basurto Hospital, EHU/UPV, Bilbao, Spain
I. González-Ortega
Affiliation:
CIBERSAM, EMBREC, Department of Psychiatry, Araba University Hospital - Santiago, EHU/UPV, Vitoria-Gasteiz, Spain
S. Alberich
Affiliation:
CIBERSAM, EMBREC, Department of Psychiatry, Araba University Hospital - Santiago, EHU/UPV, Vitoria-Gasteiz, Spain
M. Gutierrez
Affiliation:
CIBERSAM, EMBREC, Department of Psychiatry, Araba University Hospital - Santiago, EHU/UPV, Vitoria-Gasteiz, Spain
M. Martínez-Cengotitabengoa
Affiliation:
CIBERSAM, EMBREC, Department of Psychiatry, Araba University Hospital - Santiago, EHU/UPV, Vitoria-Gasteiz, Spain
F. Mosquera
Affiliation:
CIBERSAM, Araba Mental Health, Vitoria-Gasteiz, Spain
N. Cruz
Affiliation:
CIBERSAM, EMBREC, Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, IDIBAPS, Barcelona, Spain
M.A. González-Torres
Affiliation:
Department of Psychiatry, Basurto Hospital, EHU/UPV, Bilbao, Spain
C. Henry
Affiliation:
EMBREC, Department of Psychiatry, Paris, France
A. González-Pinto*
Affiliation:
CIBERSAM, EMBREC, Department of Psychiatry, Araba University Hospital - Santiago, EHU/UPV, Vitoria-Gasteiz, Spain
*
*Corresponding author. CIBERSAM, Araba University Hospital - Santiago, EHU/UPV, Olaguibel 29, Vitoria-Gasteiz, Spain. Tel.: +34 945 007770; fax: +34 945 007764. E-mail address: [email protected] (A. González-Pinto).
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Abstract

Objective

To examine the predictive diagnostic value of affective symptomatology in a first-episode psychosis (FEP) sample with 5 years’ follow-up.

Method

Affective dimensions (depressive, manic, activation, dysphoric) were measured at baseline and 5 years in 112 FEP patients based on a factor structure analysis using the Young Mania Rating Scale and Hamilton Depression Rating Scale. Patients were classified as having a diagnosis of bipolar disorder at baseline (BDi), bipolar disorder at 5 years (BDf), or “other psychosis”. The ability of affective dimensions to discriminate between these diagnostic groups and to predict a bipolar disorder diagnosis was analysed.

Results

Manic dimension score was higher in BDi vs. BDf, and both groups had higher manic and activation scores vs. “other psychosis”. Activation dimension predicted a bipolar diagnosis at 5 years (odds ratio = 1.383; 95% confidence interval, 1.205–1.587; P = 0.000), and showed high levels of sensitivity (86.2%), specificity (71.7%), positive (57.8%) and negative predictive value (90.5%). Absence of the manic dimension and presence of the depressive dimension were both significant predictors of an early misdiagnosis.

Conclusion

The activation dimension is a diagnostic predictor for bipolar disorder in FEP. The manic dimension contributes to a bipolar diagnosis and its absence can lead to early misdiagnosis.

Keywords

AffectiveBipolarDimensionFirst psychosisActivation
Type
Original article
Information
European Psychiatry , Volume 29 , Issue 7 , September 2014 , pp. 424 - 430
Copyright
Copyright © 2013 Elsevier Masson SAS

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