Impact of modification to DSM-5 criterion A for hypomania/mania in newly diagnosed bipolar patients: findings from the prospective BIO study
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Impact of modification to DSM-5 criterion A for hypomania/mania in newly diagnosed bipolar patients : findings from the prospective BIO study. / Fredskild, Mette U.; Stanislaus, Sharleny; Coello, Klara; Melbye, Sigurd A.; Kjærstad, Hanne Lie; Sletved, Kimie Stefanie Ormstrup; Suppes, Trisha; Vinberg, Maj; Kessing, Lars Vedel.
In: International Journal of Bipolar Disorders, Vol. 9, No. 1, 14, 2021.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Impact of modification to DSM-5 criterion A for hypomania/mania in newly diagnosed bipolar patients
T2 - findings from the prospective BIO study
AU - Fredskild, Mette U.
AU - Stanislaus, Sharleny
AU - Coello, Klara
AU - Melbye, Sigurd A.
AU - Kjærstad, Hanne Lie
AU - Sletved, Kimie Stefanie Ormstrup
AU - Suppes, Trisha
AU - Vinberg, Maj
AU - Kessing, Lars Vedel
N1 - Publisher Copyright: © 2021, The Author(s).
PY - 2021
Y1 - 2021
N2 - 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.
AB - 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.
KW - Activity
KW - Bipolar disorder
KW - Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5)
KW - Diagnostic and Statistical Manual of Mental Disorders Version IV (DSM-IV)
KW - Energy
KW - Irritability
KW - Mood
KW - The International Classification of Diseases 10 (ICD-10)
KW - The International Classification of Diseases 11 (ICD-11)
U2 - 10.1186/s40345-020-00219-9
DO - 10.1186/s40345-020-00219-9
M3 - Journal article
C2 - 33937949
AN - SCOPUS:85105214751
VL - 9
JO - International Journal of Bipolar Disorders
JF - International Journal of Bipolar Disorders
SN - 2194-7511
IS - 1
M1 - 14
ER -
ID: 262801113