Comparative evaluation of two self-report mania rating scales (original) (raw)
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An investigation of the self-report manic inventory as a diagnostic and severity scale for mania
Comprehensive Psychiatry, 1996
The initial study on the Self-Report Manic Inventory (SRMI} reported that it reliably diagnosed mania. In the current study, we replicated the initial study on the SRMI. We also evaluated its ability to quantify manic symptomatology and to measure change during inpatient treatment. The findings show that manic patients are capable of reporting their symptoms, regardless of their insight into their condition. They also confirm that the SRMI is a reliable diagnostic instrument and that it performs consistently over time when used with a 1-week time format. The SRMI is also sensitive to clinical improvement in hospitalized patients undergoing treatment. The SRMI correlated well with the Young Mania-Rating Scale (YMRS), which served as an external validator of SRMI scores at the beginning and end of hospitalization. Factor analysis produced two groups of manic subjects who closely resemble the hedonistic euphoric type and the energized dysphoric type initially reported by Shugar et al.
Objective: The present study examined the psychometric properties of the Young Mania Rating Scale. Methods: This cross-sectional study included 65 patients with bipolar I disorder in the manic phase and 145 healthy individuals. The patients were selected from the Razi Psychiatric Hospital and Taleghani Hospital, while the controls were selected from the general population of Tehran, using a purposive sampling method. Data were collected using the structured clinical interview for DSM-IV axis I disorders and the Young Mania Rating Scale (YMRS) and analyzed using SPSS-23 and AMOS-24. Results: Confirmatory and exploratory factor analysis revealed a three-factor structure for the YMRS. Cronbach's alpha coefficient of 0.72 indicated the acceptable reliability of YMRS. The cutoff point, sensitivity, and specificity of the YMRS were found to be 12.5, 0.93, and 0.96, respectively. Conclusion: According to the study results, YMRS showed adequate psychometric properties in the Iranian population. Therefore, it can be considered as a valuable instrument in screening patients with bipolar disorder in the manic phase.
A review of self-report and interview-based instruments to assess mania and hypomania symptoms
Giornale Italiano di Psicopatologia
Objective: The aim of this paper is to provide an overview of the self-report and interview-based instruments to assess mania/hypomania symptoms and related features, with a focus on 7 selected instruments in widespread use to illustrate their psychometric properties, comparative performance and pros and cons. Methods: A systematic search strategy was devised and queried on Medline from 1973 to 2012 using the terms mania, hypomania, instrument, scale, questionnaire, interview, validity, reliability, psychometric properties and adults, elderly, aged. To be included, a study had to be published in a peer-reviewed journal or book in English or Italian. Results: Of the 17 self-report instruments identified, two (the Mood Disorder Questionnaire (MDQ) and the Hypomania Checklist-32 (HCL-32), received the most research attention. Although the psychometric properties of these instruments are good, their use as screening instruments to detect hypomania in the community or in patients with de...
Profiles of “manic” symptoms in bipolar I, bipolar II and major depressive disorders
Journal of Affective Disorders, 2005
Background: Classical authors such as Kraepelin, as well as the emerging literature during the past decade, indicate that manic-like signs and symptoms are present to a variable degree in all mood disorders. Current nosography does not differentiate between them and only the number of symptoms or severity is used for classification. This is particularly true for mania and hypomania. This paper will analyze the patterns of manic symptoms in bipolar I (BP-I), bipolar II (BP-II) and major depressive disorders (MDD), to test the hypothesis that mania and hypomania have different profiles, and ascertain which excitatory manic phenomena do occur in unipolar MDD. Methods: Six hundred and fifty-two inpatients (158 BP-I, 122 BP-II and 372 MDD) were assessed using the operational criteria for psychotic illness checklist (OPCRIT) [Arch. Gen. Psychiatry 48 (1991) 764] with a lifetime perspective. Manic or hypomanic symptoms were investigated and compared between BP-I, BP-II and MDD. Results: When compared with BP-II, BP-I disorder had a higher prevalence of reckless activity, distractibility, psychomotor agitation, irritable mood and increased self-esteem. These five symptoms correctly classified 82.8% of BP-I and 80.1% of BP-II patients. One or two manic symptoms were observed in more than 30% of major depressive patients; psychomotor agitation was the most frequent manifestations present in 18% of the MDD group. Limitations: We did not control for severity of symptoms, nor for neuroleptic use that could produce akathisia. Conclusions: This study suggests that mania and hypomania can be differentiated in their symptom profiles, and highlights the presence of few manic symptoms, particularly psychomotor agitation, in MDD. From the standpoint of number of manic signs and symptoms, controlling for psychomotor agitation did not substantially change the predictive power of the remaining manic symptoms. Given that excitatory manic signs and symptoms are present to a decreasing degree in BP-I, BP-II and MDD, these disorders can be proposed to lie along a dimensional model. Overall, these data are compatible with the concept of a bipolar spectrum, whereby each of the affective subtypes requires specific genetic factors.
The Observer-Rated Scale for Mania (ORSM): development, psychometric properties and utility
The diagnosis of mania largely depends on the quality of information the physician is provided with. Often, the patient cannot give an accurate account of the symptom development and thus information from relatives and friends is required. No systematic rating instrument is available, however, to facilitate this. In this study, the psychometric properties of the 49-item Observer-Rated Scale for Mania (ORSM) are reported. The scale was used in 113 inpatients and the following psychometric aspects were assessed: reliability, test-retest reliability, construct validity (factor analysis, discriminant analysis, comparison of means), extreme-group validity, prognostic validity, sensitivity, specificity, positive and negative predictive values. The ORSM proved highly valid and reliable. Factor analysis revealed three factors which were labelled euphoric mania, instable mania and psychotic mania. The ORSM is a useful instrument to help non-professionals who are in regular contact with the patient diagnosed a manic/mixed episode. It thus complements existing rating scales for mania, which are either designed for professionals or are self-rating instruments.
International Journal of Bipolar Disorders, 2021
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 ...
Psychiatry and clinical neurosciences, 2017
Bipolar disorder (BD) is frequently misdiagnosed as major depression and hence reliable and culturally appropriate screening tools are needed. This study compared the 32-item Hypomania Checklist (HCL-32), the 33-item Hypomania Checklist (HCL-33), and the Mood Disorders Questionnaire (MDQ) for BD. Altogether, 350 depressed patients were included. The HCL-32, the HCL-33 and the MDQ were completed by patients to identify manic and/or hypomanic symptoms. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve between the HCL-32, the HCL-33 and the MDQ for BD and major depression were calculated and compared, using cutoffs suggested by respective validation studies. Of the three scales, the MDQ had the highest sensitivity and NPV (sensitivity = 0.90, 0.81, and 0.90 for BD vs MDD, BD-I vs MDD and BD-II vs MDD, respectively; NPV = 0.78, 0.86, and 0.86 for BD vs MDD, BD-I vs MDD and BD-II vs MDD, respectively), while the HCL-3...
2020
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 / first episode 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 visi...
The Altman Self-Rating Mania Scale
Biological Psychiatry, 1997
We report on the development, reliability, and validi O, of the Altman Self-Rating Mania Scale (ASRM). The ASRM was completed during medication washout and after treatment by 22 schizophrenic, 13 schizoaffective, 36 depressed, and 34 manic patients. The Clinician-Administered Rating Scale for Mania (CARS-M) and Mania Rating Scale (MRS) were completed at the same time to measure concurrent validi~'. Test-retest reliabili~' was assessed separately on 20 depressed and ]0 manic" patients who completed the ASRM twice during washout. Principal components analysis of ASRM items revealed three .factors." mania, psychotic symptoms, and irritability. Baseline mania subscale scores were significantly higher for manic patients compared to all other diagnostic groups. Manic patients had significantly decreased posttreatment scores for all three subscales. ASRM mania subscale scores were significantly correlated with MRS total scores (r := . 718) and CARS-M mania subscale scores (r = .766). Test-retest reliability for the ASRM was significant for all three subscales. Significant differences in severi~' levels were fi)und fi)r some symptoms between patient ratings on the ASRM and clinician ratings on the CARS-M. Mania subscale scores of greater than 5 on the ASRM resulted in values of 85.5% fbr sensitivity and 87.3%for specificity. Advantages of the ASRM over other self-rating mania scales are discussed.