Specific Criteria Beat DSM-IV in ID of Bipolar in Major Depression

Use of bipolarity-specifier criteria is valid; identifies more cases than DSM-IV-TR criteria

WEDNESDAY, Aug. 3 (HealthDay News) -- In patients being treated for a major depressive episode (MDE), use of bipolarity-specifier criteria is a valid method of identifying bipolar disorders and identifies more cases than using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria, according to a study published in the August issue of the Archives of General Psychiatry.

Jules Angst, M.D., from the Zürich University Psychiatric Hospital in Switzerland, and colleagues estimated the frequency of bipolar disorder symptoms in 5,635 patients seeking medical help for MDE. DSM-IV-TR criteria and bipolarity-specifier criteria were employed to assess the frequency of bipolar disorder, and logistic regression was used to assess the variables associated with bipolarity.

The investigators found that 16.0 percent of patients (903 patients) met the DSM-IV-TR criteria of bipolar disorder, and 47.0 percent of the patients (2,647 patients) met the bipolarity-specifier criteria. When both the definitions were used, family history of mania or hypomania and multiple past mood episodes correlated significantly with bipolarity (odds ratio, >2). In addition, the bipolarity-specifier criteria identified significant associations for comorbid substance-use disorder, manic/hypomanic states during antidepressant therapy, and current mixed mood symptoms.

"These results suggest that bipolar features are more frequent in patients with MDE than indicated by DSM-IV-TR criteria," the authors write.

All of the study authors disclosed financial ties to Sanofi-Aventis, which sponsored the study.

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