Certain Criteria Beat DSM-IV in Identifying Bipolar Disorder in Major Depression

According to a recent study, using bipolarity-specifier criteria on patients suffering from major depressive episodes (MDE) is a valid method of identifying bipolar disorders; the study also found that it identifies more cases than using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria.

Jules Angst, MD, from the Zürich University Psychiatric Hospital in Switzerland, and fellow researchers focused on the frequency of the bipolar disorder symptoms in 5,635 patients who suffered for MDE symptoms.

The researchers utilized both DSM-IV-TR criteria and bipolarity-specifier criteria in order to assess the frequency of bipolar disorder; other factors connected to bipolarity were assessed by logistic regression.

Of the 5,635 participants, the investigators discovered that 903 patients (16%) met the DSM-IV-TR criteria of bipolar disorder, while 2,647 patients (47%) met the bipolarity-specifier criteria.

When the researchers applied both definitions, family history of mania or hypomania and multiple past mood episodes were associated considerably with bipolarity (odds ratio, >2).

Further, the researchers reported that the bipolarity-specifier criteria identified connections between comorbid substance-use disorder and manic/hypomanic states throughout antidepressant therapy, as well as 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 wrote.

This study was published in the August issue of the Archives of General Psychiatry.