Journal
EUROPEAN PSYCHIATRY
Volume 29, Issue 7, Pages 424-430Publisher
CAMBRIDGE UNIV PRESS
DOI: 10.1016/j.eurpsy.2013.07.005
Keywords
Affective; Bipolar; Dimension; First psychosis; Activation
Categories
Funding
- Health Research Funds from the Spanish Government (CIBER Network) [PS09/02002]
- Health Research Funds from the Spanish Government [EC10-333, PI10/01430, PI10/01746, PI11/01977, PI11/02708, 2011/1064, 11-BI-01, 1677-DJ-030, EC10-220]
- European Regional Development Funds (FEDER)
- Basque Country Government [2008111010, 2009111047, 2010111170, 2010112009, 2011111110, 2011111113, SAIO10-PC10BF01, SAIO11-PE11BF006, SAIO11-PE11BF007, SAIO10-PR10BF01, GIC 10/80, KRONIK 11/010]
- BIOEF [BIO09/EM/010]
- CAIBER [1392-D-079]
- University of the Basque Country [GIC10/80, US10/08, EHU08/54]
- Stanley Research Foundation [03-RC-003]
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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. (C) 2013 Elsevier Masson SAS. All rights reserved.
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