title: What symptoms predict the diagnosis of mania in persons with severe/profound intellectual disability in clinical practice?
abstract: BACKGROUND
  While researchers have attempted to address the difficulties of diagnosing affective disorders in the intellectually disabled population, diagnosing bipolar disorder in an individual with severe intellectual disability (ID) remains a challenge. The aim of this study was to identify what symptoms can predict a diagnosis of mania in the intellectually disabled population.
  
  
  METHODS
  Three groups of persons with ID participated in this study: (1) individuals with a bipolar diagnosis who were currently manic; (2) individuals with an Axis I diagnosis other than bipolar disorder; and (3) individuals without an Axis I diagnosis. Two recognized measures of mania (i.e. Diagnostic Assessment for the Severely Handicapped-Revised and Parent Version of Young Mania Rating Scale) were used to evaluate symptoms of mania. A logistical regression procedure was conducted on mania items to identify which items correctly identify persons with ID who were currently manic.
  
  
  RESULTS
  Psychomotor agitation, decreased sleep, changes in mood and aggression were significantly related to the diagnosis of mania. Further, psychomotor agitation and disturbed sleep were significant predictors of a diagnosis of mania.
  
  
  CONCLUSIONS
  Problems of sleep and psychomotor agitation should alert clinicians that further assessment of bipolar symptomatology is warranted. Focusing on observable behaviours based on Diagnostic and Statistical Manual of Mental Disorder-IV criteria can be useful in formulating a diagnosis of bipolar disorder in persons with ID.
authors.affiliation: Department of Psychology, Louisiana State University, Baton Rouge, LA 70803, USA. johnmatson@aol.com
authors.forename: J L
authors.initials: JL
authors.lastname: Matson
authors.forename: M L
authors.initials: ML
authors.lastname: González
authors.forename: C
authors.initials: C
authors.lastname: Terlonge
authors.forename: R T
authors.initials: RT
authors.lastname: Thorson
authors.forename: R B
authors.initials: RB
authors.lastname: Laud
mesh_terms: D000328:Adult; D000339:Affect; D000368:Aged; D000374:Aggression / Q000523:psychology; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000523:psychology; D003702:Delusions / Q000175:diagnosis / Q000523:psychology; D003937:Diagnosis, Differential; D020920:Dyssomnias / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000175:diagnosis / Q000523:psychology; D008607:Intellectual Disability / Q000523:psychology*; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology; D008875:Middle Aged; D010552:Personality Assessment; D011595:Psychomotor Agitation / Q000175:diagnosis / Q000523:psychology; D012649:Self Concept