Toward the delineation of mania subtypes in the French National EPIMAN-II Mille Cohort. Comparisons with prior cluster analytic investigations.
BACKGROUND
Knowledge about psychopathologic presentations of mania in current clinical practice has to be refined in order to improve diagnosis and treatment.


METHODS
One thousand ninety manic patients included in the French National Study EPIMAN-II Mille were submitted to a cluster analysis on the basis of multiple variables related to the history of bipolar illness and symptoms of the current episode.


RESULTS
Four clusters were identified: "classic mania" (29.3% of patients) with less severe mania; "psychotic mania" (22.7%) with psychotic symptoms, more severe mania, younger age and social impairment; "depressive mania" (30.4%) characterized by female gender, suicide attempts, high number of previous episodes and residual symptoms; and "dual mania" (17.6%) characterized by male gender, substance use, earlier onset and poor compliance. Patients groups also differed in manic symptoms, marital status, stressors preceding illness onset, prior diagnoses, first episode polarity and temperamental characteristics.


CONCLUSIONS
Cross-sectional assessment of patients.


CONCLUSIONS
In comparing our findings with those of four prior cluster analytic studies, we integrate clinical characteristics of mania subtypes found in this very large representative French sample in contemporary practice, we suggest how such convergence of data may help improve earlier recognition, differential response to different treatments, and prevention of these subtypes. We finally suggest that such subtyping might provide clues to phenotype delineation suitable for pharmacogenetic investigations.
Adult Psychiatry Department, Ste Marguerite Hospital, 270 Bd Sainte-Marguerite, 13274 Marseille Cedex 09, France. jazorin@ap-hm.fr
Jean-Michel
JM
Azorin
Arthur
A
Kaladjian
Marc
M
Adida
Elie
E
Hantouche
Ahcene
A
Hameg
Sylvie
S
Lancrenon
Hagop Souren
HS
Akiskal
D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D001714:Bipolar Disorder / Q000145:classification* / Q000175:diagnosis* / Q000523:psychology; D016000:Cluster Analysis; D015331:Cohort Studies; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D012737:Sex Factors; D012919:Social Behavior; D019966:Substance-Related Disorders / Q000523:psychology; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data