Decreasing the minimum length criterion for an episode of hypomania: evaluation using self-reported data from patients with bipolar disorder.
Brief hypomania lasting less than 4 days may impair functioning and help to detect bipolarity. This study analyzed brief hypomania that occurred in patients with bipolar disorder who were diagnosed according to the DSM-IV criteria. Daily self-reported mood ratings were obtained from 393 patients (247 bipolar I and 146 bipolar II) for 6 months (75,284 days of data, mean 191.6 days). Episodes of hypomania were calculated using a 4, 3, 2, and single day length criterion. Brief hypomania occurred frequently. With a decrease in the minimum criterion from 4 days to 2 days, there were almost twice as many patients with an episode of hypomania (102 vs. 190), and more than twice as many episodes (305 vs. 863). Single days of hypomania were experienced by 271 (69%) of the sample. With a 2-day episode length, 33% of all hypomania remained outside of an episode. There was no significant difference in the percent of hypomanic days outside of an episode between patients with bipolar I and II disorders. There were no significant differences in the demographic characteristics of patients who met the 4-day minimum as compared with those who only experienced episodes of hypomania using a shortened length criterion. Decreasing the minimum length criterion for an episode of hypomania will cause a large increase in the number of patients who experience an episode and in the aggregate number of episodes, but will not distinguish subgroups within a sample who meet the DSM-IV criteria for bipolar disorder. Frequency may be an important dimensional aspect of brief hypomania. Clinicians should regularly probe for brief hypomania.
Department of Psychiatry and Psychotherapy, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Germany. michael.bauer@uniklinikum-dresden.de
Michael
M
Bauer
Tasha
T
Glenn
Natalie
N
Rasgon
Wendy
W
Marsh
Kemal
K
Sagduyu
Paul
P
Grof
Martin
M
Alda
Greg
G
Murray
Rodrigo
R
Munoz
Danilo
D
Quiroz
Rita
R
Bauer
Burkhard
B
Jabs
Peter C
PC
Whybrow
D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000145:classification / Q000175:diagnosis* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D057566:Self Report; D013997:Time Factors; D055815:Young Adult
Arch Gen Psychiatry. 2002 Jun;59(6):530-7
12044195
Arch Gen Psychiatry. 2008 Apr;65(4):386-94
18391127
Eur Arch Psychiatry Clin Neurosci. 2009 Nov;259 Suppl 2:S129-33
19876670
Eur Arch Psychiatry Clin Neurosci. 1991;240(6):339-48
1831665
Arch Gen Psychiatry. 2005 Dec;62(12):1322-30
16330720
J Clin Psychiatry. 2005 Jul;66(7):914-21
16013908
J Clin Psychopharmacol. 1996 Apr;16(2 Suppl 1):4S-14S
8707999
Am J Psychiatry. 1980 Feb;137(2):198-202
7352574
J Affect Disord. 2003 Jan;73(1-2):123-31
12507745
J Affect Disord. 2003 Jan;73(1-2):133-46
12507746
J Affect Disord. 2004 Aug;81(2):123-31
15306137
Soc Psychiatry Psychiatr Epidemiol. 2009 Jul;44(7):515-22
19011720
J Affect Disord. 1992 Oct;26(2):127-40
1447430
J Affect Disord. 2006 Dec;96(3):189-96
16427136
Psychiatry Res. 2008 Jun 30;159(3):359-66
18423616
J Affect Disord. 2006 Nov;96(1-2):101-5
16782206
Am J Psychiatry. 1995 Nov;152(11):1635-40
7485627
Eur Arch Psychiatry Clin Neurosci. 2001;251(1):32-4
11315516
J Psychiatr Res. 1997 Sep-Oct;31(5):593-603
9368200
Am J Psychiatry. 2006 Feb;163(2):217-24
16449474
Bipolar Disord. 2004 Feb;6(1):67-74
14996143
Arch Gen Psychiatry. 1991 Sep;48(9):807-12
1929771
J Affect Disord. 1998 Sep;50(2-3):143-51
9858074
Br J Psychiatry. 2006 Aug;189:118-23
16880480
Psychopathology. 2010;43(1):1-7
19893338