title: Investigating symptom domains of bipolar disorder for Spanish-speakers using the Bipolar Inventory of Symptoms Scale.
abstract: A Spanish language rating scale which assesses the range of bipolar disorder symptoms is needed. There are rating scales commonly used, however they do not address commonly expressed symptoms associated with bipolar disorder and have varied rating systems. There are also few comparisons of symptom severity between Spanish and English speaking patients, due to limitations in available rating scales.
  
  
  
  We conducted psychometric assessment of the Spanish language Bipolar Inventory of Symptoms Scale (BISS) (N=71) for persons with bipolar disorder, which assesses 5 domains: mania, depression, irritability, anxiety and psychosis. The Spanish BISS scores were then compared to the MADRS (Montgomery Asberg Depression Rating Scale) and the YMRS (Young Mania Rating Scale) as well as to BISS scores in an English speaking sample (N=102) with bipolar disorder from the same geographic locations.
  
  
  
  Chronbach's alphas for the Spanish BISS ranged from 0.6 to 0.93, with the psychosis domain displaying lower reliability. Correlations with the MADRS and YMRS were good and ranged from 0.70 to 0.88. The BISS differentiated well across mood states in English and Spanish versions, with mood state differentiated well using subscales and domains. For the irritability and anxiety domains, Spanish speaking participants had higher scores than English speakers across mood states. Females showed differences in symptom profiles compared to males.
  
  
  
  The sample sizes in the Spanish speaking manic group were small. The Spanish BISS, tested here primarily in patients of Mexican ancestry, may require revision in other Spanish language populations.
  
  
  
  The Spanish BISS, a Spanish language symptom rating scale for bipolar disorder, demonstrates good reliability and validity. Clinical assessment in anxiety and irritability domains is particularly relevant in a Spanish speaking sample. Consistent with prior research, females report higher depression, irritability and anxiety scores irrespective of language spoken.
authors.affiliation: University of Texas Health Science Center, Department of Psychiatry, 7703 Floyd Curl Drive, San Antonio, TX 78229, United States. Electronic address: arnoldjg@uthscsa.edu.
authors.forename: Jodi Gonzalez
authors.initials: JG
authors.lastname: Arnold
authors.affiliation: University of Texas Health Science Center, Department of Psychiatry, 7703 Floyd Curl Drive, San Antonio, TX 78229, United States.
authors.forename: Cervando
authors.initials: C
authors.lastname: Martinez
authors.affiliation: Texas Tech University Health Sciences Center, Department of Psychiatry, 5001 El Paso Drive, El Paso, TX 79905, United States.
authors.forename: Juan
authors.initials: J
authors.lastname: Zavala
authors.affiliation: University of Texas Health Science Center, Department of Pathology, 7703 Floyd Curl Drive, San Antonio, TX 78229, United States.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Prihoda
authors.affiliation: Texas Tech University Health Sciences Center, Department of Psychiatry, 5001 El Paso Drive, El Paso, TX 79905, United States.
authors.forename: Michael
authors.initials: M
authors.lastname: Escamilla
authors.affiliation: Texas Tech University Health Sciences Center, Department of Psychiatry, 5001 El Paso Drive, El Paso, TX 79905, United States.
authors.forename: Vivek
authors.initials: V
authors.lastname: Singh
authors.affiliation: University of Texas Health Science Center, Department of Psychiatry, 7703 Floyd Curl Drive, San Antonio, TX 78229, United States.
authors.forename: Melissa
authors.initials: M
authors.lastname: Bazan
authors.affiliation: Laurel Ridge Treatment Center, 17720 Corporate Woods Drive, San Antonio, TX 78259, United States.
authors.forename: Marlon
authors.initials: M
authors.lastname: Quiñones
authors.affiliation: University of Texas Health Science Center, Department of Psychiatry, 7703 Floyd Curl Drive, San Antonio, TX 78229, United States.
authors.forename: Charles L
authors.initials: CL
authors.lastname: Bowden
mesh_terms: D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology*; D001714:Bipolar Disorder / Q000175:diagnosis / Q000523:psychology*; D003863:Depression / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D006801:Humans; D007508:Irritable Mood; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D011618:Psychotic Disorders / Q000175:diagnosis / Q000523:psychology*; D015203:Reproducibility of Results; D063189:Symptom Assessment; D014177:Translations
keywords: Bipolar disorder; Hispanics; Psychometrics; Rating scale; Spanish