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[Increased sensitivity in bipolar disorder detection with the MDQ and BSDS using Ghaemi-Goodwin's criteria for the
Sergio Apfelbaum1, Pilar Regalado, Laura Herman
1Casa de Familia. Córdoba. Argentina. sergioap8@gmail.com.
Introduction:
Many patients with bipolar disorder (BD) spend around 10 years without a diagnosis and appropriate treatment. The difficulty in distinguishing bipolar from unipolar depression, the prevalence of depressive symptoms along the course of BD and patients' bias in recalling their hypomanic symptoms are some of the factors that contribute to this problem.
Objective:
This study compares the efficiency of several screening instruments for BD detection in a group of patients (n=63) with mood disorders, or cluster B personality disorders.
Method:
The diagnoses were made with structured interviews: Mini International Neuropsychiatric Interview (MINI) and Structured Clinical Diagnostic Interview for axis II (SCID-II). The patients completed the Mood Disorder Questionnaire (MDQ) and Bipolar Spectrum Disorder Scale (BSDS) and were assessed with the Bipolar Index-BI and Ghaemi-Goodwin Bipolar Spectrum Criteria. Sensitivity, specifcity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) were estimated for each instrument, along with Chi2 and T-tests. Statistical analyses were conducted using the SPSS-v16.
Results:
The BI had the best global performance with 88% specificity and 0.90 of sensitivity. The MDQ-H had the highest specificity and the MDQ-6 the highest sensitivity. However, when combining the MDQ with Ghaemi's criteria, an ostensible augment was obtained in sensitivity while maintaining good predictive values.
Conclusions:
The joint assessment of mania symptoms and typical evolving course symptoms in BD increased the probability of BD detection in this clinical sample.
