Bipolar Disorder - Mixed States: A Diagnostic Dilemma (Part-I).
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Date
2009-10
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Abstract
There is a large difference in classifying Mixed States according to the prevailing standardized
classifications because of the differential focus of the various criteria in identifying Mixed
States. Aims: To assign the Mania With Depressive symptoms patients in different groups and to
compare the phenomenology, personality profiles and psychiatric co-morbidities of these various
groups so generated. Material and Methods: 64 patients were randomly selected from the 214
Bipolar Disorder – Current episode Manic (as per DSM IV TR9) patients admitted in Psychiatry
ward of P.B.M. General Hospital,Bikaner from 1st Jan 2007 to 31st Dec. 2007. After recording
socio-demographic data on a self-designed Performa, Young’s Mania Rating Scale (YMRS)and
Montgomery Asberg Depression Rating Scale (MADRS) were administered on day 1,3,5,7 and
9 till discharge.32 patients were assigned to Mania with Depressive Symptoms on displaying 1
or more depressive symptom, excluding decreased sleep.32 patients were assigned to Pure
Mania group who displayed no Depressive symptoms. Results: 30 patients(94%) could be
assigned to Mixed states according to Vienna Criteria,25(78%) could reach the diagnosis of
Mixed States as per Cincinnati criteria, another 17(53%) were assigned to Mixed States as per
Pisa San Diego Criteria.ICD-10 could identify 5 patients(16%) and DSM IV TR appeared to
identify the least that is 3 patients(9%) Conclusion: Concept of MS couldn’t be better explained
with these existing criteria because some patients meeting one criterion are not meeting others.
Description
Keywords
Bipolar disorder-mixed states, Diagnosis
Citation
Gupta Prerana, Gupta L N, Shekhawat Lokesh, Singhal A K, Verma K K, Gocher Suresh. Bipolar Disorder - Mixed States: A Diagnostic Dilemma (Part-I). Delhi Psychiatry journal. 2009 Oct; 12 (2): 222-230.