Bipolar Depression Rating Scale Research Articles

Psychometric Properties of the Arabic Version of Bipolar Depression Rating Scale (BDRS)

Psychometric Properties of the Arabic Version of Bipolar Depression Rating Scale (BDRS)

Enhancing learning effect for students with bipolar depression through the interactive English translation teaching model

BackgroundBipolar depression students may face various challenges during the learning process, such as emotional fluctuations and lack of concentration. Traditional teaching models may not achieve ideal results in response to the special needs of such students. Given this, the study aims to explore whether the interactive English translation teaching model can bring better learning experiences and effects to students with bipolar depression. Through an in-depth analysis of the characteristics of this teaching model, combined with the characteristics of students with bipolar depression, the study aims to provide educators with new strategies and methods.Subjects and MethodsThe study selected 120 students with bipolar depression as the research subjects and randomly divided them into an experimental group and a control group. The experimental group students were taught using interactive English translation teaching mode, while the control group students were taught using traditional teaching mode. The study used the Bipolar Depression Rating Scale (BDRS) to evaluate the intervention of students with bipolar depression.ResultsBefore the experiment, there was no significant difference in bipolar depression scores between the two groups of students (P>0.05); After the experiment, the bipolar depression symptoms of the experimental group students were significantly improved and significantly lower than those of the control group students (P<0.05).ConclusionsThe interactive English translation teaching model shows promise in alleviating symptoms of bipolar depression among students. Furthermore, this model positively impacts both their learning experience and mental well-being.AcknowledgementResearch Project on Teaching Reform of Chongqing Vocational Education, No. GZ223267.

Risk of childhood trauma exposure and severity of bipolar disorder in Colombia

IntroductionBipolar disorder (BD) is higher in developing countries. Childhood trauma exposure is a common environmental risk factor in Colombia and might be associated with a more severe course of bipolar disorder in Low-Middle Income-Countries. We carried out the first case-control study (114 BD patients and 191 controls) in Colombia using a structural clinical interview and the Childhood Trauma Questionnaire-Short Form (CTQ-SF) to describe the prevalence and association between trauma exposure during childhood with a severe course of illness in a sample of BD patients.Objectivesto describe the prevalence and association between trauma exposure during childhood with a severe course of illness in a sample of BD patients.MethodsA case-control study (114 controls versus 191 controls) that assessed outpatients between 18 and 65 years old, at a teaching hospital in Barranquilla, Colombia was carried-out. All participants were assessed with the SCID-5-CV, the Young Mania Rating Scale (YMRS), and the Bipolar Depression Rating Scale (BDRS). Additionally, exposure to childhood trauma was assessed using The Childhood Trauma Questionnaire-Short Form (CTQ-SF). The CTQ-SF is a brevity 28-item Likert-type, with a five-factor structure: emotional abuse EA, physical abuse PA, sexual abuse SA, physical neglect PN, and emotional neglect EN, self-administered instrument in order to assess multiple types of trauma during childhood.We generate an outcome variable named severe bipolar disorder defined by course severe of bipolar disorder as the presence of any clinical indicator of severity, previously delimited by the research team (early-onset, rapid cycling, ideation or suicide attempt, or 3 or more hospitalizations per year). Also, we carried out bivariate and regression analyses with each clinical indicator of severity as an outcome.ResultsCases included 61.4% BD type I and 38.6% BD type II. The median age was 31.5 years (IQR, 75-24) for BD patients and 31 years old (IQR, 38-24) for healthy controls. A higher prevalence of childhood trauma was evidenced in cases compared to controls.Multivariate logistic regression model in severe bipolar disorderSevere Bipolar DisorderVariableBSEOR95% CIp valuep modelR2Emotional Abuse0.830.362.301.753.03<0.001<0.0010.10Physical Abuse1.070.432.921.545.53<0.001<0.001Sexual Abuse1.610.445.044.735.36<0.001<0.001Physical Neglect0.280.491.320.931.870.117<0.001Emotional Neglect1.240.383.452.285.23<0.001<0.001ConclusionsThis is the first association study between childhood trauma exposure as a higher risk for a severe course of illness in BD patients in Colombian. Our findings highlight the importance of screening and evaluating childhood trauma exposure during the course of BD patients.Disclosure of InterestNone Declared

Psychometric Properties of the Korean Version of Functioning Assessment Short Test in Bipolar Disorder.

The Functioning Assessment Short Test (FAST) is a relatively specific test for bipolar disorders designed to assess the main functioning problems experienced by patients. This brief instrument includes 24 items assessing impairment or disability in 6 domains of functioning: autonomy, occupational functioning, cognitive functioning, financial issues, interpersonal relationships, and leisure time. It has already been translated into standardized versions in several languages. The aim of this study is to measure the validity and reliability of the Korean version of FAST (K-FAST). A total of 209 bipolar disorder patients were recruited from 14 centers in Korea. K-FAST, Young Mania Rating Scale (YMRS), Bipolar Depression Rating Scale (BDRS), Global Assessment of Functioning (GAF) and the World Health Organization Quality of Life Assessment Instrument Brief Form (WHOQOL-BREF) were administered, and psychometric analysis of the K-FAST was conducted. The internal consistency (Cronbach's alpha) of the K-FAST was 0.95. Test-retest reliability analysis showed a strong correlation between the two measures assessed at a 1-week interval (ICC = 0.97; p < 0.001). The K-FAST exhibited significant correlations with GAF (r = -0.771), WHOQOL-BREF (r = -0.326), YMRS (r = 0.509) and BDRS (r = 0.598). A strong negative correlation with GAF pointed to a reasonable degree of concurrent validity. Although the exploratory factor analysis showed four factors, the confirmatory factor analysis of questionnaires had a good fit for a six factors model (CFI = 0.925; TLI = 0.912; RMSEA = 0.078). The K-FAST has good psychometric properties, good internal consistency, and can be applicable and acceptable to the Korean context.

Evaluation of Psychosis Signs and Symptoms According to the Metacognitive Model: Determining Validity and Reliability of Turkish Version of The Beliefs about Paranoia Scale Short Form( BaPS-SF)e and The Measure of Common Responses to Unusual Experiences (MCR)

Introduction: The aim of the study was to determine the validity and reliability of Turkish version of The Beliefs about Paranoia Scale Short Form( BaPS-SF) and The Measure of Common Responses to Unusual Experiences (MCR). Method:105 patients diagnosed with schizophrenia, schizoaffective disorder and bipolar disorder with psychotic features with psychotic signs and symptoms and 80 healthy controls without any psychiatric diagnosis in the past or at the time of evaluation were included in the study. Patients were evaluated with the Positive and Negative Symptom Scale, the Bipolar Depression Rating Scale, the Young Mania Rating Scale, the Hamilton Anxiety Rating Scale and the Cognitive Attention Syndrome 1 Scale (CAS-1), in addition to the BaPS-SF and MCR. Informed consent and permission from the ethics committee were obtained from the participants in the study (Ethics Committee No: 21-KAEK-053).Study data were analyzed with SPSS. Results:The age of the patients was 38.40 (11.94) years, and the control group was 37.11 (12.551) years. The groups were similar in terms of age, gender and education level. Married people were more common in the healthy control group (p=0.005). AII psychopathology scales were significantly higher in the psychosis group (all p values &lt;0.001).The internal consistency of the BaPS-SF was high (Cronbach a=0.898). lt was determined that the BaPS-SF has a three-factor structure: survival strategy, normalizing beliefs and negative beliefs. lt was determined that the MCR has a three-factor structure: social control and reassurance seeking, threat monitoring and avoidance and conscious self-regulation attempts The internal consistency of the subscales ranged from 0.867 to 0.876. Discussion: Current results show that BaPS-SF and MCR are valid and reliable for Turkish population.

Management of Psychiatric Disorders in Patients with Cardiovascular Diseases.

Management of Psychiatric Disorders in Patients with Cardiovascular Diseases.

The effects of supportive-expressive dynamic psychotherapy on the outcomes of bipolar disorder in men

Background and aims: Bipolar disorder (BD) is a chronic disorder with high recurrence rate and significant disability. BD is refractory to treatments and afflicted patients experience disease recurrence despite medication therapy. Therefore, appropriate psychosocial interventions are needed to improve the effectiveness of medication therapy and facilitate BD management. The aim of this study was to evaluate the effects of supportive-expressive dynamic psychotherapy (SEDP) on the outcomes of BD in men. Methods: This double-blind randomized clinical study was conducted in 2017–2018 using a two-group pretest-posttest design. Participants were thirty hospitalized men with BD conveniently selected from Khorshid hospital, Isfahan, Iran, and randomly assigned to an intervention (n = 15) and a control (n = 15) group. Participants in the control group received conventional medication therapy, while participants in the intervention group received conventional medication therapy as well as SEDP in twelve 60-minute one-to-one sessions. Participants in both groups completed the Bipolar Depression Rating Scale before, immediately after, three months after, and six months after the intervention. The SPSS program for Windows (v. 23.0) was employed to analyze the data via the analysis of covariance and the repeated measures analysis of variance. Results: Although the mean score of bipolar depression significantly decreased at the first posttest, the between-group difference was not significant (P &gt; 0.05). However, the mean score of bipolar depression in the intervention group was significantly less than the control group at the second and the third posttests (P &lt; 0.05). Conclusion: SEDP is effective in significantly reducing mood symptoms among men with BD.

Confirmatory evaluation of the bipolar depression rating scale (BDRS) in a large sample of female patients with bipolar depression

Objective The Bipolar Depression Rating Scale (BDRS) is a structured rating scale designed to assess depressive and mixed symptoms in bipolar disorder (BD). Previous studies evaluating the scale have been performed on small samples or on patients in a depressive phase, but not on patients in a mixed or manic phase. This study evaluated the Persian version of the BDRS regarding its factor structure, reliability, and validity in a large sample of Iranian women with BD in a depressive or mixed/manic phase. Methods Three-hundred and one female BD inpatients completed the BDRS, the Beck Depression Inventory-II (BDI-II), the Hamilton Depression Rating Scale (HDRS), the Montgomery-Åsberg Depression Rating Scale (MADRS), and the Young Mania Rating Scale (YMRS). Results The BDRS demonstrated a three-factor structure with good reliability. The BDRS and its psychological and somatic symptom clusters had stronger correlations with other measures of depressive symptoms than a measure of mania. The BDRS mixed symptom cluster also had a stronger correlation with a measure of mania than other measures of depression, supporting the scales’ convergent and discriminant validity. Conclusions The BDRS demonstrated psychometric validity in assessing depressive and mixed symptoms in Iranian women with BD in a depressive or mixed/manic phase. KEY POINTS The Bipolar Depression Rating Scale (BDRS) was validated in Iranian women with BD. The BDRS showed a three-factor structure, similar to the original validation. The BDRS had good reliability based on Omega and test-retest coefficients. The findings provided evidence for the convergent and discriminant validity of the BDRS.

Psychometric Properties of the Chinese Version of the Bipolar Depression Rating Scale for Bipolar Disorder.

IntroductionUnlike unipolar depression, depressive episode of bipolar disorder is often associated with clinical characteristics, such as atypical and mixed symptoms. However, there are currently no valid and reliable specific tools available to assess the specific psychiatric symptomatology of depressive episode of bipolar disorder in China. Therefore, we aimed to evaluate the psychometric properties of the Chinese version of the Bipolar Depression Rating Scale (BDRS) in Chinese patients with bipolar disorder.MethodsThe sample of this study included 111 patients with bipolar disorder (30 male, 81 female). All participants were interviewed with the Chinese version of the BDRS (BDRS-C), the 17-item Hamilton Depression Rating Scale (HAMD-17), the Montgomery-Asberg Depression Rating Scale (MADRS) and the Young Mania Rating Scale (YMRS). A psychometric analysis of the BDRS was conducted.ResultsThe Cronbach’s alpha coefficient of the BDRS-C reached a value of 0.869. The BDRS-C score and scores for the HAMD-17 (r = 0.819, p < 0.01), the MADRS (r = 0.882, p < 0.01) and the YMRS (r = 0.355, p < 0.01) exhibited significant positive correlations. Close correlations were observed between the mixed subscale score of the BDRS-C and the YMRS score (r = 0.784, p < 0.01). Exploratory factor analysis resulted in three factors: a primary depressive symptoms cluster, a secondary depressive symptoms cluster, and a mixed symptoms cluster.ConclusionThe Chinese version of the BDRS has satisfactory psychometric properties. This is a valid and reliable instrument to assess depressive symptomatology in patients with bipolar disorder.

Behavioral health integration in a nurse-led federally qualified health center: Outcomes of care.

Over the past 20 years, significant evidence has emerged for collaborative care in the treatment of depression and anxiety disorders in primary care. The purpose of this project was to integrate an interprofessional and collaborative care model of behavioral health services into routine nurse-led primary care delivered to vulnerable and underserved populations across the lifespan. Team members included psychiatric nurse practitioners (PMHNPs), a registered nurse, and a case manager. An Access database was developed to track clients seen by the PMHNPs. Three key outcome measures were tracked over time: Posttraumatic Stress Disorder (PTSD) Checklist Civilian Version, Hamilton Depression Rating Scale (HAM-D), and Bipolar Depression Rating Scale (BDRS). A retrospective analysis of client outcome data from January 2017 through December 2019 was conducted. There were 118 patients included who were mostly female (63.6%), White (90.7%), and not Hispanic (69.5%), with Medicaid as their primary insurance (74.6%). For each outcome, models with linear and quadratic function forms for time were fit. The final model for PTSD Checklist Score had a linear functional form for time and the final models for BDRS and HAM-D had linear and quadratic terms for time. All predictors were significantly associated with the outcome. This program demonstrated that a patient-centered, nurse-led team approach to the treatment of depression, bipolar depression, and PTSD can be successful in primary care.

Impact of metabolic syndrome and clinical features on functioning in patients with bipolar disorder: a cross-sectional study.

Objective:The metabolic syndrome (MS) is highly prevalent among patients with bipolar disorder (BD), and may affect progression, functioning, and comorbid conditions in BD. The aim of this study was to investigate the effect of clinical variables and MS on overall functioning and specific areas of functioning in patients with BD.Methods:A total of 210 participants (140 participants with BD I and BD II in remission and 70 non-psychiatric control subjects) were included. The investigators administered the Young Mania Rating Scale (YMRS), the Bipolar Depression Rating Scale (BDRS), the Global Assessment of Functioning Scale (GAF), and the Bipolar Disorder Functioning Scale (BDFS). The participants completed the Beck Depression Scale (BDS) and the Beck Anxiety Scale (BAS). MS was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. Hierarchical regression analysis was used to investigate potential correlations of comorbid MS with clinical variables and level of functioning.Results:Level of functioning did not differ between patients with and without MS. However, there were significant correlations between the level of functioning subscales and the number of depressive episodes (p = 0.033), level of general functioning (p = 0.012), duration of illness (p = 0.012), BDS (p = 0.005), BDRS (p = 0.021), BAS total scores (p = 0.021), number of hypomanic episodes (p = 0.022), number of hospitalizations (p = 0.003), employment status (p = 0.032), and diagnosis of BD I (p = 0.007) and BD II (p = 0.044).Conclusion:Our findings suggest that clinical variables had a greater effect on functioning than MS in BD patients.

Physical Activity as a Predictor of Clinical Trial Outcomes in Bipolar Depression: A Subanalysis of a Mitochondrial-Enhancing Nutraceutical Randomized Controlled Trial.

Individuals with bipolar disorder (BD) generally engage in low levels of physical activity (PA), and yet few studies have investigated the relationship between PA and change in BD symptom severity. The aim of this subanalysis of an adjunctive nutraceutical randomized controlled trial for the treatment of bipolar depression was to explore the relationship between PA, the active adjunctive treatments (a nutraceutical "mitochondrial cocktail"), and clinical outcomes. Participants with bipolar depression were randomized to receive N-acetylcysteine alone, N-acetylcysteine with a combination of nutraceuticals (chosen for the potential to increase mitochondrial activity), or placebo for 16 weeks. Participants (n = 145) who completed the International Physical Activity Questionnaire-Short Form (IPAQ-SF; measured at Week 4) were included in this exploratory subanalysis. Assessments of BD symptoms, functioning, and quality of life were completed at monthly visits up until Week 20. Generalised Estimating Equations were used to explore whether IPAQ-SF scores were a moderator of treatment received on outcomes of the study. Week-4 PA was not related to changes in Montgomery Åsberg Depression Rating Scale scores across the study until Week 20. However, participants who engaged in more PA and who received the combination treatment were more likely to have a reduction in scores on the Bipolar Depression Rating Scale (P = 0.03). However, this was not consistent in all domains explored using the IPAQ-SF. Participants who engaged in higher levels of PA also experienced greater improvement in social and occupational functioning and less impairment in functioning due to their psychopathology and improvement in quality of life at Week 20, irrespective of treatment. This study provides novel evidence of the association between PA and reduction in BD symptoms in a nutraceutical clinical trial. However, further research assessing the potential synergistic effects of PA in BD is required.

Meditation for treating adults with bipolar disorder II: A multi-city study.

There is a need to generate evidence on whether meditation's core aspect of building and nurturing calm and peace serves as a mood stabilizer for current and recurrent episodes of depression through the acute and maintenance phases of treating bipolar disorder II affected patients. A 2-year longitudinal multi-city randomized controlled trial experiment was conducted comprising 311 bipolar disorder II affected patients in the intervention and control group respectively across eight African and Asian cities. The Bipolar Depression Rating Scale (BDRS) was administered with the intervention and control groups that were equal at baseline. Meditation had a positive impact on the intervention group. Post intervention BDRS scores were significantly lower for patients from Asian cities, men, Hindus and Buddhists, middle class, and married patients as well as those who attended all the meditation rounds and regularly self-practiced. Within the BDRS outcome measure, depressive symptoms were impacted the most as compared with mixed symptoms. Meditation helped alleviate guilt, depressed mood, and helplessness-hopelessness. The meditation programme can be used as a combination therapy along with pharmacological treatment to treat mood instability and depression among patients with bipolar disorder II.

Early maladaptive schemas and suicidal risk in inpatients with bipolar disorder

The present study aimed to assess the associations of early maladaptive schemas (EMSs) and clinical factors (hypomanic/manic and depressive symptoms) with suicidal risk (current suicidal ideation and lifetime suicide attempts) in inpatients with bipolar disorder (BD). One hundred inpatients with BD completed the Young Schema Questionnaire-Short Form (YSQ-SF), the Bipolar Depression Rating Scale (BDRS), the Young Mania Rating Scale (YMRS), and the Beck Scale for Suicide Ideation (BSSI). 59% of patients had lifetime suicide attempts and 59% showed high suicidal risk (BSSI ≥ 6). BD patients with lifetime suicide attempts had higher scores on the entitlement and social isolation schemas, depression, and hypomanic/manic symptoms than those without such attempts. Patients with high suicidal risk had higher levels of depressive and hypomanic/manic symptoms as well as some EMSs than those without high suicidal risk. Logistic regression analyses revealed that hypomanic/manic symptoms as well as the entitlement and defectiveness schemas were significantly associated with current suicidal ideation. Also, the entitlement and social isolation schemas were associated with lifetime suicide attempts. These results suggest that the entitlement, social isolation, and defectiveness schemas may relate to suicidal risk in patients with BD.

Psychopathological Features of Bipolar Depression: Italian Validation of the Bipolar Depression Rating Scale (I-BDRS).

Background: Aim of the study was the validation of the Bipolar Disorder Rating Scale (BDRS) in an Italian population. Secondary aim was the evaluation of differences between unipolar and bipolar depression and between bipolar I and II depressed patients.Method: 125 Bipolar Disorder and 60 Major Depressive Disorder patients were administered an Italian translation of the BDRS (I-BDRS), Hamilton Depression Rating Scale (HDRS), Montgomery-Asberg Depression Rating Scale (MADRS), Young Mania Rating Scale (YMRS) and Temperament and Character Inventory-Revised (TCI-R).Results: I-BDRS showed considerable validity and reliability. Factor analysis found 3 subscales, two linked to depressive symptoms and one to mixed symptoms. Measures concerning depression (MADRS and HAM-D) were positively related to the I-BDRS's subscales, but mostly to the two subscales measuring depression. In mixed symptoms, the mean of the bipolar group was significantly higher than the unipolar group suggesting that the BDRS was able to distinguish between unipolar and bipolar depressed patients.Conclusion: I-BDRS is a valid scale for the measurement of depression in BD patients, with a notable internal consistency (Cronbach's α 0.82), a significant consistency between items/total (Cronbach's α from 0.80 to 0.82) and positive correlation with other scales (MADRS r = 0.67, p < 0.001; HDRS r = 0.81, p < 0.001; YMRS r = 0.46 p < 0.0001). The mixed state sub-scale shows usefulness in differentiating bipolar from unipolar patients. I-BDRS could be a sensitive tool, both in pure depression and in mixed states, and could be used in the everyday screening and treatment of Bipolar Disorder.

Eye movement desensitization and reprocessing therapy versus supportive therapy in affective relapse prevention in bipolar patients with a history of trauma: study protocol for a randomized controlled trial

BackgroundUp to 60% of patients with bipolar disorder (BD) have a history of traumatic events, which is associated with greater episode severity, higher risk of comorbidity and higher relapse rates. Trauma-focused treatment strategies for BD are thus necessary but studies are currently scarce. The aim of this study is to examine whether Eye Movement Desensitization and Reprocessing (EMDR) therapy focusing on adherence, insight, de-idealisation of manic symptoms, prodromal symptoms and mood stabilization can reduce episode severity and relapse rates and increase cognitive performance and functioning in patients with BD.Methods/designThis is a single-blind, randomized controlled, multicentre trial in which 82 patients with BD and a history of traumatic events will be recruited and randomly allocated to one of two treatment arms: EMDR therapy or supportive therapy. Patients in both groups will receive 20 psychotherapeutic sessions, 60 min each, during 6 months. The primary outcome is a reduction of affective episodes after 12 and 24 months in favour of the EMDR group. As secondary outcome we postulate a greater reduction in affective symptoms in the EMDR group (as measured by the Bipolar Depression Rating Scale, the Young Mania Rating Scale and the Clinical Global Impression Scale modified for BD), and a better performance in cognitive state, social cognition and functioning (as measured by the Screen for Cognitive Impairment in Psychiatry, The Mayer-Salovey-Caruso Emotional Intelligence Test and the Functioning Assessment Short Test, respectively). Traumatic events will be evaluated by The Holmes-Rahe Life Stress Inventory, the Clinician-administered PTSD Scale and the Impact of Event Scale.DiscussionThe results of this study will provide evidence whether a specific EMDR protocol for patients with BD is effective in reducing affective episodes, affective symptoms and functional, cognitive and trauma symptoms.Trial registrationThe trial is registered at ClinicalTrials.gov, identifier: NCT02634372. Registered on 3 December 2015.

Clinical differences between unipolar and bipolar depression

IntroductionEpidemiological studies indicate that the majority of patients with bipolar disorder are diagnosed many years later. Unipolar depression represents the most frequent misdiagnosis.ObjectivesThis study aimed to examine the symptom profiles of depressed patients in order to identify clinical specificities of bipolar depression.MethodsA total of 31 depressed patients were recruited from psychiatry outpatient department of Hedi Chaker university hospital in Sfax (Tunisia), during October and November 2016. Unipolar and bipolar patients were compared on a broad range of parameters, including sociodemographic and clinical characteristics. Depressive symptoms were rated using the Montgomery Asberg Depression Rating Scale (MADRS) and Bipolar Depression Rating Scale (BDRS).ResultsThe total sample comprised 31 patients with 16 men and 15 women. It involved 20 with unipolar depression and 11 with bipolar depression. Patients with bipolar depression had more family history of bipolar disorder (P = 0.037) and a triggering factor had been identified less often (P = 0.03). MADRS scores were similar in bipolar and unipolar patient (median score 28.22 versus 28.36; P = 0.964). BDRS scores were significantly higher in bipolar depressed patients (median score 33 versus 25; P = 0.01). The mixed subscale (item 16 to 20) scores were particularly higher (median 6 vs. 1.2; P ≤ 0.01) especially concerning irritability (P = 0.001). Increased motor drive (P = 0.004) and agitation (P = 0.008).ConclusionOur findings suggest that the presence of mixed symptoms is very important to recognize depressed patients as having a bipolar disorder. We also recommend routine use of the BDRS for patients presenting for treatment of depression.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Determinants of functioning in euthymic patients with bipolar disorder: A structural equation modelling approach

BackgroundEuthymic patients with bipolar disorder (BD) experience residual symptoms. Interestingly, residual symptoms appear to impact the natural course of BD and represent potential predictors of recurrence and functional impairment.ObjectivesThe study aimed to analyse the relationship between residual depressive symptoms, sleep disturbances and cognitive impairment as determinants of psychosocial functioning in a large sample of euthymic BD patients.MethodsWe performed a cross-sectional study of 468 BD outpatients in clinical remission for at least 6 months. Bipolar Depression Rating Scale (BDRS), Pittsburgh Sleep Quality Index (PSQI) scale, Visual Analogic Scales (VAS) evaluated cognitive impairment and functioning assessment short test were used to assess residual symptomatology and functioning of patients. We evaluated functioning with. Structural equation modelling (SEM) was used to describe the relationships among the residual depressive symptoms, sleep disturbances, perceived cognitive performance and functioning.ResultsSEM showed good fit. This model revealed that residual depressive symptoms (path coefficient = 0.37) and perceived cognitive performance (path coefficient = 0.27) were the most important features significantly related to psychosocial functioning. Sleep disturbances were indirectly associated with functioning via residual depressive symptoms and perceived cognitive performance (path coefficient = 0.23).ConclusionsThis study contributes to a better understanding of the determinants of psychosocial functioning during the interepisodic periods of BD patients. These findings should have implications for the improvement of functioning of BD patients in a personalized approach to treatment.Disclosure of interestCOI: Dr. Samalin reports personal fees and nonfinancial support from Astra-Zeneca, Bristol Myers Squibb, Janssen, Lundbeck, and Otsuka.The authors L. Boyer, A. Murru, I. Pacchiarotti, M. Reinares, C.M. Bonnin, C. Torrent, V. Norma, P. Corinna, I. de Chazeron, M. Boucekine, P.A. Geoffroy, F. Bellivier, P.M. Llorca, E. Vieta have have not supplied their declaration of competing interest.

Residual depressive symptoms, sleep disturbance and perceived cognitive impairment as determinants of functioning in patients with bipolar disorder

BackgroundMany patients with bipolar disorder (BD) experience residual symptoms during their inter-episodic periods. The study aimed to analyse the relationship between residual depressive symptoms, sleep disturbances and self-reported cognitive impairment as determinants of psychosocial functioning in a large sample of euthymic BD patients. MethodsThis was a cross-sectional study of 468 euthymic BD outpatients. We evaluated the residual depressive symptoms with the Bipolar Depression Rating Scale, the sleep disturbances with the Pittsburgh Sleep Quality Index, the perceived cognitive performance using visual analogic scales and functioning with the Functioning Assessment Short Test. Structural equation modelling (SEM) was used to describe the relationships among the residual depressive symptoms, sleep disturbances, perceived cognitive performance and functioning. ResultsSEM showed good fit with normed chi square=2.46, comparative fit index=0.94, root mean square error of approximation=0.05 and standardized root mean square residuals=0.06. This model revealed that residual depressive symptoms (path coefficient =0.37) and perceived cognitive performance (path coefficient=0.27) were the most important features significantly related to psychosocial functioning. Sleep disturbances were indirectly associated with functioning via residual depressive symptoms and perceived cognitive performance (path coefficient=0.23). ConclusionsThis study contributes to a better understanding of the determinants of psychosocial functioning during the inter-episodic periods of BD patients. These findings should facilitate decision-making in therapeutics to improve the functional outcomes of BD during this period.

Feasibility of the Korean version of the Bipolar Depression Rating Scale in Adolescents with Early-Onset Bipolar Disorder.

ObjectiveThis study explores the feasibility and psychometric properties of the Korean version of the Bipolar Depression Rating Scale (BDRS) in adolescents with Early-onset bipolar disorders.MethodsFifty-three participants (aged 13–18) with early-onset bipolar disorders (40 depressed and 18 euthymic, 5 patients were assessed at depressed state and reassessed after remission) were recruited. All participants were assessed using the BDRS, the Hamilton Depression Rating Scale (HAM-D), the Montgomery-Asperg Depression Rating Scale (MADRS), the Young Mania Rating Scale (YMRS), and the Modified Overt Aggression scale (MOAS).ResultsBDRS exhibited good internal validity and significant correlations with the HAM-D and the MADRS. In item to scale correlations, all items on the BDRS were significantly correlated with the BDRS total scores except for ‘increased motor drive’ and ‘increased speech’, ‘depressed mood’ and ‘worthlessness’ showed the highest mean scores and endorsement rates. BDRS score of the depressed group was significantly higher compared with the euthymic group. Three factors (i.e., psychosomatic, mood, and mixed) were identified in the principal component analysis and hierarchical cluster analysis of the BDRS.ConclusionIn this study, we report that the Korean version of BDRS is a feasible and reliable tool for the assessment of depression in adolescents with Early-onset bipolar disorders.