Mood Disorder Questionnaire Research Articles

Investigation of the correlation between mood disorder symptoms and disease activity and functional status in rheumatoid arthritis patients

To investigate the correlation between depressive-anxiety symptoms, mixed features, disease activity, and functional status in patients with rheumatoid arthritis (RA) in the light of the shared underlying etiology in both disorders. The study included 556 patients with RA. RA disease activity was measured using the Disease Activity Score 28-joint count C reactive protein (DAS28-CRP), and the patients were evaluated by a Health Assessment Questionnaire (HAQ). The Hospital Anxiety and Depression Scale (HADS), Mood Disorder Questionnaire (MDQ), and Modified Hypomania Checklist (mHCL) were used to evaluate the mixed depression and bipolarity status of the patients. Of the patients, 430 (77.3%) were female and 126 (22.7%) were male. The median age was 57 years, the median HAQ score was 0.55 points, and the median DAS28-CRP score was 4.1 points. The evaluation of the patients by DAS28-CRP revealed that 58.5% of the patients had moderate and severe disease activity, while only 23.4% of them were in remission. The group using the combination of synthetic disease-modifying anti-rheumatic drugs (sDMARD) and steroid therapy had significantly higher HAD-depression, HAD-anxiety, mHCL, DAS28-CRP, HAQ, and MDQ scores than the group using sDMARD alone. The grouping of the patients based on the DAS28-CRP cut-off scores showed that the patients with moderate and severe disease activity had significantly higher HADS, mHCL, MDQ scores than those in remission and those with mild disease activity (p < 0.001). Disease severity and functional status in RA can be affected by comorbid anxiety-depressive and mixed symptoms. Therefore, clinicians should consider screening the depressive-anxiety and mixed mood symptoms of RA patients. Moreover, patients who use steroid therapy are more susceptible to mood symptoms (anxiety, depression, bipolarity), which should also be considered during the follow-up of patients.

Screening for bipolar disorder in a tertiary mental health centre using EarlyDetect: A machine learning-based pilot study

• Bipolar disorder (BD) detection accuracy can be enhanced using self-report composite measures. • Core symptoms of BD and family history of BD predicts BD. • BD classification remains accurate using as few as 5-10 questions. • Machine-learning approach is effective to enhance BD detection and superior to MDQ. : Bipolar disorder (BD) is a prevalent mental health illness with a direct impact on patient's well-being. Self-report-based BD screening questionnaires such as the Mood Disorder Questionnaire (MDQ) is economical and clinically validated. We use a machine-learning approach to test whether utilizing our composite screening application - EarlyDetect (ED), designed for assessing an array of mental health illness, can enhance bipolar disorder screening over MDQ. : This was a retrospective, naturalistic study at a tertiary mental health centre in western Canada. Participants ( n = 955; 56.4% female; mean age 35.4; 18.7% BD) completed ED and underwent a clinical interview with a blinded psychiatrist for diagnostic accuracy. Elastic net and leave-one-out cross-validation was used to make more confident predictions at an individual level. : Using composite scoring, the balanced accuracy of our tool was 80.6%, with a sensitivity of 73.7% and a specificity of 87.5%. Compared with the MDQ original scoring method, the fully composite ED model improved balanced accuracy by 6.9%, sensitivity by 14.5%, while maintaining specificity. : Patients were assessed using clinical psychiatric evaluations, which are subjective. There is also the potential for self-reporting bias. BD subtypes were not differentiated. The cross-sectional design of this study rules out conclusions of causality. : Our results show improved BD detection accuracy using composite measures.

Investigation of the correlation between mood disorder symptoms and disease activity and functional status in rheumatoid arthritis patients.

To investigate the correlation between depressive-anxiety symptoms, mixed features, disease activity, and functional status in patients with rheumatoid arthritis (RA) in the light of the shared underlying etiology in both disorders. The study included 556 patients with RA. RA disease activity was measured using the Disease Activity Score 28-joint count C reactive protein (DAS28-CRP), and the patients were evaluated by a Health Assessment Questionnaire (HAQ). The Hospital Anxiety and Depression Scale (HADS), Mood Disorder Questionnaire (MDQ), and Modified Hypomania Checklist (mHCL) were used to evaluate the mixed depression and bipolarity status of the patients. Of the patients, 430 (77.3%) were female and 126 (22.7%) were male. The median age was 57 years, the median HAQ score was 0.55 points, and the median DAS28-CRP score was 4.1 points. The evaluation of the patients by DAS28-CRP revealed that 58.5% of the patients had moderate and severe disease activity, while only 23.4% of them were in remission. The group using the combination of synthetic disease-modifying anti-rheumatic drugs (sDMARD) and steroid therapy had significantly higher HAD-depression, HADanxiety, mHCL, DAS28-CRP, HAQ, and MDQ scores than the group using sDMARD alone. The grouping of the patients based on the DAS28-CRP cut-off scores showed that the patients with moderate and severe disease activity had significantly higher HADS, mHCL, MDQ scores than those in remission and those with mild disease activity (p < 0.001). Disease severity and functional status in RA can be affected by comorbid anxiety-depressive and mixed symptoms. Therefore, clinicians should consider screening the depressive-anxiety and mixed mood symptoms of RA patients. Moreover, patients who use steroid therapy are more susceptible to mood symptoms (anxiety, depression, bipolarity), which should also be considered during the follow-up of patients.

#3108 Initial assessment structure in a specialist outpatient clinic for acquired brain injury in adults

Consistent with the NHS quality agenda, Dept. of Health, 20111 there has been a drive to routinely incorporate outcome and performance measurement data in clinical practice. An absolute requirement within NHS services2 are Patient-Rated Outcome Measures (PROMS) which are used by some Royal College of Psychiatry faculties to quantify outcomes, improve accountability, performance management and service. They can also be used to screen for common health problems and ensure the comprehensive assessment of complex Acquired Brain Injury (ABI) Patients who typically present with various neurological and psychiatric comorbidities.The North Bristol NHS Trust Outpatient Clinic at The Frenchay Brain Injury Rehabilitation Centre and The Rosa Burden, Southmead Hospital, conducts new assessments and regular patient reviews for referrals from South West England. As part of a quality improvement initiative a semi-structured process of assessment was trialled, to improve patient experience by providing a comprehensive initial assessment, improving treatment productivity and reducing over-running clinics.MethodReferrals were audited and common reasons for referrals identified. Questionnaires and tools used in the clinic were reviewed and those most frequently used were compiled. The evidence for questionnaires utilized for different psychiatric comorbidities and applicability in ABI was examined in the literature. The finalized patient questionnaires booklet section and their sequence was decided based on expert peer recommendations and patient feedback. The collateral section was similarly developed with some questionnaires modified for operational reasons.SECTION ONE: SELF RATED PRE-ASSESSMENT QUESTIONNAIRERivermead Post Concussion Symptoms Questionnaire, Patient Health Questionnaire (15): Somatic Screen, Patient Health Questionnaire-9: Depression screen, General Anxiety Disorder 7: Anxiety screen, Mood Disorder Questionnaire: Bipolar Affective Disorder screen and the Civilian Version PTSD Checklist.SECTION TWO: CARER/FAMILY PRE-ASSESSMENT QUESTIONNAIREModified Overt Aggression Scalescreen for aggression, Neuropsychiatry Inventory Questionnaire: assesses psychiatric symptoms in patients with neurological disordersOutcomeThe final booklet was divided into three sections:Patient-Rated, ObserverRated and Clinician Section. Consultation efficiency was improved with the Patient and Observer rated sections completed prior to the initial assessment. The checklist is used for all initial assessments with good uptake and allowed for standardization of clinical information gathering. PROMs for mood are collected at each clinic appointment with other domains repeated if abnormal at initial clinic assessment or clinically relevant.References Fossey M, Parsonage M. Outcomes and performance in liaison psychiatry: developing a measurement framework. Centre for Mental Health and Royal College of Psychiatrists Report June 2014. Trigwell P, Kustow J, Santhouse A, et al. Framework for routine outcome measurement in liaison psychiatry (FROM-LP): faculty of liaison psychiatry royal college of psychiatrists faculty report. The Royal College of Psychiatrists 2015. vretveit J, Zubkoff L, Nelson EC, et al. Using patient-reported outcome measurement to improve patient care. Int J Qual Health Care 2017 Oct 1;29(6):874879.

Psychological predictors of bipolarity in panic disorder.

BACKGROUNDPanic disorders frequently occur with affective disorders, particularly bipolar disorder. Patients with panic disorder and bipolar disorder are more likely to present with severe symptoms, such as high rates of suicidal behavior, poor symptomatic and functional recovery, and poor drug responses.AIMTo investigate the psychological characteristics of panic disorder patients related to bipolarity.METHODSA total of 254 patients (136 men and 118 women, mean age = 33.48 ± 3.2 years) who were diagnosed with panic disorder were included in the study. Panic disorder with bipolarity (BP+) was defined as a score of ≥ 7 on the Korean version of the Mood Disorder Questionnaire (K-MDQ), and a score lower than 7 was considered as a panic disorder without bipolarity (BP-). Self-report questionnaires were analyzed to examine their association with bipolarity. Psychological tests used in the study were the Mood Disorder Questionnaire (MDQ), Panic Disorder Severity Scale, Beck Depression Inventory, State-Trait Anxiety Inventory (STAI), Temperament and Character Inventory (TCI), and Minnesota Multiphasic Personality Inventory (MMPI). Statistical analyses were performed to evaluate the correlation between bipolarity of panic disorder patients and various psychological test results indicative of psychological characteristics.RESULTSPatients with a K-MDQ score of 7 or more were considered to have a history of manic or hypomanic episodes (BP+ group, n = 128), while patients with K-MDQ scores below 7 were defined as those without bipolarity (BP- group, n = 126). The BP+ group were more likely to be unmarried (single 56.2% vs 44.4%, P = 0.008) and younger (30.78 ± 0.59 vs 37.11 ± 3.21, P < 0.001). Additionally, the BP+ group had significantly higher scores on psychological assessment scales, such as the hypochondriasis, psychopathic deviate, masculinity-femininity, psychasthenia, schizophrenia, and hypomania (Ma) in MMPI, and novelty seeking, harm avoidance and self-transcendence in TCI, and STAI (state and trait) compared to the BP- group. In logistic regression analysis, depression in MMPI, self-directedness in TCI, and age were negatively associated with MDQ score, meanwhile, Ma in MMPI and STAI (trait) were positively associated with MDQ score.CONCLUSIONThe result of this study suggests that almost 50% of patients with panic disorder are likely to have hypomanic or manic symptoms, and certain psychological factors are associated bipolarity in panic disorder.

Self-report screening instruments differentiate bipolar disorder and borderline personality disorder.

BackgroundBipolar disorder (BD) and borderline personality disorder (BPD) share overlapping phenomenology and are frequently misdiagnosed. This study investigated the diagnostic accuracy of the Mood Disorder Questionnaire (MDQ) and McLean Screening Instrument for Borderline Personality Disorder (MSI) in a clinical inpatient setting and whether individual screening items could differentiate BD from BPD.Methods757 sequential inpatients admitted to a Mood Disorder Unit completed both the MDQ and MSI. Screen positive for the MDQ was defined as ≥7/13 symptoms endorsed with concurrence and at least moderate impact. Screen positive for the MSI was defined as a score of ≥7. The clinical discharge summary diagnosis completed by a board‐certified psychiatrist was used as the reference standard to identify concordance rates of a positive screen with clinical diagnosis. Individual items predicting one disorder and simultaneously predicting absence of other disorder by odds ratio (OR>and <1) were identified.ResultsBoth screening instruments were more specific than sensitive (MDQ 83.7%/ 67.8%, MSI 73.2% / 63.3%). MDQ individual items (elevated mood, grandiosity, increased energy, pressured speech, decreased need for sleep, hyperactivity) were significant predictors of BD diagnosis and non‐predictors of BPD diagnosis. Whereas MSI subitem, self‐harm behaviors/suicidal attempts predicted BPD in the absence of BD; distrust and irritability were additional predictors of BPD.ConclusionWhile this study is limited by the lack of structured diagnostic interview, these data provide differential symptoms to discriminate BD and BPD. Further work with larger datasets and more rigorous bioinformatics machine learning methodology is encouraged to continue to identify distinguishing features of these two disorders to guide diagnostic precision and subsequent treatment recommendations.

The relationship between circadian typology and lifetime experiences of hypomanic symptoms

Circadian rhythms have been known to be associated with bipolar disorders. There are many cases in which hypomanic symptoms are not recognized as indicators of an illness. This study aimed to determine the correlation between the experience of lifetime hypomanic symptoms and circadian typology of university students. A total of 8,562 university students participated in the study. The participants completed the Composite Scale of Morningness (CSM) for circadian typology and Mood Disorder Questionnaire (MDQ). Chi-square test and analysis of variance were performed, and the post-hoc result was computed using the FDR adjusted p-values. Overall, the MDQ score was higher in the evening-type group. There was no significant difference between the intermediate-type group and morning-type group for male students. In the evening-type group, the positive response rate was significantly higher for 10 out of 13 items in the MDQ. The evening-type group was more likely to experience hypomanic symptoms. This study showed that circadian and seasonal characteristics related to circadian typology are associated with lifetime hypomanic symptoms. Hence, further investigation is needed to determine the eveningness trait, as it could be a trait marker of bipolar spectrum disorder.

589 Identification of bipolar disorder in the perinatal context: the role of the mood disorder questionnaire

Optimizing perinatal outcomes for women with bipolar disorder (BD) requires identification and effective treatment. However, recognition of BD during the perinatal period is challenging as the phenotypic expression most often overlaps with perinatal unipolar depression. Misdiagnosis of postpartum depressive symptoms can have detrimental consequences, yet the optimal approach to distinguish between unipolar and bipolar depression in the perinatal period is unclear. This retrospective cohort study included all women enrolled in a perinatal collaborative care program (COMPASS) between 1/2017 and 9/2020. During this time, the intended approach for all obstetric patients included universal screening for depression twice antenatally and once postpartum. Women with positive screening questionnaires for depression were referred to COMPASS for ongoing management. Once referred, women were asked to complete a series of additional screening questionnaires for other mental health conditions, including the Mood Disorder Questionnaire (MDQ) for BD. Women with any clinical concern for BD based on these evaluations or on clinical assessment by COMPASS social workers were then evaluated by a perinatal psychiatrist and a formal psychiatric diagnosis was made. We compared sociodemographic and clinical characteristics of all women who had enrolled in COMPASS with and without BD in bivariable analyses. We then evaluated test characteristics of the MDQ for identification of BD. During the study period, 1228 women were enrolled in COMPASS and 50 (4.1%) were diagnosed with BD by a psychiatrist. Compared to women without BD, women with BD were more likely to have public insurance and were less likely to be married (Table 1) with no other identified differences. The MDQ had a good discriminatory capacity for BD (AUC=0.82) with test characteristics at each score cut-off depicted in Table 2. The MDQ can be used in the setting of a positive perinatal depression screen to identify women with BD. A score of at least 8 provides reasonable discrimination with 90% of women being correctly classified.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

The Rapid Mood Screener (RMS): a novel and pragmatic screener for bipolar I disorder

Objective Depressive episodes and symptoms of bipolar I disorder are commonly misdiagnosed as major depressive disorder (MDD) in primary care. The novel and pragmatic Rapid Mood Screener (RMS) was developed to screen for manic symptoms and bipolar I disorder features (e.g. age of depression onset) to address this unmet clinical need. Methods A targeted literature search was conducted to select concepts thought to differentiate bipolar I from MDD and screener tool items were drafted. Items were tested and refined in cognitive debriefing interviews with individuals with self-reported bipolar I or MDD (n = 12). An observational study was conducted to evaluate predictive validity. Participants with clinical interview-confirmed bipolar I or MDD diagnoses (n = 139) completed a draft 10-item screening tool and other questionnaires. Data were analyzed to identify the smallest possible subset of items with optimized sensitivity and specificity. Results Adults with confirmed bipolar I (n = 67) or MDD (n = 72) participated in the observational study. Ten draft screening tool items were reduced to 6 final RMS items based on the item-level analysis. When 4 or more items of the RMS were endorsed (“yes”), sensitivity was 0.88 and specificity was 0.80; positive and negative predictive values were 0.80 and 0.88, respectively. These properties were an improvement over the Mood Disorder Questionnaire in the same analysis sample while using 60% fewer items. Conclusion The pragmatic 6-item RMS differentiates bipolar I disorder from MDD in patients with depressive symptoms, providing real-world guidance to primary care practitioners on whether a more comprehensive assessment for bipolar I disorder is warranted.

Bipolar disorder: Prevalence, help-seeking and use of mental health care in England. Findings from the 2014 Adult Psychiatric Morbidity Survey

BackgroundTo date, the lifetime prevalence of Bipolar Disorder (BD) and BD patients’ access to mental health care in England has not been systematically studied. MethodsWe used data from the Adult Psychiatric Morbidity Survey 2014 (N = 7546). The Mood Disorders Questionnaire (MDQ) was used to screen for BD. Associations between sociodemographic and clinical variables and use of mental health services were investigated. Weighted regression modelling established factors associated with being in receipt of care for mental health problems over the last year. ResultsThe lifetime prevalence of BD in the community in England was 1.7%. Approximately 40% had not received mental health care in the last year, and only 16.9% had received BD specific treatment. 14.6% had asked for a specific form of help but not received it. Psychopathology differed between individuals who successfully sought care and those who didn't. Obtaining care was independently associated with female sex (p<0.0001, odds ratio(OR):4.65 (Confidence Interval (CI):2.18–10.30), unemployment (p = 0.02, OR: 2.65 (C.I: 1.23–5.88) and suicidal ideation (p = 0.04, OR: 3.36, (C.I: 1.04–10.89). LimitationsThe MDQ is less sensitive than some of the longer measures, especially in the general population. Some between-group comparisons may have suffered from limited power. ConclusionsThe lifetime prevalence of BD in England was similar to rates worldwide. Most people with BD had not received any specific treatment for the condition in the last year, while 1 in 7 had requested specific help but did not receive it. Secondary mental health services in England for BD appear suboptimal.

Irritability and mood symptoms in adolescent girls: Trait anxiety and emotion dysregulation as mediators

BackgroundIrritability is a common symptom in youth that is thought to be predictive of mood disorders. Its effects on mood are likely to be age-dependent, with direct and indirect mediators. We assessed age-related effects and mediators of irritability in adolescent girls with subthreshold depressive and manic symptoms. MethodsWe analysed the irritability item from the Mood Disorder Questionnaire in 3 cohorts of girls aged 12-18years (N=229); 12-13years (N=82); 14-15years (N=68); and 16-18years (N=79). They also completed mood, anxiety and emotion regulation questionnaires. MANOVA, correlations and bootstrapped mediation analyses were performed with SPSS®v25 and Hayes Processv3.5®. ResultsOverall, irritable girls had higher depressive and manic symptoms, trait anxiety and emotion dysregulation than those who were not irritable. Significantly higher rates of irritability were observed in mid-adolescents (aged 14-15years; p = 0.001). Notably, irritability exerted effects on depressive symptoms via trait anxiety, non-acceptance of emotions and dysregulation in emotion clarity throughout adolescence. However, irritability directly exerted effects on manic symptoms in mid-adolescence but in older adolescents, their relationship was indirect via impulse control dysregulation. LimitationsThe cross-sectional design and non-clinical sample limit generalisability of our findings. ConclusionsIrritability is involved in subthreshold depressive symptoms, via trait anxiety and perceptual emotion dysregulation. On the other hand, irritability is directly and indirectly associated with subthreshold manic symptoms via dysregulated impulse control depending on age. Therefore, screening for irritability, trait anxiety and emotion dysregulation throughout adolescence may facilitate the early detection of subthreshold depressive and manic symptoms, and the implementation of preventive strategies.

Current and Retrospective Childhood Ratings of Emotional Fluctuations in Adults With ADHD.

Introduction: Emotional fluctuations and mood swings are common among adults with Attention Deficit/Hyperactivity Disorder (ADHD). Here we investigated if these problems could be retrospectively traced back to childhood behavior.Methods: Adults with an ADHD diagnosis (n = 502, 48% female) and a population-based control sample (n = 818, 59% female) completed the Adult ADHD Self-report Scale (ASRS), the Wender Utah Rating Scale (WURS) and the Mood Disorder Questionnaire (MDQ). All participants also provided self-reported information about co-existent psychiatric and somatic diseases, and demographic data. Reports on the MDQ were used to define subgroups with [MDQ(+)] and without [MDQ(–)] life-time periods of emotional fluctuations and the WURS scale was used to retrospectively assess childhood ADHD related behaviors and symptoms.Results: 50.2% of the ADHD group and 5% of the controls were defined with emotional fluctuations [MDQ(+)]. Childhood behavior ratings of “impulsivity,” “loosing of control,” and “trouble with authorities” independently predicted emotional fluctuations reported in adulthood via logistic regression analyses. Inclusion of these three items in a classification analysis gave an accuracy score around 70% in identifying each of the two MDQ categories in the ADHD group.Discussion: The strong association between self-reported features of emotional problems in childhood and in adulthood suggests a trajectory that should be detected and remediated at an early age. Future longitudinal studies should prioritize the examination of developmental mechanisms explaining the persistence of emotional problems from childhood into adulthood.

Symptoms of bipolar disorder are associated with lower bariatric surgery completion rates and higher food addiction

BackgroundBipolar disorder (BP) is highly comorbid with obesity, however, little is known about how BP might be associated with bariatric surgery outcomes. MethodsIn this retrospective clinical cohort study, 1034 patients completed a psychological evaluation, and screening positive for possible BP was defined as a score ≥7 and moderate disability on the Mood Disorders Questionnaire. Food addiction (FA), subthreshold binge eating disorder (BED), and illegal drug use were also assessed using standardized questionnaires. ResultsThe 54 (5.2%) patients screening positive for BP were less likely to have bariatric surgery compared to 980 (94.8%) patients who screened negative for BP (5 patients or 9.3% vs 273 patients, or 27.9%). Patients with possible BP also had significantly higher prevalence of FA (37% vs 13.2%), subthreshold BED (29.6% vs 8.3%) and illegal drug use (7.4% vs 2.1%). ConclusionsIn this retrospective clinical cohort study, patients who screened positive for BP had a higher prevalence of food addiction, subthreshold binge eating disorder and recent illegal drug use. They also demonstrated lower completion rates for having bariatric surgery. Clearly, more needs to be learned about how to help patients with symptoms of bipolar disorder manage their obesity and behavioral challenges.

Clinical Correlates of False Positive Assignment in Bipolar Screening Measures Across Psychiatric Diagnoses among Patients without Bipolar Disorder.

ObjectiveIn this study, we aimed to determine clinical correlates of false positive assignment (FPA) on commonly used bipolar screening questionnaires. MethodsA retrospective chart review was conducted to a total of 3885 psychiatric outpatients. After excluding patients who have bipolar spectrum illnesses, patients who were assigned as having hypomania on the mood disorder questionnaire (MDQ) or the hypomania checklist-32 (HCL-32) were identified as patients who had FPA. Psychiatric diagnoses and severity of emotional symptoms were compared between patients with and without FPA. ResultsPatients with FPA on the MDQ showed significant associations with presence of major depressive disorder, generalized anxiety disorder, and alcohol-use disorder, while patients with FPA on the HCL-32 showed associations with presence of panic disorder and agoraphobia. FPA on the MDQ was also associated with greater emotional symptoms and lifetime history of suicide attempts. Logistic regression analysis showed that male sex, younger age, presence of alcohol-use disorder, and severity of depression and obsessive-compulsive symptoms were significantly associated with FPA on the MDQ. ConclusionThe FPA for the MDQ was associated with clinical factors linked to trait impulsivity, and the FPA for both the MDQ and the HCL-32 could be related to increased anxiety.

Comparison of Psychological Status and Investment Style Between Bitcoin Investors and Share Investors.

Bitcoin has unique characteristics that have inspired people to invest in it as well as distinct drawbacks. With a rapid increase in Bitcoin prices in the short term, more investors enthusiastically began investing in it, raising concerns about a speculative bubble. This study investigated the multiple factors involved in the Bitcoin craze despite concerns about its shortcomings. In what concerns to personality traits and psychological states, online use patterns, and investment patterns, we first hypothesized that Bitcoin investors would show differences in multiple factors when compared to share investors. Based on our assumptions about these differences, we secondly hypothesized that investors’ personality, psychological states, and investment patterns could predict whether they would invest in Bitcoin or shares. In total, 307 respondents completed the research protocol and were sorted into Bitcoin investors (n = 101), share investors (n = 102), and non-investors (n = 104). A self-report questionnaire on demographic data, online use patterns, investment patterns as well as the Fear of Missing Out (FoMO) scale, Temperament and Character Inventory-Revised-Short (TCI-RS), Mood Disorder Questionnaire (MDQ), trait anxiety part of the State-Trait Anxiety Inventory (STAI-T), and the Korean version of the Canadian Problem Gambling Index (K-CPGI) were administered. The results of this study indicated that Bitcoin investments can be attributed to the interaction of multiple factors, among which personality, psychological states, and investment patterns are particularly important. Specifically, the investment pattern is the strongest predictive factor for Bitcoin investment. Bitcoin investors were distinct with regard to higher novelty seeking, higher gambling tendencies, and unique investment patterns. Thus, personality, psychological states, and investment patterns could explain the substantial investments in Bitcoin.

Suicidal behavior is four times more frequent in university students with bipolar disorder assessed by an online version of Mood Disorder Questionnaire

Introduction: Bipolar disorder (BD) in young people is frequently associated with suicidal behavior. The main objective of this research is to evaluate if university students who have BD show more suicidal behavior than those who do not have BD. Materials and Methods: 583 university students from Fortaleza, Brazil, participated in this study. Volunteers over 18 years of age who were attending public or private universities from March to December 2019 were able to participate. A sociodemographic and clinical questionnaire and the Mood Disorder Questionnaire (MDQ) were filled out. According to MDQ, participants were classified into three groups: 1) individuals without BD (n=318); 2) individuals with subthreshold BD symptoms (n=160); 3) individuals with BD (n=105). Results: Compared to those who do not have BD, individuals with BD had four times less plans for the future (x2=16.00; p=0.000), considered four times life less worth living (x2=13.44; p=0.001), assumed two times more frequently death as welcome if it comes (x2=19.10; p=0.000), thought two times more about getting hurt (x2=75.32; p=0.000), had seven times more specific plans to die (x2=39.93; p=0.000) and had four times more suicide attempts (x2=33.50; p=0.000). Conclusions: Suicidal behavior was four times more prominent in university students with BD than in those who did not have BD.

Suicidal behavior is four times more frequent in university students with bipolar disorder assessed by an online version of Mood Disorder Questionnaire

Suicidal behavior is four times more frequent in university students with bipolar disorder assessed by an online version of Mood Disorder Questionnaire

Bipolar Spectrum in Patients with Conversion Disorder

Background: The frequency of bipolar spectrum in patients with conversion disorder is not well known, while it is important to be aware of comorbid bipolarity in the management of conversion disorder. Objectives: The study aimed to identify the frequency of bipolar spectrum disorder among people with conversion disorder and the factors associated with this comorbidity. Methods: The participants were 96 consecutive patients aged 18 - 65 years, referring to the emergency department or admitted to the psychiatric wards of two university general hospitals in Tehran, Iran, in 2019. Patients fulfilled the DSM-IV criteria for conversion disorder based on the structured clinical interview (SCID). The Mood Disorder questionnaire (MDQ) was used to identify bipolar spectrum disorder. Demographic characteristics and other relevant correlated factors were also recorded using a checklist. Data were analyzed using Pearson chi-square/Fisher’s exact test and logistic regression model. Results: The frequency of bipolar spectrum disorder based on the MDQ was 35.4% in patients with conversion disorder. The results of the logistic regression model using the Backward Conditional method showed that only two variables, namely antidepressant-induced mania/hypomania (OR = 39; CI 95%: 4.56 - 333.7) and history of hospitalization in the psychiatric ward (OR = 7.1, CI 95%: 2.05 - 24.65), remained as associated factors after controlling for other variables. Conclusions: Our study showed a higher frequency of bipolar spectrum disorder in patients with conversion disorder than did previous epidemiological studies in Iran and other countries. Such significant comorbidity should discourage potentially harmful off-label use of antidepressants for the treatment of conversion disorder instead of looking for other underlying psychiatric or social problems. Further research is suggested in this area.

Bidirectional comorbidity between bipolarand obsessive-compulsive disorders: symptoms frequency, treatment challenges and underexplored areas

The high comorbidity of bipolar- (BD) and obsessive-compulsive disorder (OCD) is a challenge in the psychiatric field. This topic has been scarcely investigated in Latin America, and we could not find published studies conducted in Venezuela. Given the common difficulty to establish a categorical diagnosis in comorbid conditions, we assessed the frequency of current OC symptoms (OCS) in subjects with primary BD, and of BD symptoms (BDS) insubjects with primary OCD. We administered the Yale-Brown Obsessive-CompulsiveScale (Y-BOCS) to 40 patients with BD, and the Young Mania RatingScale (YMRS) and the Mood Disorder Questionnaire (MDQ) to 42 patients withOCD. We observed clinically significant OCS (Y-BOCS score ≥ 16) in 20% of BDsubjects, and current hypomania or mania in 16.7% and 19% of OCD patientsrespectively. A significant positive correlation between age and YMRS was detectedin OCD females, p = 0.04. We here confirmed the high comorbidity inthe bipolar and obsessive-compulsive dimensions. Numerous studies identifythe clinical burden, diagnostic difficulties and treatment intricacy of this comorbidity,which warrants for further research to assist this sensible population.We illustrate the challenges of pharmacological and psychological treatment,and the issue of family history of psychopathology, with two conspicuousclinical vignettes extracted from the studied sample.

The Factor Structure of the Mood Disorder Questionnaire in Tunisian Patients.

Background:The Mood Disorder Questionnaire (MDQ) is a frequently used screening tool for the early detection of Bipolar Disorder (BD), which is often unrecognized or misdiagnosed at its onset. In this study, data from Tunisia has been used to evaluate the psychometric properties of the Arabic MDQ.Methods:The sample included 151 patients with a current major depressive episode. The Arabic adapted version of the Structured Clinical Interview for DSM-IV-TR was used to formulate a diagnosis, yielding 62 patients with BD and 89 with unipolar Major Depressive Disorder (MDD). Principal component analysis with parallel analysis was used to establish the spontaneous distribution of the 13 core items of the MDQ. Confirmatory Factor Analysis (CFA) was used to check the available factor models. Receiver Operating Characteristic (ROC) analysis was used to assess the capacity of the MDQ to distinguish patients with BD from those with MDD.Results:Cronbach’s α in the sample was 0.80 (95%CI: 0.75 to 0.85). Ordinal α was 0.88. Parallel analysis suggested two main components, which explained 59% of variance in the data. CFA found a good fit for the existing unidimensional, the two-factor, and the three-factor models. ROC analysis showed that at a threshold of 7, the MDQ was able to distinguish patients with BD from those with MDD with extraordinary negative predictive value (0.92) and a positive diagnostic likelihood ratio of 3.8.Conclusion:The Arabic version of the MDQ showed good measurement properties in terms of reliability, factorial validity and discriminative properties.