Exploring Informative Items for Bipolar Disorder Classification Using Machine Learning With Anger Coping Styles in Combination With the Mood Disorder Questionnaire and Bipolar Spectrum Diagnostic Scale

BackgroundScreening scales for bipolar disorder including the Mood Disorder Questionnaire (MDQ) and Bipolar Spectrum Diagnostic Scale (BSDS) have been plagued by high false positive rates confounded by presence of borderline personality disorder. This study examined the accuracy of these scales for detecting bipolar disorder among patients referred for eating disorders and explored the possibility of simultaneous assessment of co-morbid borderline personality disorder.MethodsParticipants were 78 consecutive female patients who were referred for evaluation of an eating disorder. All participants completed the mood and eating disorder sections of the SCID-I/P and the borderline personality disorder section of the SCID-II, in addition to the MDQ and BSDS. Predictive validity of the MDQ and BSDS was evaluated by Receiver Operating Characteristic analysis of the Area Under the Curve (AUC).ResultsFifteen (19%) and twelve (15%) patients fulfilled criteria for bipolar II disorder and borderline personality disorder, respectively. The AUCs for bipolar II disorder were 0.78 (MDQ) and 0.78 (BDSD), and the AUCs for borderline personality disorder were 0.75 (MDQ) and 0.79 (BSDS).ConclusionsAmong patients being evaluated for eating disorders, the MDQ and BSDS show promise as screening questionnaires for both bipolar disorder and borderline personality disorder.

The Bipolarity index: a clinician-rated measure of diagnostic confidence

Youth with depression may be at a higher risk of developing bipolar disorder (BD). Self-reported, dimensional measures, like the Bipolar Spectrum Diagnostic Scale (BSDS), aim to assess for BD in these groups. We explored properties of this instrument within a cohort of depressed, help-seeking youth. We used baseline data from two randomized controlled trials for depressed youth (aged 15-25years) who had no history of BD or psychosis and who completed the BSDS (n=240; mean Age=19.9years, SD=2.7; Female=57%). Structured diagnostic assessments were repeated at 26-weeks to detect new-onset BD. We examined false-positive rates for concurrent BD using established thresholds on the BSDS, utilised factor analyses to determine its underlying structure, and explored associations between the BSDS and demographic, clinical, and personality variables using linear regressions. False-positives rates were high. Most (60%) participants scored above BSDS thresholds at baseline, though none developed BD over the 26-week study period. A three-factor model best fit BSDS items, representing depression, mania, and lability factors. BSDS total, mania and lability sub-scale scores were associated with similar characteristics, with a different pattern of association for the BSDS depression subscale. With no long-term follow-up of the current sample nor a separate bipolar youth sample, we were unable to determine the overall discriminant validity, sensitivity, or longer-term predictive validity of the BSDS. At recommended thresholds, BSDS has high false positive rates for detecting current BD in youth with moderate to severe depression, especially with mental state or personality disorder comorbidities.

Revue de presse

Purpose: Bipolar disorder (BD) is characterized by alternating episodes of mania or hypomania and depression, resulting in substantial psychosocial impairment. Despite its clinical importance, BD is frequently underrecognized or misdiagnosed as major depressive disorder (MDD) or other psychiatric conditions. This review aims to summarize current diagnostic criteria, key clinical differentiating features, and validated assessment tools in order to enhance diagnostic accuracy and facilitate earlier recognition in clinical practice.Current concepts: The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), and the International Classification of Diseases, 11th Revision, define mania and hypomania by abnormal mood elevation accompanied by increased activity or energy. Bipolar I disorder requires the presence of at least one manic episode, whereas bipolar II disorder requires both hypomanic and major depressive episodes. Cyclothymic disorder and broader bipolar spectrum concepts emphasize subthreshold or atypical presentations that may be overlooked by categorical diagnostic systems. Structured and self-report instruments, including the structured clinical interview for DSM-5-TR, mood disorder questionnaire, hypomania checklist-32, bipolar spectrum diagnostic scale, and Young mania rating scale, play an important role in standardized assessment and longitudinal monitoring.Discussion and conclusion: Accurate diagnosis of BD requires integration of structured diagnostic interviews, standardized rating scales, collateral information, and longitudinal clinical observation. The differential diagnosis from MDD, borderline personality disorder, attention-deficit/hyperactivity disorder, and schizophrenia depends on careful evaluation of episode duration, illness course, and associated functional impairment. Future diagnostic approaches may benefit from dimensional and personalized models incorporating biomarkers, neuroimaging, and digital phenotyping.

The relationship between chronotype and mood fluctuation in the general population

The link between bipolarity and substance use: A controlled clinic based study.

The broad clinical spectrum of bipolar disorder is under-diagnosed and may affect up to 5% of the population. In recent years, several instruments have been developed to aid screening, diagnosis and research into bipolar spectrum disorders. Here we review the strengths and limitations of these instruments, which include the Mood Disorder Questionnaire (MDQ), the Hypomania Checklist (HCL-32) and the Bipolar Spectrum Diagnostic Scale (BSDS). We focus on the potential use of these instruments in primary care and community psychiatric settings.

Screening for bipolar disorders in Spanish-speaking populations: Sensitivity and specificity of the Bipolar Spectrum Diagnostic Scale–Spanish Version

Screening for bipolar disorder in a Spanish sample of outpatients with current major depressive episode

The lifetime prevalence of bipolar disorders and the use of antidepressant drugs in bipolar depression in Italy

Optimization of the Mood Disorder Questionnaire in identification of perinatal bipolar disorder

Cross validation with the mood disorder questionnaire (MDQ) of an instrument for the detection of hypomania in Brazil: The 32 item hypomania symptom check-list, first Revision (HCI-32-R1)

The diagnosis of mood disorders (MD) during pregnancy is challenging and may bring negative consequences to the maternal-fetal binomial. The long waitlist for specialized psychiatric evaluation in Brazil contributes to the treatment omission. Almost 20.0% of women treated with antidepressants have a positive screening for bipolar disorder. Therefore, it has been recommended the investigation of depressive and bipolar disorder during prenatal care. Unfortunately, the screening for mood disorders is not a reality in Brazil and many childbearing women remain undiagnosed. The objective of this study is to observe the frequency of MD and the effectiveness of screening scales for routine use by health professionals during prenatal care in high-risk pregnancies. This cross-sectional study included 61 childbearing women in their second trimester who were interviewed using the Edinburgh Postnatal Depression Scale (EPDS) and the Mood Disorder Questionnaire (MDQ). The cut-off point was EPDS ≥ 13 and MDQ ≥ 7 and the SCID-5 was the gold standard diagnosis. MD were diagnosed in 24.6% of the high-risk pregnancies. EDPS was positive in 19.7% and the frequency of major depression was 8.2%. 16.4% of the childbearing women were diagnosed with bipolar disorder, while MDQ was positive in 36.1%. 11.5% of the women had EPDS and MDQ positive. EPDS sensitivity was 80.0% and specificity 92.1%, whereas MDQ presented a sensitivity of 70.0% and specificity of 70.6%. There is a high prevalence of MD in high-risk pregnancies. The routine use of EPDS simultaneously to MDQ during antenatal care is effective and plays an important role in early diagnosis, counselling, and promotion of perinatal mental health.

BackgroundStudies about the two most used and validated instruments for the early detection of Bipolar Disorder (BD), the 32 - item Hypomania Checklist (HCL - 32) and the Mood Disorder Questionnaire (MDQ), are scarce in non-Western countries. This study aimed to explore the reliability, factor structure, and criterion validity of their Arabic versions in a sample of Tunisian patients diagnosed with mood disorders.MethodsThe sample included 59 patients with BD, 86 with unipolar Major Depressive Disorder (MDD) and 281 controls. Confirmatory factor analysis was applied to show that a single global score was an appropriate summary measure of the screeners in the sample. Receiver Operating Characteristic analysis was used to assess the capacity of the translated screeners to distinguish patients with BD from those with MDD and controls.ResultsReliability was good for both tools in all samples. The bifactor implementation of the most reported two-factor model had the best fit for both screeners. Both were able to distinguish patients diagnosed with BD from putatively healthy controls, and equally able to distinguish patients diagnosed with BD from patients with MDD.ConclusionBoth screeners work best in excluding the presence of BD in patients with MDD, which is an advantage in deciding whether or not to prescribe an antidepressant.