RESUMO

OBJECTIVE: To assess the sensitivity and specificity of two self-report instruments for detection of bipolarity in a sample of Argentinean patients. METHOD: Spanish versions of the MDQ and the BSDS were administered over four months at 11 sites in Argentina. Diagnoses were made using DSM-IV criteria and the MINI. The study sample consisted of patients diagnosed with Bipolar Disorder (BD) Types I, II, or NOS. BDNOS diagnoses were made using extended guidelines for bipolar spectrum symptoms. Unipolar patients were used as a control group. Of 493 patients screened, 354 completed evaluation by MDQ and MINI, and 363 by BSDS and MINI. RESULTS: Specificity of MDQ was 0.97 and BSDS was 0.81. MDQ sensitivity was 0.70 for bipolar type I (BD-I), 0.52 for bipolar II (BD-II) and 0.31 for bipolar not otherwise specified (BDNOS). BSDS sensitivities were 0.75, 0.70 and 0.51 respectively. LIMITATIONS: This study was performed in specialized outpatient settings and thus its results are not necessarily representative for other clinical settings. There was not a systematic evaluation of comorbid psychiatric disease or test-retest reliability. CONCLUSION: The local versions of the MDQ and the BSDS showed a sensitivity and specificity comparable to previous research. Our results indicate that in this sample, MDQ was more specific for BD and BSDS was more sensitive to detect BD-II and NOS. Since BD-I is more readily recognized than bipolar spectrum disorders, enhanced sensitivity of BSDS for soft bipolarity may be an advantage.

Assuntos

Transtorno Bipolar/diagnóstico , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Inquéritos e Questionários , Adolescente , Adulto , Idoso , Argentina , Transtorno Bipolar/etnologia , Transtorno Bipolar/psicologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Humor , Pacientes Ambulatoriais , Psicometria/instrumentação , Sensibilidade e Especificidade , Pesos e Medidas

RESUMO

BACKGROUND: The purpose of this study is to examine the prevalence of affective temperaments between clinically unaffected relatives of bipolar patients and secondarily to investigate the impact of these "subaffective" forms on their quality of life (QoL). METHODS: The study was performed in seven sites across Argentina. We administered the scales TEMPS-A and Quality of Life Index to a sample of 114 non-ill first degree relatives of bipolar disorder patients ("cases") and 115 comparison subjects without family history of affective illness ("controls"). We used The Mood Disorder Questionnaire to rule out clinical bipolarity. RESULTS: Mean scores on all TEMPS-A subscales were significantly higher in cases, except for hyperthymia. The prevalence of affective temperaments, according to Argentinean cut-off points, was also higher, with statistical significance for cyclothymic and anxious temperaments. Regarding QoL, we found no significant differences between both groups, except for interpersonal functioning, which was better in controls. A detailed subanalysis showed significant effects of QoL domains for all temperaments, except for the hyperthymic. LIMITATIONS: We used self-report measures. A larger sample size would have provided us greater statistical power for certain analyses. CONCLUSIONS: Our findings support the concept of a spectrum of subthreshold affective traits or temperaments - especially for the cyclothymic and anxious - in bipolar pedigrees. We further demonstrated that, except for the hyperthymic, quality of life was affected by these temperaments in "clinically well" relatives. Overall, our data are compatible with the "endophenotype" and "subaffective" theses for affective temperaments.

Assuntos

Transtorno Bipolar/genética , Transtornos do Humor/genética , Fenótipo , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Temperamento , Adulto , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/genética , Transtornos de Ansiedade/psicologia , Argentina , Transtorno Bipolar/epidemiologia , Transtorno Bipolar/psicologia , Estudos de Casos e Controles , Estudos Transversais , Transtorno Ciclotímico/diagnóstico , Transtorno Ciclotímico/epidemiologia , Transtorno Ciclotímico/genética , Transtorno Distímico/epidemiologia , Transtorno Distímico/genética , Transtorno Distímico/psicologia , Feminino , Humanos , Relações Interpessoais , Humor Irritável , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/epidemiologia , Transtornos do Humor/psicologia , Qualidade de Vida/psicologia , Inquéritos e Questionários

RESUMO

Schizophrenia is an illness characterized by its syndromic polimorphism and a global impairment of personality traits, that means a lot of suffering for patients and their families. Lately, under the framework of the "neurodevelopmental theory of schizophrenia", the scientific community has paid attention to the need of detecting the illness before onset or as soon as possible. The study of premorbid personality traits, as "schizotaxia" or schizoid or schyzotypal personality, altogether with the study of the so called "basic symptoms" an premorbid states are designed to detect at risk subjects. The need of not waiting until acute onset syndromes in an attempt to more early interventions, due to the fact that there is strong evidence about the existence of early symptoms which proper identification will allow, in the future, to identify subjects at risk an earlier interventions. In this paper we will review only some of the great number of papers recently published on the subject.

Assuntos

Transtornos Psicóticos/diagnóstico , Esquizofrenia/diagnóstico , Humanos , Transtornos Psicóticos/complicações , Transtornos Psicóticos/prevenção & controle , Esquizofrenia/complicações , Esquizofrenia/prevenção & controle , Fatores de Tempo

RESUMO

Schizophrenia is an illness characterized by its syndromic polimorphism and a global impairment of personality traits, that means a lot of suffering for patients and their families. Lately, under the framework of the [quot ]neurodevelopmental theory of schizophrenia[quot ], the scientific community has paid attention to the need of detecting the illness before onset or as soon as possible. The study of premorbid personality traits, as [quot ]schizotaxia[quot ] or schizoid or schyzotypal personality, altogether with the study of the so called [quot ]basic symptoms[quot ] an premorbid states are designed to detect at risk subjects. The need of not waiting until acute onset syndromes in an attempt to more early interventions, due to the fact that there is strong evidence about the existence of early symptoms which proper identification will allow, in the future, to identify subjects at risk an earlier interventions. In this paper we will review only some of the great number of papers recently published on the subject.

RESUMO

Schizophrenia is an illness characterized by its syndromic polimorphism and a global impairment of personality traits, that means a lot of suffering for patients and their families. Lately, under the framework of the [quot ]neurodevelopmental theory of schizophrenia[quot ], the scientific community has paid attention to the need of detecting the illness before onset or as soon as possible. The study of premorbid personality traits, as [quot ]schizotaxia[quot ] or schizoid or schyzotypal personality, altogether with the study of the so called [quot ]basic symptoms[quot ] an premorbid states are designed to detect at risk subjects. The need of not waiting until acute onset syndromes in an attempt to more early interventions, due to the fact that there is strong evidence about the existence of early symptoms which proper identification will allow, in the future, to identify subjects at risk an earlier interventions. In this paper we will review only some of the great number of papers recently published on the subject.

RESUMO

In this article, the author reviews the description of the cycloid psychosis out of the researches of the German psychiatric Karl Leonhard, placing them inside the wide field of the endogenous psychosis.

Assuntos

Periodicidade , Transtornos Psicóticos/classificação , Transtornos Psicóticos/psicologia , Antipsicóticos/uso terapêutico , Humanos , Transtornos Psicóticos/tratamento farmacológico

RESUMO

In this article, the author reviews the description of the cycloid psychosis out of the researches of the German psychiatric Karl Leonhard, placing them inside the wide field of the endogenous psychosis.

RESUMO

In this article, the author reviews the description of the cycloid psychosis out of the researches of the German psychiatric Karl Leonhard, placing them inside the wide field of the endogenous psychosis.