Anxiety, irritability, and agitation as indicators of bipolar mania with depressive symptoms: a post hoc analysis of two clinical trials

International Journal of Bipolar Disorders

Volumn 5, Issue 1, 2017, Pages

  Suppes, Trisha ^a   Eberhard, Jonas ^b,c,d   Lemming, Ole ^b   Young, Allan H ^d   McIntyre, Roger S ^e  

^a STANFORD UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b H LUNDBECK A S   (Denmark)

^c LUND UNIVERSITY   (Sweden)

^d KING'S COLLEGE LONDON   (United Kingdom)

^e UNIVERSITY HEALTH NETWORK   (Canada)

Author keywords

Agitation; Anxiety; Bipolar disorder; Depression; Irritability; Mixed features; Remission

Indexed keywords

ASENAPINE; OLANZAPINE; PLACEBO;

ADULT; AGITATION; ANXIETY; ARTICLE; BIPOLAR MANIA; CONTROLLED STUDY; DEPRESSION; DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS; DOUBLE BLIND PROCEDURE; FEMALE; HUMAN; HYPERACTIVITY; IRRITABILITY; MAJOR CLINICAL STUDY; MALE; MIXED MANIA AND DEPRESSION; MONTGOMERY ASBERG DEPRESSION RATING SCALE; MOTOR ACTIVITY; PHENOMENOLOGY; POSITIVE AND NEGATIVE SYNDROME SCALE; POST HOC ANALYSIS; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; REMISSION; YOUNG MANIA RATING SCALE;

EID: 85056221268     PISSN: None     EISSN: 21947511     Source Type: Journal    
DOI: 10.1186/s40345-017-0103-7     Document Type: Article

References (43)

1. Akiskal HS, Hantouche EG, Bourgeois ML, Azorin JM, Sechter D, Allilaire JF, et al. Gender, temperament, and the clinical picture in dysphoric mixed mania: findings from a French national study (EPIMAN). J Affect Disord. 1998;50(2–3):175–86.
2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.
3. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Association; 2013.
4. Azorin JM, Aubrun E, Bertsch J, Reed C, Gerard S, Lukasiewicz M. Mixed states vs. pure mania in the French sample of the EMBLEM study: results at baseline and 24 months—European mania in bipolar longitudinal evaluation of medication. BMC Psychiatry. 2009;9:33.
5. Barbuti M, Pacchiarotti I, Vieta E, Azorin JM, Angst J, Bowden CL, et al. Antidepressant-induced hypomania/mania in patients with major depression: evidence from the BRIDGE-II-MIX study. J Affect Disord. 2017;219:187–92.
6. Cassidy F. Anxiety as a symptom of mixed mania: implications for DSM-5. Bipolar Disord. 2010;12(4):437–9.
7. Eberhard J, Weiller E. Suicidality and symptoms of anxiety, irritability, and agitation in patients experiencing manic episodes with depressive symptoms: a naturalistic study. Neuropsychiatr Dis Treat. 2016;12:2265–71.
8. Fagiolini A, Coluccia A, Maina G, Forgione RN, Goracci A, Cuomo A, Young AH. Diagnosis, epidemiology and management of mixed states in bipolar disorder. CNS Drugs. 2015;29(9):725–40.
9. Feske U, Frank E, Mallinger AG, Houck PR, Fagiolini A, Shear MK, et al. Anxiety as a correlate of response to the acute treatment of bipolar I disorder. Am J Psychiatry. 2000;157(6):956–62.
10. Fountoulakis KN, Grunze H, Vieta E, Young A, Yatham L, Blier P, et al. The International College of Neuro-Psychopharmacology (CINP) treatment guidelines for Bipolar disorder in adults (CINP-BD-2017), part 3: the clinical guidelines. Int J Neuropsychopharmacol. 2016. [Epub ahead of print].
11. Goodwin GM, Haddad PM, Ferrier IN, Aronson JK, Barnes T, Cipriani A, et al. Evidence-based guidelines for treating bipolar disorder: Revised third edition recommendations from the British Association for Psychopharmacology. J Psychopharmacol. 2016;30(6):495–553.
12. Guy W. ECDEU assessment manual for psychopharmacology, revised. Rockville: National Institute of Mental Health; 1976.
13. Hantouche EG, Akiskal HS, Azorin JM, Châtenet-Duchêne L, Lancrenon S. Clinical and psychometric characterization of depression in mixed mania: a report from the French National Cohort of 1090 manic patients. J Affect Disord. 2006;96(3):225–32.
14. Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull. 1987;13(2):261–76.
15. Koukopoulos A, Sani G, Ghaemi SN. Mixed features of depression: why DSM-5 is wrong (and so was DSM-IV). Br J Psychiatry. 2013;203(1):3–5.
16. Kraepelin E. Manic–depressive insanity and paranoia. Edinburgh: E&S Livingstone; 1921.
17. Machado-Vieira R, Luckenbaugh DA, Ballard ED, Henter ID, Tohen M, Suppes T, Zarate CA Jr. Increased activity or energy as a primary criterion for the diagnosis of bipolar mania in DSM-5: findings from the STEP-BD study. Am J Psychiatry. 2017;174(1):70–6.
18. McElroy SL, Keck PE Jr, Pope HG Jr, Hudson JI, Faedda GL, Swann AC. Clinical and research implications of the diagnosis of dysphoric or mixed mania or hypomania. Am J Psychiatry. 1992;149(12):1633–44.
19. McIntyre RS, Weiller E. Real-world determinants of adjunctive antipsychotic prescribing for patients with major depressive disorder and inadequate response to antidepressants: a case review study. Adv Ther. 2015;32(5):429–44.
20. McIntyre RS, Cohen M, Zhao J, Alphs L, Macek TA, Panagides J. A 3-week, randomized, placebo-controlled trial of asenapine in the treatment of acute mania in bipolar mania and mixed states. Bipolar Disord. 2009;11(7):673–86.
21. McIntyre RS, Cohen M, Zhao J, Alphs L, Macek TA, Panagides J. Asenapine in the treatment of acute mania in bipolar I disorder: a randomized, double-blind, placebo-controlled trial. J Affect Disord. 2010;122(1–2):27–38.
22. McIntyre RS, Tohen M, Berk M, Zhao J, Weiller E. DSM-5 mixed specifier for manic episodes: evaluating the effect of depressive features on severity and treatment outcome using asenapine clinical trial data. J Affect Disord. 2013a;150(2):378–83.
23. McIntyre RS, Miguelez M, Vogel Marler S, Baker RA, Rahman Z. Analysis of aripiprazole clinical data using the proposed DSM-5 diagnostic criteria for mixed features in bipolar disorder. Poster abstract NR8-08 at American Psychiatric Association 2013 Annual Meeting. 2013b. http://www.psychiatry.org/psychiatrists/search-directories-databases/library-and-archive. Accessed 18 May 2017.
24. McIntyre RS, Soczynska JK, Cha DS, Woldeyohannes HO, Dale RS, Alsuwaidan MT, et al. The prevalence and illness characteristics of DSM-5-defined “mixed feature specifier” in adults with major depressive disorder and bipolar disorder: results from the International Mood Disorders Collaborative Project. J Affect Disord. 2015;172:259–64.
25. Miller S, Suppes T, Mintz J, Hellemann G, Frye MA, McElroy SL, et al. Mixed depression in bipolar disorder: prevalence rate and clinical correlates during naturalistic follow-up in the Stanley Bipolar Network. Am J Psychiatry. 2016;173(10):1015–23.
26. Montgomery SA, Åsberg M. A new depression scale designed to be sensitive to change. Br J Psychiatry. 1979;134:382–9.
27. Muralidharan K, Ali M, Silveira LE, Bond DJ, Fountoulakis KN, Lam RW, Yatham LN. Efficacy of second generation antipsychotics in treating acute mixed episodes in bipolar disorder: a meta-analysis of placebo-controlled trials. J Affect Disord. 2013;150(2):408–14.
28. Perich T, Hadzi-Pavlovic D, Frankland A, Breakspear M, Loo C, Roberts G, et al. Are there subtypes of bipolar depression? Acta Psychiatr Scand. 2016;134(3):260–7.
29. Scott J, Vaaler AE, Fasmer OB, Morken G, Krane-Gartiser K. A pilot study to determine whether combinations of objectively measured activity parameters can be used to differentiate between mixed states, mania, and bipolar depression. Int J Bipolar Disord. 2017;5(1):5.
30. Shim IH, Woo YS, Bahk WM. Prevalence rates and clinical implications of bipolar disorder “with mixed features” as defined by DSM-5. J Affect Disord. 2015;173:120–5.
31. Solé E, Garriga M, Valentí M, Vieta E. Mixed features in bipolar disorder. CNS Spectr. 2017;22(2):134–40.
32. Spearing MK, Post RM, Leverich GS, Brandt D, Nolen W. Modification of the Clinical Global Impressions (CGI) scale for use in bipolar illness (BP): the CGI-BP. Psychiatry Res. 1997;73(3):159–71.
33. Stahl SM, Morrissette DA, Faedda G, Fava M, Goldberg JF, Keck PE, et al. Guidelines for the recognition and management of mixed depression. CNS Spectr. 2017;22(2):203–19.
34. Suppes T, Mintz J, McElroy SL, Altshuler LL, Kupka RW, Frye MA, et al. Mixed hypomania in 908 patients with bipolar disorder evaluated prospectively in the Stanley Foundation Bipolar Treatment Network: a sex-specific phenomenon. Arch Gen Psychiatry. 2005;62(10):1089–96.
35. Swann AC, Lafer B, Perugi G, Frye MA, Bauer M, Bahk WM, et al. Bipolar mixed states: an International Society for Bipolar Disorders task force report of symptom structure, course of illness, and diagnosis. Am J Psychiatry. 2013;170(1):31–42.
36. Targum SD, Nierenberg A. The complexity of “mixed” depression: a common clinical presentation. Innov Clin Neurosci. 2011;8(6):38–42.
37. Tohen M, McIntyre RS, Kanba S, Fujikoshi S, Katagiri H. Efficacy of olanzapine in the treatment of bipolar mania with mixed features defined by DSM-5. J Affect Disord. 2014;168:136–41.
38. University of South Florida. Florida Medicaid Drug Therapy Management Program sponsored by the Florida Agency for Health Care Administration. 2015 Florida Best Practice Psychotherapeutic Medication Guidelines for Adults. 2015. http://www.medicaidmentalhealth.org/_assets/file/Guidelines/Web_2015-Psychotherapeutic%20Medication%20Guidelines%20for%20Adults_Final_Approved1.pdf. Accessed 18 May 2017.
39. Vieta E, Valentí M. Mixed states in DSM-5: implications for clinical care, education, and research. J Affect Disord. 2013;148(1):28–36.
40. Vieta E, Grunze H, Azorin JM, Fagiolini A. Phenomenology of manic episodes according to the presence or absence of depressive features as defined in DSM-5: results from the IMPACT self-reported online survey. J Affect Disord. 2014;156:206–13.
41. Yatham LN, Kennedy SH, Parikh SV, Schaffer A, Beaulieu S, Alda M, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2013. Bipolar Disord. 2013;15(1):1–44.
42. Young AH, Eberhard J. Evaluating depressive symptoms in mania: a naturalistic study of patients with bipolar disorder. Neuropsychiatr Dis Treat. 2015;11:1137–43.
43. Young RC, Biggs JT, Ziegler VE, Meyer DA. A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry. 1978;133:429–35.