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首页> 外文期刊>The journal of clinical psychiatry >What is hypomania? Tetrachoric factor analysis and kernel estimation of DSM-IV hypomanic symptoms.
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What is hypomania? Tetrachoric factor analysis and kernel estimation of DSM-IV hypomanic symptoms.

机译：什么是轻躁狂？ DSM-IV低躁狂症状的四胆因子分析和核估计。

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BACKGROUND: The DSM-IV definition of hypomania, which relies on clinical consensus and historical tradition, includes several "nonspecific" symptoms. The aim of this study was to identify the core symptoms of DSM-IV hypomania. METHOD: In an outpatient private practice, 266 bipolar II disorder (BP-II) and 138 major depressive disorder (MDD) remitted patients were interviewed by a bipolar-trained psychiatrist, for different study goals. Patients were questioned, using the Structured Clinical Interview for DSM-IV, about the most common symptoms and duration of recent threshold and subthreshold hypomanic episodes. Data were recorded between 2002 and 2006. Four different samples, assessed with the same methodology, were pooled for the present analyses. Tetrachoric factor analysis was used to identify core hypomanic symptoms. Distribution of symptoms by kernel estimation was inspected for bimodality. Validity of core hypomania was tested by receiver operating characteristic (ROC) analysis. RESULTS: The distribution of subthreshold and threshold hypomanic episodes did not show bimodality. Tetrachoric factor analysis found 2 uncorrelated factors: factor 1 included the classic talkativeness, and increase in goal-directed activity (overactivity); factor 2 included the "nonspecific" symptoms irritable mood, racing/crowded thoughts, and distractibility. Factor 1 discriminatory accuracy for distinguishing BP-II versus MDD was high (ROC area = 0.94). The distribution of the 5-symptom episodes of factor 1 showed clear-cut bimodality. Similar results were found for episodes limited to 3 behavioral symptoms of factor 1 (decreased need for sleep, talkativeness, and overactivity) and 4 behavioral symptoms of factor 1 (adding elevated mood), with high discriminatory accuracy. CONCLUSIONS: A core, categorical DSM-IV hypomania was found that included 3 to 5 symptoms, ie, behavioral symptoms and elevated mood. Behavioral symptoms (overactivity domain) could be the basic phenotype of hypomania. This finding could help in probing for hypomania and reduce misdiagnosis. Biologic research could focus more on the underpinnings of the overactivity domain specifically.
机译：背景：关于躁狂症的DSM-IV定义依赖于临床共识和历史传统，包括几种“非特异性”症状。这项研究的目的是确定DSM-IV低躁狂症的核心症状。方法：在门诊私人执业中，接受过双极性训练的精神病医生针对不同的研究目标采访了266例双相情感障碍II型患者（BP-II）和138例重度抑郁症（MDD）缓解的患者。使用针对DSM-IV的结构化临床访谈对患者进行了询问，询问最常见的症状以及最近出现的阈值和亚阈值躁狂发作的持续时间。记录了2002年至2006年之间的数据。汇集了四个使用相同方法评估的不同样本进行本次分析。四胆因子分析用于确定核心的躁狂症状。检查通过核估计的症状分布的双峰性。核心轻躁狂症的有效性通过接受者工作特征（ROC）分析进行了测试。结果：亚阈值和阈值躁狂发作的分布没有显示出双峰性。四肢因素分析发现了2个不相关的因素：因素1包括经典的健谈和目标导向活动（过度活动）的增加;因素2包括“非特异性”症状，易怒的情绪，赛车/拥挤的思想和分心。区分BP-II和MDD的因子1区分准确度很高（ROC面积= 0.94）。因子1的5症状发作的分布表现出明显的双峰性。对于限于3种因素1的行为症状（减少睡眠，健谈和过度活动的需要）和4种因素1的行为症状（增加情绪）的发作，也发现了相似的结果，具有较高的判别准确性。结论：发现一种核心的，分类性的DSM-IV低躁狂症，包括3至5个症状，即行为症状和情绪升高。行为症状（过度活动域）可能是低躁狂症的基本表型。这一发现可能有助于探索躁狂症并减少误诊。生物学研究可以更专注于过度活跃域的基础。

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