Document Detail


Toward the delineation of mania subtypes in the French National EPIMAN-II Mille Cohort. Comparisons with prior cluster analytic investigations.
MedLine Citation:
PMID:  18574610     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Knowledge about psychopathologic presentations of mania in current clinical practice has to be refined in order to improve diagnosis and treatment. METHODS: One thousand ninety manic patients included in the French National Study EPIMAN-II Mille were submitted to a cluster analysis on the basis of multiple variables related to the history of bipolar illness and symptoms of the current episode. RESULTS: Four clusters were identified: "classic mania" (29.3% of patients) with less severe mania; "psychotic mania" (22.7%) with psychotic symptoms, more severe mania, younger age and social impairment; "depressive mania" (30.4%) characterized by female gender, suicide attempts, high number of previous episodes and residual symptoms; and "dual mania" (17.6%) characterized by male gender, substance use, earlier onset and poor compliance. Patients groups also differed in manic symptoms, marital status, stressors preceding illness onset, prior diagnoses, first episode polarity and temperamental characteristics. LIMITATIONS: Cross-sectional assessment of patients. CONCLUSIONS: In comparing our findings with those of four prior cluster analytic studies, we integrate clinical characteristics of mania subtypes found in this very large representative French sample in contemporary practice, we suggest how such convergence of data may help improve earlier recognition, differential response to different treatments, and prevention of these subtypes. We finally suggest that such subtyping might provide clues to phenotype delineation suitable for pharmacogenetic investigations.
Authors:
Jean-Michel Azorin; Arthur Kaladjian; Marc Adida; Elie Hantouche; Ahcene Hameg; Sylvie Lancrenon; Hagop Souren Akiskal
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-06-20
Journal Detail:
Title:  European archives of psychiatry and clinical neuroscience     Volume:  258     ISSN:  1433-8491     ISO Abbreviation:  Eur Arch Psychiatry Clin Neurosci     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2009-01-13     Completed Date:  2009-03-02     Revised Date:  2009-05-11    
Medline Journal Info:
Nlm Unique ID:  9103030     Medline TA:  Eur Arch Psychiatry Clin Neurosci     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  497-504     Citation Subset:  IM    
Affiliation:
Adult Psychiatry Department, Ste Marguerite Hospital, 270 Bd Sainte-Marguerite, 13274 Marseille Cedex 09, France. jazorin@ap-hm.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Analysis of Variance
Bipolar Disorder / classification*,  diagnosis*,  psychology
Cluster Analysis
Cohort Studies
Female
France
Humans
Male
Middle Aged
Patient Compliance / psychology,  statistics & numerical data
Severity of Illness Index
Sex Factors
Social Behavior
Substance-Related Disorders / psychology
Suicide, Attempted / psychology,  statistics & numerical data

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