Phenomenological subtypes of mania and their relationships with substance use disorders

Objective The aim of the present study was to determine the distinct clusters of subtypes among patients with bipolar disorder (BD) and the relationship between the clinical features of BD patients, particularly substance use disorders (SUDs) and the clusters. Method The present study initially assessed 96 inpatients who were hospitalized in the psychiatric clinic of BakIrköy Prof. Mazhar Osman Training and Research Hospital for Psychiatry and Neurology, for a BD manic episode. All patients were evaluated during the initial 3 days of their admission using the Young Mania Rating Scale (YMRS), the Montgomery-Asberg Depression Rating Scale (MADRS),the Scale for the Assessment of Positive Symptoms (SAPS), the Michigan Alcoholism Screening Test (MAST) and a sociodemographic questionnaire. The factor structures of the psychopathological scale items were determined with factor analyses and based on the factor loadings, cluster analyses were performed. The relationships among the clusters and the clinical variables were then evaluated. Results The factor analyses generated three factors: increased psychomotor activity, dysphoria, and psychosis. A hierarchical cluster analysis was applied to the three factor loadings, and revealed that factor 1 (increased psychomotor activity) was high in cluster 1 and that the effects of factors 2 (dysphoria) and 3 (psychosis) were high in cluster 2. Within cluster 1 (Psychomotor elevation), 39% of patients were diagnosed with an alcohol use disorder while 31.6% of patients in the cluster 2 (dysphoric-psychotic) were diagnosed with both alcohol and cannabis use disorders. Within cluster 2 (dysphoric-psychotic), 47.4% of patients had one suicide attempt and 21.1% of patients had two or more attempts during their lifetime. Conclusion There was a significant difference in the presence of SUDs between patients with psychomotor elevation and patients in dysphoric-psychotic cluster. This may be point out that pure manic patients with BD self-medicate using the sedative effects of alcohol and the causal relationship between cannabis and psychosis. Using a dimensional approach to study BD may enhance detection of the biological correlates of BD and improve the treatment and outcomes of the disorder. © 2014 Elsevier B.V.

Yazar Güclü O.
Şenormanci Ö.
Aydin E.
Erkiran M.
Köktürk F.
Yayın Türü Article
Tek Biçim Adres https://hdl.handle.net/20.500.12628/6998
Tek Biçim Adres 10.1016/j.jad.2014.11.016
Konu Başlıkları Bipolar disorder
Cluster analysis
Substance use disorder
Koleksiyonlar Araştırma Çıktıları | WoS | Scopus | TR-Dizin | PubMed | SOBİAD
Scopus İndeksli Yayınlar Koleksiyonu
WoS İndeksli Yayınlar Koleksiyonu
Dergi Adı Journal of Affective Disorders
Dergi Cilt Bilgisi 174
Sayfalar 569 - 573
Yayın Yılı 2015
Eser Adı
[dc.title]
Phenomenological subtypes of mania and their relationships with substance use disorders
Yazar
[dc.contributor.author]
Güclü O.
Yazar
[dc.contributor.author]
Şenormanci Ö.
Yazar
[dc.contributor.author]
Aydin E.
Yazar
[dc.contributor.author]
Erkiran M.
Yazar
[dc.contributor.author]
Köktürk F.
Yayın Yılı
[dc.date.issued]
2015
Yayıncı
[dc.publisher]
Elsevier
Yayın Türü
[dc.type]
article
Özet
[dc.description.abstract]
Objective The aim of the present study was to determine the distinct clusters of subtypes among patients with bipolar disorder (BD) and the relationship between the clinical features of BD patients, particularly substance use disorders (SUDs) and the clusters. Method The present study initially assessed 96 inpatients who were hospitalized in the psychiatric clinic of BakIrköy Prof. Mazhar Osman Training and Research Hospital for Psychiatry and Neurology, for a BD manic episode. All patients were evaluated during the initial 3 days of their admission using the Young Mania Rating Scale (YMRS), the Montgomery-Asberg Depression Rating Scale (MADRS),the Scale for the Assessment of Positive Symptoms (SAPS), the Michigan Alcoholism Screening Test (MAST) and a sociodemographic questionnaire. The factor structures of the psychopathological scale items were determined with factor analyses and based on the factor loadings, cluster analyses were performed. The relationships among the clusters and the clinical variables were then evaluated. Results The factor analyses generated three factors: increased psychomotor activity, dysphoria, and psychosis. A hierarchical cluster analysis was applied to the three factor loadings, and revealed that factor 1 (increased psychomotor activity) was high in cluster 1 and that the effects of factors 2 (dysphoria) and 3 (psychosis) were high in cluster 2. Within cluster 1 (Psychomotor elevation), 39% of patients were diagnosed with an alcohol use disorder while 31.6% of patients in the cluster 2 (dysphoric-psychotic) were diagnosed with both alcohol and cannabis use disorders. Within cluster 2 (dysphoric-psychotic), 47.4% of patients had one suicide attempt and 21.1% of patients had two or more attempts during their lifetime. Conclusion There was a significant difference in the presence of SUDs between patients with psychomotor elevation and patients in dysphoric-psychotic cluster. This may be point out that pure manic patients with BD self-medicate using the sedative effects of alcohol and the causal relationship between cannabis and psychosis. Using a dimensional approach to study BD may enhance detection of the biological correlates of BD and improve the treatment and outcomes of the disorder. © 2014 Elsevier B.V.
Kayıt Giriş Tarihi
[dc.date.accessioned]
2019-12-23
Açık Erişim Tarihi
[dc.date.available]
2019-12-23
Yayın Dili
[dc.language.iso]
eng
Konu Başlıkları
[dc.subject]
Bipolar disorder
Konu Başlıkları
[dc.subject]
Cluster analysis
Konu Başlıkları
[dc.subject]
Substance use disorder
Haklar
[dc.rights]
info:eu-repo/semantics/closedAccess
ISSN
[dc.identifier.issn]
0165-0327
İlk Sayfa Sayısı
[dc.identifier.startpage]
569
Son Sayfa Sayısı
[dc.identifier.endpage]
573
Dergi Adı
[dc.relation.journal]
Journal of Affective Disorders
Dergi Cilt Bilgisi
[dc.identifier.volume]
174
Tek Biçim Adres
[dc.identifier.uri]
https://dx.doi.org/10.1016/j.jad.2014.11.016
Tek Biçim Adres
[dc.identifier.uri]
https://hdl.handle.net/20.500.12628/6998
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44
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patients cluster factor alcohol analyses between clusters disorder psychomotor (dysphoric-psychotic) psychosis present cannabis evaluated during diagnosed Rating clinical Within factors relationship loadings effects disorders (dysphoria) suicide (psychosis) (Psychomotor elevation) activity) (increased attempt Objective correlates dimensional
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