The performance of DSM-III-R major depression criteria in the diagnosis of bipolar mixed states.


Journal Article

Two hundred thirty-seven (237) manic patients diagnosed by DSM-III-R criteria as either purely manic (204) or mixed bipolar (33) were reviewed for analysis of the diagnostic performance of the DSM-III-R criteria required to diagnose the mixed bipolar state. We calculated the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic efficiency of each of the 9 DSM-III-R criteria for major depression in this cohort. As predicted, four of the major depression criteria had low diagnostic utility, with PPV's less than 0.3. Those items were: weight change; sleep disturbance; psychomotor change; and diminished ability to think or concentrate or indecisiveness. Four symptoms: anhedonia, fatigue, feelings of worthlessness or guilt, and recurrent thoughts of death or suicidal ideation had acceptable utility for the diagnosis of mixed states.

Full Text

Cited Authors

  • Cassidy, F; Murry, E; Forest, K; Carroll, BJ

Published Date

  • October 1997

Published In

Volume / Issue

  • 46 / 1

Start / End Page

  • 79 - 81

PubMed ID

  • 9387090

Pubmed Central ID

  • 9387090

Electronic International Standard Serial Number (EISSN)

  • 1573-2517

International Standard Serial Number (ISSN)

  • 0165-0327

Digital Object Identifier (DOI)

  • 10.1016/s0165-0327(97)00084-0


  • eng