Is the 6‐item, self‐report HAM‐D an effective depression screening measure with bipolar disorder?

Kraun, Lotan; O’Rourke, Norm; Osher, Yamima; Bersudsky, Yuly; Belotherkovsky, Dany; Bachner, Yaacov G.

doi:10.1111/ppc.12509

Cited by 10 publications

(8 citation statements)

References 28 publications

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“…Consistent with existing research [ 47 , 48 ], depression and hypo/mania are positively correlated (r=.29; P= .01), suggesting that depression and hypo/mania are not inverse clinical states. Often participants reported both types of BD symptoms (eg, mixed features).…”

Section: Resultssupporting

confidence: 88%

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Ecological Momentary Assessment of Bipolar Disorder Symptoms and Partner Affect: Longitudinal Pilot Study

Yerushalmi¹,

Sixsmith²,

Star³

et al. 2021

JMIR Form Res

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Background The World Health Organization ranks bipolar disorder (BD) as the 7th leading cause of disability. Although the effects on those with BD are well described, less is reported on the impact of BD on cohabiting partners or any interactions between the two; this requires in vivo data collection measured each day over several months. Objective We set out to demonstrate the utility of ecological momentary assessment with BD couples measured using yoked smartphone apps. When randomly prompted over time, we assumed distinct patterns of association would emerge between BD symptoms (both depression and hypo/mania) and partner mood (positive and negative affect). Methods For this pilot study, we recruited an international sample of young and older adults with BD and their cohabiting partners where available. Both participants and partners downloaded separate apps onto their respective smartphones. Within self-specified “windows of general availability,” participants with BD were randomly prompted to briefly report symptoms of depression and hypo/mania (ie, BDSx), positive and negative mood (ie, POMS-15; partners), and any important events of the day (both). The partner app was yoked to the participant app so that the former was prompted roughly 30 minutes after the participant with BD or the next morning if outside the partner’s specified availability. Results Four couples provided 312 matched BD symptom and partner mood responses over an average of 123 days (range 65-221 days). Both were GPS- and time-stamped (mean 3:11 hrs between questionnaires, SD 4:51 hrs). Total depression had a small but significant association with positive (r=–.14; P=.02) and negative partner affect (r=.15; P=.01]. Yet total hypo/mania appeared to have no association with positive partner affect (r=–.01; P=.87); instead, negative partner affect was significantly correlated with total hypo/mania (r=.26; P=.01). However, when we look specifically at BD factors, we see that negative partner affect is associated only with affrontive symptoms of hypo/mania (r=.38; P=.01); elation or loss of insight appears unrelated to either positive (r=.10; P=.09) or negative partner affect (r=.02; P=.71). Yet affrontive symptoms of hypo/mania were significantly correlated with negative affect, but only when couples were together (r=.41; P=.01), not when apart (r=.22; P=.12). That is, these angry interpersonal symptoms of hypo/mania appear to be experienced most negatively by spouses when couples are together. Conclusions These initial findings demonstrate the utility of in vivo ambulatory data collection in longitudinal mental health research. Preliminary analyses suggest different BD symptoms are associated with negative and positive partner mood. These negative effects appear greater for hypo/mania than depressive symptoms, but proximity to the person with BD is important.

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Section: Resultssupporting

confidence: 88%

“…The BDS x was developed for ecological momentary sampling of BD symptoms via smartphone app [ 43 , 44 ] but has also been validated for use online [ 45 , 46 ] and as a printed-page screening measure with BD outpatients [ 47 , 48 ]. In this study, α=.88 for depressive symptoms and α=.71 for the hypo/mania subscale.…”

Section: Methodsmentioning

confidence: 99%

Ecological Momentary Assessment of Bipolar Disorder Symptoms and Partner Affect: Longitudinal Pilot Study

Yerushalmi¹,

Sixsmith²,

Star³

et al. 2021

JMIR Form Res

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“…Concurrent validity of BDS x responses by BD I outpatients has been demonstrated relative to the self-reported Hamilton Rating Scale for Depression (HAMD-6) and the Altman Self-Rating Mania Scale (Kraun et al 2020). Similarly, sensitivity (and specificity) are high for the BDS x depression subscale at 88% (and 76%), respectively (Osher et al 2020).…”

Section: Bds Xmentioning

confidence: 91%

“…Internal consistency of BDS x responses by BD I outpatients was recorded as α = 0.90 for the depression subscale (cognitive + somatic symptoms; Osher et al 2020) but lower for the hypo/mania subscale at α = 0.76 (affrontive + elation/loss of insight; Kraun et al 2020). This difference may be due to lower frequency of hypo/manic versus depressive symptoms (Judd et al 2002).…”

Section: Bds Xmentioning

confidence: 99%

Is the 4-factor model of symptomology equivalent across bipolar disorder subtypes?

O’Rourke

Sixsmith

Michael

et al. 2021

Int J Bipolar Disord

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Background Research with the BDSx (Bipolar Disorder Symptom Scale) suggests a 4-factor structure of responses: two depression (cognitive, somatic) and two hypo/mania factors (elation/loss of insight, affrontive symptoms). The two depression and two hypo/mania factors are correlated; and affrontive symptoms of hypo/mania (e.g., furious, disgusted, argumentative) are positively correlated with both depression factors suggesting pathways for mixed symptom presentation. This grouping of affrontive symptoms of hypo/mania organically emerged in exploratory research and has subsequently been supported in confirmatory analyses between samples and over time. The BDSx has been clinically validated with BD outpatients. Results Over 19 days, we recruited an international sample of 784 adults with BD using micro-targeted, social media advertising (M = 44.48 years, range 18–82). All participants indicated that they had BD (subtype, if known) and had been diagnosed with BD (month, year). This sample size was sufficient to confirm the 4-factor model across subtypes and compare the three (BD I, BD II, BD NOS). Responses to 19 of 20 BDSx items were psychometrically consistent across BD subtypes. Only responses to the ‘hopeless’ item were significantly higher for those with BD II. Conclusions When comparing models, it appears that affrontive symptoms are significantly and uniformly associated with hypo/mania and both depression factors across subtypes. In contrast to BD diagnostic criteria, this suggests that affrontive symptoms are central to the clinical presentation of hypo/mania and mixed symptomology across BD subtypes.

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“…The HAM-D on review, assesses severity of depression and should not be used for comparison to the DSM-5 diagnostic criteria for major depression. Current versions of the HAM-D demonstrated a sensitivity of 75% and a specificity of 84% for depression screening and take about 20-30 minutes to administer (Kraun et al, 2020). This instrument demonstrates good validity and utility for assessing depression severity but not for diagnosis of mood disorders (Kraun et al, 2020).…”

Section: -Item Scale To Assess Behavioral Health Risks Associated Wit...mentioning

confidence: 93%

Family-focused approaches support outcomes of the patient with bipolar disorder: A family practice lens

Aitchison¹

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Bipolar disorder (BD) has significant individual and family consequences and is consistently managed in the family practice setting when there is a lack of specialty services.Family appears to be an underutilized resource and yet is consistently mentioned in current guidelines. This literature review was conducted to determine how family can be incorporated into the family practice setting to improve patient outcomes. A list of recommendations was developed to provide evidence-based rationale to primary care providers to integrate family into the psychosocial management. In doing so, this provides additional resources that are consistent with current recommendations and can support patients with BD.

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Is the 6‐item, self‐report HAM‐D an effective depression screening measure with bipolar disorder?

Cited by 10 publications

References 28 publications

Ecological Momentary Assessment of Bipolar Disorder Symptoms and Partner Affect: Longitudinal Pilot Study

Ecological Momentary Assessment of Bipolar Disorder Symptoms and Partner Affect: Longitudinal Pilot Study

Is the 4-factor model of symptomology equivalent across bipolar disorder subtypes?

Family-focused approaches support outcomes of the patient with bipolar disorder: A family practice lens

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