Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Articles & Searches Download to citation manager Citing Articles via HighWire Citing Articles via Google Scholar Articles by Maj, M. Articles by Tortorella, A. Search for Related Content PubMed Citation Articles by Maj, M. Articles by Tortorella, A. Bipolar Disorder Diagnostic Criteria

Reliability and Validity of Four Alternative Definitions of Rapid-Cycling Bipolar Disorder

OBJECTIVE: This study tested the reliability and validity of four definitions of rapid cycling. METHOD: Two trained psychiatrists, using the Schedule for Affective Disorders and Schizophrenia, independently assessed 210 patients with bipolar disorder. They checked whether each patient met four definitions of rapid cycling: one consistent with DSM-IV criteria, one waiving criteria for duration of affective episodes, one waiving such criteria and requiring at least one switch from mania to depression or vice versa during the reference year, and one waiving duration criteria and requiring at least 8 weeks of fully symptomatic affective illness during the reference year. The interrater reliability was calculated by Cohen's kappa statistic. Patients who met each definition according to both psychiatrists were compared to those who did not meet any definition (nonrapid-cycling group) on demographic and clinical variables. All patients were followed up for 1 year. RESULTS: Kappa values were 0.93, 0.73, 0.75, and 0.80, respectively, for the four definitions of rapid cycling. The groups meeting the second and third definitions included significantly more female and bipolar II patients than did the nonrapid-cycling group. Those two groups also had the lowest proportion of patients with a favorable lithium prophylaxis outcome and the highest stability of the rapid-cycling pattern on follow-up. The four groups of rapid-cycling patients did not differ significantly among themselves on any of the assessed variables. CONCLUSIONS: The expression "rapid cycling" encompasses a spectrum of conditions. The DSM-IV definition, although quite reliable, covers only part of this spectrum, and the conditions that are excluded are very typical in terms of key validators and are relatively stable over time.

This article has been cited by other articles:

				G. Goodwin and Consensus Group of the British Association for Psy Evidence-based guidelines for treating bipolar disorder: revised second edition--recommendations from the British Association for Psychopharmacology J Psychopharmacol, June 1, 2009; 23(4): 346 - 388. [Abstract] [PDF]

				E. K. GREEN, R. RAYBOULD, S. MACGREGOR, S. HYDE, A. H. YOUNG, M. C. O'DONOVAN, M. J. OWEN, G. KIROV, L. JONES, I. JONES, et al. Genetic variation of brain-derived neurotrophic factor (BDNF) in bipolar disorder: Case-control study of over 3000 individuals from the UK The British Journal of Psychiatry, January 1, 2006; 188(1): 21 - 25. [Abstract] [Full Text] [PDF]

				R. W. Kupka, D. A. Luckenbaugh, R. M. Post, T. Suppes, L. L. Altshuler, P. E. Keck Jr., M. A. Frye, K. D. Denicoff, H. Grunze, G. S. Leverich, et al. Comparison of Rapid-Cycling and Non-Rapid-Cycling Bipolar Disorder Based on Prospective Mood Ratings in 539 Outpatients Am J Psychiatry, July 1, 2005; 162(7): 1273 - 1280. [Abstract] [Full Text] [PDF]

				C. D. Schneck, D. J. Miklowitz, J. R. Calabrese, M. H. Allen, M. R. Thomas, S. R. Wisniewski, S. Miyahara, M. D. Shelton, T. A. Ketter, J. F. Goldberg, et al. Phenomenology of Rapid-Cycling Bipolar Disorder: Data From the First 500 Participants in the Systematic Treatment Enhancement Program Am J Psychiatry, October 1, 2004; 161(10): 1902 - 1908. [Abstract] [Full Text] [PDF]

				M. Berk and S. Dodd Review: rapid cycling bipolar disorder associated with female gender and bipolar type II subgroup Evid. Based Ment. Health, August 1, 2004; 7(3): 91 - 91. [Full Text] [PDF]

				W. Coryell, D. Solomon, C. Turvey, M. Keller, A. C. Leon, J. Endicott, P. Schettler, L. Judd, and T. Mueller The Long-term Course of Rapid-Cycling Bipolar Disorder Arch Gen Psychiatry, September 1, 2003; 60(9): 914 - 920. [Abstract] [Full Text] [PDF]

				G. M. Goodwin Evidence-Based Guidelines for Treating Bipolar Disorder: Recommendations from the British Association for Psychopharmacology J Psychopharmacol, June 1, 2003; 17(2): 149 - 173. [Abstract] [PDF]

				M. Maj, R. Pirozzi, L. Magliano, and L. Bartoli The Prognostic Significance of "Switching" in Patients With Bipolar Disorder: A 10-Year Prospective Follow-Up Study Am J Psychiatry, October 1, 2002; 159(10): 1711 - 1717. [Abstract] [Full Text] [PDF]

Get information about faster international access.

Privacy Policy

Copyright © 1999 American Psychiatric Association. All rights reserved.

Home | Search | Current Issue | Past Issues | Subscribe | All APPI Journals | Help | Contact Us