Increased sensitivity in bipolar disorder detection with the MDQ and BSDC using ghaemi-goodwin’s criteria for the bipolar spectrum

Abstract

Introduction: Many patients with bipolar disorder (BD) spend around 10 years without a diagnosis and appropriate
treatment. The difficulty in distinguishing bipolar from unipolar depression, the prevalence of depressive symptoms along the
course of BD and patients’ bias in recalling their hypomanic symptoms are some of the factors that contribute to this problem.
Objective: This study compares the efficiency of several screening instruments for BD detection in a group of patients (n=63) with
mood disorders, or cluster B personality disorders. Method: The diagnoses were made with structured interviews: Mini International
Neuropsychiatric Interview (MINI) and Structured Clinical Diagnostic Interview for axis II (SCID-II). The patients completed the
Mood Disorder Questionnaire (MDQ) and Bipolar Spectrum Disorder Scale (BSDS) and were assessed with the Bipolar Index-BI and
Ghaemi-Goodwin Bipolar Spectrum Criteria. Sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value
(NPV) were estimated for each instrument, along with Chi2 and T–tests. Statistical analyses were conducted using the SPSS-v16.
Results: The BI had the best global performance with 88% specificity and 0.90 of sensitivity. The MDQ-H had the highest specificity
and the MDQ-6 the highest sensitivity. However, when combining the MDQ with Ghaemi’s criteria, an ostensible augment was
obtained in sensitivity while maintaining good predictive values. Conclusions: The joint assessment of mania symptoms and typical
evolving course symptoms in BD increased the probability of BD detection in this clinical sample.