관해기 양극성 외래 환자에서 한국형 기분장애 질문지 위음성군의 특성
The Characteristics of Bipolar Outpatients in Remission Showing False-Negatives on the Korean Version of Mood Disorder Questionnaire
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Objectives The Mood Disorder Questionnaire (MDQ) has been validated as a diagnostic screening instrument for the detection of patients with bipolar disorder, but some patients with bipolar disorder obtain false negative screens. So we investigated demographic and clinical characteristics in false-negative MDQ in bipolar patients. Methods The participants were 60 DSM-IV bipolar outpatients in remission. All completed the Korean version of the Mood Disorder Questionnaire (K-MDQ) and the Korean version of the Beck Cognitive Insight Scale (K-BCIS) and were assessed by a trained clinician on the Young Mania Rating Scale, the Hamilton Depression Rating Scale and the Global Assessment of Functioning scale. The patients were categorized into two groups according to their K-MDQ score excluding further two questions (MDQ ≥7 : K-MDQ-positives and MDQ <7 : K-MDQ-negatives). Differences in demographic and clinical characteristics between these two groups were analyzed. Results There were no statistically significant differences between K-MDQ-positives and K-MDQ-negatives on the demographic and clinical variables, except on the K-BCIS where K-MDQ-negatives reported significantly lower scores on the K-BCIS composite index and self-reflectiveness subscale. Conclusion These results suggest that lack of insight is a confounding factor in screening for bipolar disorder using the K-MDQ.
Abstract
Objectives The Mood Disorder Questionnaire (MDQ) has been validated as a diagnostic screening instrument for the detection of patients with bipolar disorder, but some patients with bipolar disorder obtain false negative screens. So we investigated demographic and clinical characteristics in false-negative MDQ in bipolar patients. Methods The participants were 60 DSM-IV bipolar outpatients in remission. All completed the Korean version of the Mood Disorder Questionnaire (K-MDQ) and the Korean version of the Beck Cognitive Insight Scale (K-BCIS) and were assessed by a trained clinician on the Young Mania Rating Scale, the Hamilton Depression Rating Scale and the Global Assessment of Functioning scale. The patients were categorized into two groups according to their K-MDQ score excluding further two questions (MDQ ≥7 : K-MDQ-positives and MDQ <7 : K-MDQ-negatives). Differences in demographic and clinical characteristics between these two groups were analyzed. Results There were no statistically significant differences between K-MDQ-positives and K-MDQ-negatives on the demographic and clinical variables, except on the K-BCIS where K-MDQ-negatives reported significantly lower scores on the K-BCIS composite index and self-reflectiveness subscale. Conclusion These results suggest that lack of insight is a confounding factor in screening for bipolar disorder using the K-MDQ.
참고문헌 (40)
- Angst J, "Recurrence of bipolar disorders and major depression. A life-long perspective", Eur Arch Psychiatry Clin Neurosci, 253, pp.236~240 (2003)
- Gitlin MJ, "Relapse and impairment in bipolar disorder", Am J Psychiatry, 152, pp.1635~1640 (1995)
- Akiskal HS, "The evolving bipolar spectrum. Prototypes I, II, III, and IV", Psychiatr Clin North Am, 22, pp.517~534 (1999)
- Baethge C, "Does prophylaxis-delay in bipolar disorder influence outcome? Results from a long-term study of 147 patients", Acta Psychiatr Scand, 107, pp.260~267 (2003)
- Akiskal HS, "Re-evaluating the prevalence of and diagnostic composition within the broad clinical spectrum of bipolar disorders", J Affect Disord, 59(1), pp.5~30 (2000)
- Hirschfeld RM, "Bipolar spectrum disorder: improving its recognition and diagnosis", J Clin Psychiatry, 62(14), pp.5~9 (2001)
- Hirschfeld RM, "Perceptions and impact of bipolar disorder: how far have we really come? Results of the national depressive and manic-depressive association 2000 survey of individuals with bipolar disorder", J Clin Psychiatry, 64, pp.161~174 (2003)
- Shi L, "The impact of unrecognized bipolar disorders for patients treated for depression with antidepressants in the fee-for-services California Medicaid (Medi-Cal) program", J Affect Disord, 82, pp.373~383 (2004)
- Boerlin HL, "Bipolar depression and antidepressant-induced mania: a naturalistic study", J Clin Psychiatry, 59, pp.374~379 (1998)
- Spitzer RL, "The Structured Clinical Interview for DSM-III-R (SCID). I: History, rationale, and description", Arch Gen Psychiatry, 49, pp.624~629 (1992)
- Griner P, "Misuser of laboratory tests and diagnostic procedures", N Engl J Med, 307, pp.1336~1339 (1966)
- Hirschfeld RM, "Development and validation of a screening instrument for bipolar spectrum disorder: the Mood Disorder Questionnaire", Am J Psychiatry, 157, pp.1873~1875 (2000)
- Hirschfeld RM, "Validity of the mood disorder questionnaire: a general population study", Am J Psychiatry, 160, pp.178~180 (2003)
- Hirschfeld RM, "Recognition and diagnosis of bipolar disorder", J Clin Psychiatry, 65(15), pp.5~9 (2004)
- Yatham LN, "Diagnosis and management of patients with bipolar II disorder", J Clin Psychiatry, 66(1), pp.13~17 (2005)
- Parker G, "Screening for bipolar disorder: the utility and comparative properties of the MSS and MDQ measures", J Affect Disord, 109, pp.83~89 (2008)
- Pallanti S, "Awareness of illness and subjective experience of cognitive complaints in patients with bipolar I and bipolar II disorder", Am J Psychiatry, 156, pp.1094~1096 (1999)
- Dell’Osso L, "Insight into illness in patients with mania, mixed mania, bipolar depression and major depression with psychotic features", Bipolar Disord, 4, pp.315~322 (2002)
- Ghaemi SN, "Lack of insight in psychotic and affective disorders: a review of empirical studies", Harv Rev Psychiatry, 2, pp.22~33 (1994)
- Ghaemi SN, "Lack of insight in bipolar disorder. The acute manic episode", J Nerv Ment Dis, 183, pp.464~467 (1995)
- Miller CJ, "Sensitivity and specificity of the Mood Disorder Questionnaire for detecting bipolar disorder", J Affect Disord, 81, pp.167~171 (2004)
- Brissos S, "Quality of life in bipolar type I disorder and schizophrenia in remission: clinical and neurocognitive correlates", Psychiatry Res, 160, pp.55~62 (2008)
- 전 덕 인, "한국형 기분장애 질문지의 타당화 연구", 신경정신의학, 44(5), pp.583~590 (2005), 대한신경정신의학회
- Beck AT, "A new instrument for measuring insight: the Beck Cognitive Insight Scale", Schizophr Res, 68, pp.319~329 (2004)
- 김유라, "정신분열병 환자의 인지적 병식에 관한 연구", 한국심리학회지 임상, 25(4), pp.1011~1027 (2006), 한국임상심리학회
- 정희연, "Young조증 평가 척도의 한국판 표준화 연구", 신경정신의학, 42(2) (2003), 대한신경정신의학회
- 이중서, "한국판 Hamilton 우울증 평가 척도의 신뢰도, 타당도 연구", 신경정신의학, 44(4), pp.456~465 (2005), 대한신경정신의학회
- Judd LL, "The long-term natural history of the weekly symptomatic status of bipolar I disorder", Arch Gen Psychiatry, 59, pp.530~537 (2002)
- Judd LL, "A prospective investigation of the natural history of the long-term weekly symptomatic status of bipolar II disorder", Arch Gen Psychiatry, 60, pp.261~269 (2003)
- Chung KF, "Validation of the Chinese version of the Mood Disorder Questionnaire in a psychiatric population in Hong Kong", Psychiatry Clin Neurosci, 62, pp.464~471 (2008)
- Sanchez-Moreno J, "Adaptation and validation of the Spanish version of the Mood Disorder Questionnaire for the detection of bipolar disorder", Bipolar Disord, 10, pp.400~412 (2008)
- Hardoy MC, "Validation of the Italian version of the “Mood Disorder Questionnaire” for the screening of bipolar disorders", Clin Pract Epidemiol Ment Health, 1, pp.8~ (2005)
- Konuk N, "Validation of the Turkish version of the mood disorder questionnaire for screening bipolar disorders", Turk Psikiyatri Derg, 18, pp.147~154 (2007)
- Weber Rouget B, "Screening for bipolar disorders using a French version of the Mood Disorder Questionnaire (MDQ)", J Affect Disord, 88, pp.103~108 (2005)
- Markova IS, "Insight in clinical psychiatry. Insight in psychiatry", pp.66~172 (2005), Cambridge: United Kingdom at the University Press Inc
- Amador XF, "Assessment of insight in psychosis", Am J Psychiatry, 150, pp.873~879 (1993)
- Ghaemi SN, "Is insight in mania state-dependent?: a meta-analysis", J Nerv Ment Dis, 192, pp.771~775 (2004)
- Heinrichs DW, "Early insight and the management of schizophrenic decompensation", J Nerv Ment Dis, 173, pp.133~138 (1985)
- Yen CF, "Changes in insight among patients with bipolar I disorder: a 2-year prospective study", Bipolar Disord, 9, pp.238~242 (2007)
- Coli MJ, "Cognitive insight in inpatient with psychotic, bipolar and major depression disorders", J Psychopathol Behav Assess, 28, pp.243~249 (2006)