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Cincinnati criteria for mixed mania and suicidality in patients with acute mania.
- Source :
-
Comprehensive psychiatry [Compr Psychiatry] 2004 Jan-Feb; Vol. 45 (1), pp. 62-9. - Publication Year :
- 2004
-
Abstract
- The association between suicidality and diagnoses of mixed mania, as defined using both DSM-IV and Cincinnati criteria, was studied in 576 consecutive manic inpatients. Of the whole sample, 51 (8.9%) had suicidal ideation and 13 (2.3%) attempted suicide during the index episode. Suicidality was significantly more frequent in patients with a diagnosis of mixed mania, whether the diagnosis was made by DSM-IV or Cincinnati criteria. A multiple logistic regression analysis revealed that an additive combination of a diagnosis of mixed mania, the depression severity, and the Global Assessment of Functioning (GAF) score was significant in predicting suicidal ideation, when using the DSM-IV criteria. A diagnosis of mixed mania alone was significant in a similar analysis, when using the Cincinnati criteria. The adjusted odds ratio for a diagnosis of mixed mania to having suicidality was much higher when using the latter criteria (4.0 v 14.0). A subsequent logistic regression analysis indicated that the Cincinnati mixed mania alone, rather than an additive combination of the DSM-IV mixed mania and the depression severity, achieved the most appropriate prediction of suicidal ideation in the sample. These findings did not differ, even when suicidality was defined as having a suicide attempt during the index episode. Our finding that suicidality was more strongly associated with Cincinnati mixed mania than with DSM-IV mixed mania is probably due to that suicidal patients who do not meet DSM-IV criteria for mixed mania are classified into mixed mania, or/and that the depressive syndrome, related to suicidality, is more appropriately assessed among manic patients, when using the Cincinnati criteria. There was no evidence that marital status, employment, a lifetime history of alcohol or substance abuse, or a history of suicide attempts before the index episode was significantly associated with suicidality in the sample. Manic patients with suicidality may have a greater severity of residual depressive symptoms at discharge.
- Subjects :
- Acute Disease
Adult
Bipolar Disorder epidemiology
Bipolar Disorder psychology
Depressive Disorder diagnosis
Depressive Disorder epidemiology
Depressive Disorder psychology
Diagnostic and Statistical Manual of Mental Disorders
Female
Germany
Humans
International Classification of Diseases
Logistic Models
Male
Middle Aged
Odds Ratio
Patient Admission
Psychometrics statistics & numerical data
Reproducibility of Results
Risk Assessment statistics & numerical data
Suicide statistics & numerical data
Suicide, Attempted statistics & numerical data
Suicide Prevention
Bipolar Disorder diagnosis
Personality Assessment statistics & numerical data
Suicide psychology
Suicide, Attempted psychology
Subjects
Details
- Language :
- English
- ISSN :
- 0010-440X
- Volume :
- 45
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Comprehensive psychiatry
- Publication Type :
- Academic Journal
- Accession number :
- 14671739
- Full Text :
- https://doi.org/10.1016/S0010-440X(03)00145-7