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2 results

  • Item response modeling of DSM-IV mania symptoms in two representative US epidemiological samples

  • A. Agrawal, J. I. Nurnberger, Jr., M. T. Lynskey
  • Journal:
    Psychological Medicine / Volume 40 / Issue 9 / September 2010
    Published online by Cambridge University Press:
    02 December 2009, pp. 1549-1558
  • Background

    There is considerable debate surrounding the effective measurement of DSM-IV symptoms used to assess manic disorders in epidemiological samples.

    Method

    Using two nationally representative datasets, the National Epidemiological Survey of Alcohol and Related Conditions (NESARC, n=43 093 at wave 1, n=34 653 at 3-year follow-up) and the National Comorbidity Survey – Replication (NCS-R, n=9282), we examined the psychometric properties of symptoms used to assess DSM-IV mania. The predictive utility of the mania factor score was tested using the 3-year follow-up data in NESARC.

    Results

    Criterion B symptoms were unidimensional (single factor) in both samples. The symptoms assessing flight of ideas, distractibility and increased goal-directed activities had high factor loadings (0.70–0.93) with moderate rates of endorsement, thus providing good discrimination between individuals with and without mania. The symptom assessing grandiosity performed less well in both samples. The quantitative mania factor score was a good predictor of more severe disorders at the 3-year follow-up in the NESARC sample, even after controlling for a past history of DSM-IV diagnosis of manic disorder.

    Conclusions

    These analyses suggest that questions based on some DSM symptoms effectively discriminate between individuals at high and low liability to mania, but others do not. A quantitative mania factor score may aid in predicting recurrence for patients with a history of mania. Methods for assessing mania using structured interviews in the absence of clinical assessment require further refinement.

  • Part II - The Social Context of Mental Health and Illness

  • Edited by Teresa L. Scheid, University of North Carolina, Charlotte, Tony N. Brown, Vanderbilt University, Tennessee
  • Book:
    A Handbook for the Study of Mental Health
    Published online:
    05 June 2012
    Print publication:
    16 November 2009, pp 163-406

  • Summary

    An important issue in assessing the societal burden of mental disorders is whether the evidence of increasing prevalence in recent cohorts is real or a methodological artifact. The chapter begins with a broad overview of results concerning the estimated lifetime prevalence, age-of-onset distributions, projected lifetime risk, cohort effects, and sociodemographic correlates of the Diagnostic and Statistical Manual DSM-IV disorders assessed in the National Comorbidity Survey Replication (NCS-R). It then turns to a discussion of the prevalence of these same disorders in the year before the NCS-R interview. This is followed by a brief review of data regarding trends in disorder prevalence and treatment in the NCS-R compared to a decade earlier in the baseline NCS. The chapter closes with a discussion of interpretations and implications of these results along with anticipated future directions in the investigation of the prevalence of mental disorders.