ASPOFAFF :: Journal - Volume 1 :: Issue 2 :: Vol 1 - Iss 2 - Short Communication - Linking Instability to Mood-Incongruent Psychotic Features in Acute Mania: Data on 1090 patients


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ASPOFAFF :: Journal - Volume 1 :: Issue 2 :: Vol 1 - Iss 2 - Short Communication - Linking Instability to Mood-Incongruent Psychotic Features in Acute Mania: Data on 1090 patients – “EPIMAN-II”

Vol 1 - Iss 2 - Short Communication - Linking Instability to Mood-Incongruent Psychotic Features in Acute Mania: Data on 1090 patients – “EPIMAN-II” #41

Linking Instability to Mood-Incongruent Psychotic Features in Acute Mania: Data on 1090 patients – “EPIMAN-II” Azorin JM1, Hantouche EG2, Akiskal HS3, Lancrenon S4, Châtenet-Duchêne L5 1 Hôpital Ste Marguerite, Marsielle 2 Mood Center, Université Paris VI, Hôpital Pitié-Salpêtrière, Paris 3 International Mood Center, UCSD, San Diego 4 Sylia-Stat, Antomy 5 CNS Department Sanofi-Synthelabo, Le Plessis Robinson-France Following the EPIMAN study (Akiskal et al, 1998), a new French study (EPIMAN-II Thousand) was initiated with the objective of including 1000 patients with acute mania. In this report, data are focused on the role of mood instability in psychotic mania. Method: “EPIMAN-II Thousand” is a national multi-site collaborative study dedicated to the clinical sub-types of mania. It involved training 317 French psychiatrists working in different sites representative of France. The study actually succeeded in recruiting 1090 cases admitted for acute mania (DSM-IV criteria). Assessment of psychotic features was made using the full version of SAPS (Andreasen). An agenda for mood stability was completed three times daily, and during the first week of hospitalization, by nursing staff and patients. Results: The rate of severe mania with psychotic features was 49,9%: 33,4% with mood-congruent (MCP) and 16,5% with mood-incongruent (MICP) features. The global group with psychotic mania was characterized by a younger age of disorder onset (26-27 years vs 30 years in Non Psychotic (NP) mania, p<0,05) and of seeking help (27-29 vs 32 years, p<0,05). In theMICP sub-group, prior diagnoses were more likely to be toward schizophrenic disorders (26,3% vs 17,6% (MCP) vs 8,5% in NP, p=0,0001), schizo-affective disorder (24,0% vs 17,9% (MCP) vs 12,7% in NP, p=0,001). The mean of maximal daily variations on mood agenda, were significantly elevated (p<0,05) in the MICP during day-1-3: 2,3 vs others groups (1,7 in MCP and 1,8 in NP); and during day 1-7: 2,0 vs others groups (1,6 in MCP and 1,6 in NP). Conclusion: Mania with mood-incongruent psychotic features begins earlier than other forms of mania, and is likely to be misrepresented as schizophrenic disorder. High mood instability could be one of the major factors related to mood-incongruence of psychotic features in mania. Bibliography: Akiskal HS et al. Gender, temperament, and the clinical picture in dysphoric mixed mania: findings from EPIMAN study. J Affect Disord 1998; 50: 175-86. Funding source: unrestricted grant from Sanofi-Aventis

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