Abstract：
A commonly used measure to assess mixed features in depressed patients is the Young Mania Rating Scale (YMRS), which only partially aligns with the DSM-5 criteria. Different algorithms on the YMRS have been used to approximate the DSM-5 mixed features criteria. In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we examined the agreement and validity of different approaches towards assessing the mixed features specifier.
Three hundred nine depressed psychiatric patients were interviewed with the Structured Clinical Interview for DSM-IV, the DSM-5 Mixed Features Specifier Interview (DMSI) and the YMRS. Seven definitions of mixed features were examined, two based on the DMSI and five from the YMRS.
The prevalence of mixed features varied 8-fold amongst the 7 definitions. The level of agreement between the YMRS definitions and the DMSI was poor. For each definition, mixed features were significantly more common in patients with bipolar disorder than major depressive disorder. A family history of bipolar disorder was significantly associated with the DMSI assessment of mixed features but none of the YMRS approaches.
The ratings on the measures were not independent of each other. The sample size was too small to compare the patients with bipolar I and bipolar II disorder.
While there was evidence of validity for both the DSM-5 and YMRS approaches towards identifying mixed features, the 2 approaches are not interchangeable. The algorithm on the YMRS used to classify patients has a significant impact on prevalence.
Three hundred nine depressed psychiatric patients were interviewed with the Structured Clinical Interview for DSM-IV, the DSM-5 Mixed Features Specifier Interview (DMSI) and the YMRS. Seven definitions of mixed features were examined, two based on the DMSI and five from the YMRS.
The prevalence of mixed features varied 8-fold amongst the 7 definitions. The level of agreement between the YMRS definitions and the DMSI was poor. For each definition, mixed features were significantly more common in patients with bipolar disorder than major depressive disorder. A family history of bipolar disorder was significantly associated with the DMSI assessment of mixed features but none of the YMRS approaches.
The ratings on the measures were not independent of each other. The sample size was too small to compare the patients with bipolar I and bipolar II disorder.
While there was evidence of validity for both the DSM-5 and YMRS approaches towards identifying mixed features, the 2 approaches are not interchangeable. The algorithm on the YMRS used to classify patients has a significant impact on prevalence.
摘要：
背景：评估抑郁症患者混合特征的常用方法是青年躁狂症评定量表（YMRS），仅部分符合DSM-5标准。YMRS上的不同算法已用于近似DSM-5混合特征标准。在罗德岛改善诊断评估和服务方法（MIDAS）项目的本报告中，我们研究了评估混合特征说明符的不同方法的一致性和有效性。
方法：通过DSM-IV的结构化临床访谈，对三百九个抑郁症精神病患者进行了访谈，DSM-5混合功能说明符访谈(DMSI)和YMRS。研究了混合特征的七个定义，两个基于DMSI，五个来自YMRS。
结果：混合特征的患病率在7个定义中变化了8倍。YMRS定义与DMSI之间的协议水平很低。对于每个定义，混合特征在双相情感障碍患者中明显多于重度抑郁障碍.双相情感障碍家族史与混合特征的DMSI评估显着相关，但没有YMRS方法。
结论：这些措施的评级不是彼此独立的。样本量太小，无法比较双相I型和双相II型患者。
结论：虽然有证据表明DSM-5和YMRS方法识别混合特征的有效性，这两种方法是不可互换的。用于对患者进行分类的YMRS算法对患病率有显著影响。
方法：通过DSM-IV的结构化临床访谈，对三百九个抑郁症精神病患者进行了访谈，DSM-5混合功能说明符访谈(DMSI)和YMRS。研究了混合特征的七个定义，两个基于DMSI，五个来自YMRS。
结果：混合特征的患病率在7个定义中变化了8倍。YMRS定义与DMSI之间的协议水平很低。对于每个定义，混合特征在双相情感障碍患者中明显多于重度抑郁障碍.双相情感障碍家族史与混合特征的DMSI评估显着相关，但没有YMRS方法。
结论：这些措施的评级不是彼此独立的。样本量太小，无法比较双相I型和双相II型患者。
结论：虽然有证据表明DSM-5和YMRS方法识别混合特征的有效性，这两种方法是不可互换的。用于对患者进行分类的YMRS算法对患病率有显著影响。
