{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T07:07:25Z","timestamp":1761894445119},"reference-count":39,"publisher":"Cambridge University Press (CUP)","issue":"2","license":[{"start":{"date-parts":[[2020,4,16]],"date-time":"2020-04-16T00:00:00Z","timestamp":1586995200000},"content-version":"unspecified","delay-in-days":4795,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur. psychiatr."],"published-print":{"date-parts":[[2007,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S092493380024501X_abs1\" sec-type=\"other\"><jats:title>Background<\/jats:title><jats:p>DSM-IV definition of hypomania of bipolar-II disorder (BP-II), which includes elevated\/irritable mood change as core feature (i.e., it must always be present), is not based on sound evidence.<\/jats:p><\/jats:sec><jats:sec id=\"S092493380024501X_abs2\" sec-type=\"other\"><jats:title>Study aim<\/jats:title><jats:p>Following classic descriptions of hypomania, was to test if hypomania could be diagnosed on the basis of its number (9) of DSM-IV symptoms, setting no-priority symptom.<\/jats:p><\/jats:sec><jats:sec id=\"S092493380024501X_abs3\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>Consecutive 422 depression-<jats:italic>remitted<\/jats:italic> outpatients were re-interviewed by a mood specialist psychiatrist using the Structured Clinical Interview for DSM-IV Axis I Disorders-Clinician Version [a semi-structured interview modified by Benazzi and Akiskal (J Affect Disord, 2003; J Clin Psychiatry, 2005) to improve the probing for BP-II] in a private practice. History of <jats:italic>episodes<\/jats:italic> of subthreshold (i.e., 2 or more symptoms) and threshold (i.e., meeting DSM-IV criteria of elevated mood plus at least 3 symptoms, or irritable mood plus at least 4) hypomania, lasting at least 2 days, and which were the most common symptoms during the episodes, were systematically assessed.<\/jats:p><\/jats:sec><jats:sec id=\"S092493380024501X_abs4\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Bipolar-II disorder (BP-II) patients (according to DSM-IV criteria, apart from hypomania duration) were 260, and major depressive disorder (MDD) patients were 162. Mood change was present in all BP-II by definition. The most common symptoms were overactivity, which was present in almost all BP-II, followed by elevated mood and racing thoughts. ROC analysis of the number of hypomanic symptoms predicting BP-II found that a cut point of 5 or more symptoms over 9 had the best combination of sensitivity (90%) and specificity (84%), and the highest figure of correctly classified (87%) BP-II. History of episodes of 5 or more hypomanic symptoms was met by almost all BP-II.<\/jats:p><\/jats:sec><jats:sec id=\"S092493380024501X_abs5\" sec-type=\"other\"><jats:title>Limitations<\/jats:title><jats:p>Single interviewer.<\/jats:p><\/jats:sec><jats:sec id=\"S092493380024501X_abs6\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>Following classic descriptions of hypomania, not setting any priority among the three basic domains of hypomania (mood, thinking, behavior), results suggest that a cutoff number of 5 symptoms over 9 (of those listed by DSM-IV) could be used to diagnose hypomania of BP-II. Diagnosing hypomania by counting a checklist of symptoms should make it easier to diagnose BP-II, and should reduce the current high misdiagnosis of BP-II as MDD, significantly impacting the treatment of depression.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.eurpsy.2006.06.003","type":"journal-article","created":{"date-parts":[[2006,11,29]],"date-time":"2006-11-29T22:25:15Z","timestamp":1164839115000},"page":"99-103","source":"Crossref","is-referenced-by-count":19,"title":["Challenging DSM-IV criteria for hypomania: Diagnosing based on number of no-priority symptoms"],"prefix":"10.1017","volume":"22","author":[{"given":"Franco","family":"Benazzi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2020,4,16]]},"reference":[{"key":"S092493380024501X_bib34","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2004.01.005"},{"key":"S092493380024501X_bib33","doi-asserted-by":"publisher","DOI":"10.1016\/S0193-953X(05)70101-5"},{"key":"S092493380024501X_bib28","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-0327(02)00319-1"},{"key":"S092493380024501X_bib25","volume-title":"Structured clinical interview for DSM-IV axis I disorders-clinician version (SCID-CV)","author":"First","year":"1997"},{"key":"S092493380024501X_bib29","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.60.3.261"},{"key":"S092493380024501X_bib22","first-page":"53","volume-title":"DSM-IV Sourcebook, volume 2","author":"Dunner","year":"1996"},{"key":"S092493380024501X_bib21","doi-asserted-by":"publisher","DOI":"10.1016\/S0193-953X(02)00025-4"},{"key":"S092493380024501X_bib18","doi-asserted-by":"publisher","DOI":"10.1177\/070674370404900312"},{"key":"S092493380024501X_bib15","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2004.07.004"},{"key":"S092493380024501X_bib30","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-0327(02)00326-9"},{"key":"S092493380024501X_bib8","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-0327(02)00322-1"},{"key":"S092493380024501X_bib5","volume-title":"Text revision (DSM-IV-TR)","year":"2000"},{"key":"S092493380024501X_bib2","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.1176\/ajp.134.11.1227","article-title":"Cyclothymic disorder: validating criteria for inclusion in the bipolar affective group","volume":"134","author":"Akiskal","year":"1977","journal-title":"Am J Psychiatry"},{"key":"S092493380024501X_bib19","doi-asserted-by":"publisher","DOI":"10.1159\/000082029"},{"key":"S092493380024501X_bib32","doi-asserted-by":"publisher","DOI":"10.1016\/S0193-953X(05)70103-9"},{"key":"S092493380024501X_bib36","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.59.8.736"},{"key":"S092493380024501X_bib26","volume-title":"Manic-depressive illness","author":"Goodwin","year":"1990"},{"key":"S092493380024501X_bib16","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2004.07.034"},{"key":"S092493380024501X_bib31","doi-asserted-by":"publisher","DOI":"10.1097\/00005053-192104000-00057"},{"key":"S092493380024501X_bib10","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-0327(02)00333-6"},{"key":"S092493380024501X_bib6","first-page":"1","article-title":"Practice guideline for the treatment of patients with bipolar disorder (revision)","volume":"159","year":"2002","journal-title":"Am J Psychiatry"},{"key":"S092493380024501X_bib12","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-440X(00)90142-1"},{"key":"S092493380024501X_bib4","doi-asserted-by":"publisher","DOI":"10.1016\/S0193-953X(05)70093-9"},{"key":"S092493380024501X_bib7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2005.05.011"},{"key":"S092493380024501X_bib1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v66n0715"},{"key":"S092493380024501X_bib17","doi-asserted-by":"publisher","DOI":"10.1007\/s004060170065"},{"key":"S092493380024501X_bib14","doi-asserted-by":"publisher","DOI":"10.1016\/S0278-5846(03)00158-1"},{"key":"S092493380024501X_bib13","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-1781(03)00198-7"},{"key":"S092493380024501X_bib38","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.2006.163.5.846"},{"key":"S092493380024501X_bib23","doi-asserted-by":"publisher","DOI":"10.1046\/j.1399-5618.2003.00073.x"},{"key":"S092493380024501X_bib20","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2004.00125.x"},{"key":"S092493380024501X_bib39","unstructured":"[39] Zimmerman, M. , McGlinchey, J.B. , Young, D.D. , Chelminski, I. 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