{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T09:01:05Z","timestamp":1759482065946},"reference-count":17,"publisher":"Cambridge University Press (CUP)","issue":"3","license":[{"start":{"date-parts":[[2014,11,7]],"date-time":"2014-11-07T00:00:00Z","timestamp":1415318400000},"content-version":"unspecified","delay-in-days":3903,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CNS spectr."],"published-print":{"date-parts":[[2004,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p><jats:bold>Background:<\/jats:bold><jats:italic>This study examined the prevalence of irritability in patients with bipolar I disorder during an episode of<\/jats:italic>Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV)<jats:italic>major depression who do not meet criteria for a mixed episode<\/jats:italic>.<\/jats:p><jats:p><jats:bold>Method:<\/jats:bold><jats:italic>A chart review of 111 patients with bipolar I disorder treated at the Massachusetts General Hospital Bipolar Clinic between 1998 and 2000 identified 34 patients who met criteria for a<\/jats:italic>DSM-IV<jats:italic>major depressive episode in the absence of (1) mood elevation and\/or (2) irritability associated with any additional above threshold<\/jats:italic>DSM-IV<jats:italic>symptoms of mania. Data gathered from the charts utilized prospective ratings made routinely at each clinic visit using the Clinical Monitoring Form (CMF), a structured assessment instrument which includes modified versions of the mood modules of the Structured Clinical Interview for<\/jats:italic>DSM-IV.<jats:italic>Data from these 34 patients were reviewed to determine the presence of irritability<\/jats:italic>.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold><jats:italic>The frequency of abnormal irritability in these 34 patients followed a bimodal distribution: 26% of the patients showed abnormal irritability \u226575% of the time, compared with 68% of the patients with abnormal irritabihty \u226430% of the time. Of the high-irritability patients, psychomotor agitation was rated as definitely present to a significant degree in 44%. Talkativeness and distractibility were rated present but subthreshold in one patient each. All other symptoms of<\/jats:italic>DSM-IV<jats:italic>mania were absent<\/jats:italic>.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold><jats:italic>Approximately 25% of patients with bipolar I disorder who meet criteria for a<\/jats:italic>DSM-IV<jats:italic>major depressive episode also experienced substantial irritability in the absence of associated symptoms of mania. Our results suggest that abnormal irritability is not limited to mania or mixed states<\/jats:italic>.<\/jats:p>","DOI":"10.1017\/s1092852900009020","type":"journal-article","created":{"date-parts":[[2016,8,2]],"date-time":"2016-08-02T03:27:55Z","timestamp":1470108475000},"page":"227-231","source":"Crossref","is-referenced-by-count":26,"title":["Presence of Irritability During Depressive Episodes in Bipolar Disorder"],"prefix":"10.1017","volume":"9","author":[{"given":"Thilo","family":"Deckersbach","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roy H.","family":"Perlis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W. 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