{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T04:11:52Z","timestamp":1778299912660,"version":"3.51.4"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,5,3]],"date-time":"2021-05-03T00:00:00Z","timestamp":1620000000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,5,3]],"date-time":"2021-05-03T00:00:00Z","timestamp":1620000000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Bipolar Disord"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>DSM-IV states that criterion A for diagnosing hypomania\/mania is mood change. The revised DSM-5 now states that increased energy or activity must be present alongside mood changes to diagnose hypomania\/mania, thus raising energy\/activity to criterion A. We set out to investigate how the change in criterion A affects the diagnosis of hypomanic\/manic visits in patients with a newly diagnosed bipolar disorder.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In this prospective cohort study, 373 patients were included (median age\u2009=\u200932; IQR, 27\u201340). Women constituted 66% (n\u2009=\u2009245) of the cohort and 68% of the cohort (n\u2009=\u2009253) met criteria for bipolar type II, the remaining patients were diagnosed bipolar type I. Median number of contributed visits was 2 per subject (IQR, 1\u20133) and median follow-up time was 3\u00a0years (IQR, 2\u20134). During follow-up, 127 patients had at least one visit with fulfilled DSM-IV criterion A. Applying DSM-5 criterion A reduced the number of patients experiencing a hypomanic\/manic visit by 62% at baseline and by 50% during longitudinal follow-up, compared with DSM-IV criterion A. Fulfilling DSM-5 criterion A during follow-up was associated with higher modified young mania rating scale score (OR\u2009=\u20091.51, CL [1.34, 1.71], p\u2009&lt;\u20090.0001) and increased number of visits contributed (OR\u2009=\u20091.86, CL [1.52, 2.29], p\u2009&lt;\u20090.0001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Applying the stricter DSM-5 criterion A in a cohort of newly diagnosed bipolar patients reduced the number of patients experiencing a hypomanic\/manic visit substantially, and was associated with higher overall young mania rating scale scores, compared with DSM-IV criterion A. Consequently, fewer hypomanic\/manic visits may be detected in newly diagnosed bipolar patients with applied DSM-5 criterion A, and the upcoming ICD-11, which may possibly result in longer diagnostic delay of BD as compared with the DSM-IV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40345-020-00219-9","type":"journal-article","created":{"date-parts":[[2021,5,3]],"date-time":"2021-05-03T10:54:08Z","timestamp":1620039248000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Impact of modification to DSM-5 criterion A for hypomania\/mania in newly diagnosed bipolar patients: findings from the prospective BIO study"],"prefix":"10.1186","volume":"9","author":[{"given":"Mette U.","family":"Fredskild","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharleny","family":"Stanislaus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klara","family":"Coello","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sigurd A.","family":"Melbye","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanne Lie","family":"Kj\u00e6rstad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimie Stefanie Ormstrup","family":"Sletved","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trisha","family":"Suppes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maj","family":"Vinberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars Vedel","family":"Kessing","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,5,3]]},"reference":[{"key":"219_CR1","volume-title":"Diagnostic and Statistical manual of mental disorders: DSM-IV","author":"Association. 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Written informed consent was provided by all participants. The study complied with the Declaration of Helsinki principles.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was provided by all participants.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Lars Vedel Kessing has in the past 3\u00a0years been a consultant for Lundbeck. Maj Vinberg has in the past 3\u00a0years been a consultant for Lundbeck, Janssen Cilag and Sunovion.Trisha Suppes has in the past 3\u00a0years reported: Grants from Merck, National Institute on Drug Abuse, National Institute of Health, VA Cooperative Studies Program, and VA OR&D PRIME Care, Palo Alto Health Sciences, Stanley Medical Research Institute, Pathways Genomics. Consulting fees from Allergan, Inc., Intracellular Therapies, Sunovion Pharmaceuticals, Inc., and Impel NeuroPharma Inc. Honoraria from CME Institute (Physicians Postgraduate Press, Inc.) and CMEology. Royalties from American Psychiatric Association Publishing, Hogrefe Publishing, Jones and Bartlett, and Wolters Kluwer Health (UpToDate). Travel reimbursement from Sunovion Pharmaceuticals, Inc.The remaining authors declare no conflicts of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"14"}}