{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T20:58:56Z","timestamp":1771102736878,"version":"3.50.1"},"reference-count":32,"publisher":"FapUNIFESP (SciELO)","issue":"4","license":[{"start":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T00:00:00Z","timestamp":1569888000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T00:00:00Z","timestamp":1569888000000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T00:00:00Z","timestamp":1569888000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Trends Psychiatry Psychother."],"abstract":"<jats:p>Abstract  Introduction  Although bipolar disorder (BD) is traditionally included among mood disorders, some authors believe that changes in energy and motor activity, rather than mood changes, represent the true cardinal symptoms in mania and depression. The aim of the current study was to identify which cluster of the Hamilton Depression Rating Scale (HAM-D) better distinguishes between mania, depression and euthymia.  Method  A group of 106 patients with BD were followed for 13 years and repeatedly assessed with the HAM-D as well as with other clinical scales. To perform a comparison, HAM-D items were classified according to clinical criteria into three clusters: energy\/activity symptoms, mood symptoms, and other symptoms. Item response theory (IRT) analyses were performed to provide a test information curve for those three clusters. We measured the prevalence of one cluster of symptoms over the other two throughout the latent trait.  Results  Considering HAM-D items individually, the IRT analysis revealed that there was a mixture of mood and energy\/activity symptoms among the most discriminative items, both in depression and in euthymia. However, in mania, only energy\/activity symptoms \u2013 i.e., general somatic symptoms and retardation \u2013 were among the most informative items. Considering the classification of items, both in depression as in mania, the energy\/activity cluster was more informative than the mood cluster according to the IRT analysis.  Conclusion  Our data reinforce the view of hyperactivity and motor retardation as cardinal changes of mania and depression, respectively.<\/jats:p>","DOI":"10.1590\/2237-6089-2018-0116","type":"journal-article","created":{"date-parts":[[2020,1,21]],"date-time":"2020-01-21T09:58:09Z","timestamp":1579600689000},"page":"401-408","source":"Crossref","is-referenced-by-count":5,"title":["Mood versus energy\/activity symptoms in bipolar disorder: which cluster of Hamilton Depression Rating Scale better distinguishes between mania, depression, and euthymia?"],"prefix":"10.1590","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4769-2684","authenticated-orcid":false,"given":"Elie","family":"Cheniaux","sequence":"first","affiliation":[{"name":"Universidade Federal do Rio de Janeiro,  Brazil; Universidade do Estado do Rio de Janeiro,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael de Assis da","family":"Silva","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio de Janeiro,  Brazil; Universidade Federal do Estado do Rio de Janeiro,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina M. T.","family":"Santana","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio de Janeiro,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio Egidio","family":"Nardi","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio de Janeiro,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Filgueiras","sequence":"additional","affiliation":[{"name":"Universidade do Estado do Rio de Janeiro,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","published-online":{"date-parts":[[2019,10]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/j.jad.2009.04.018","article-title":"The quantitative assessment of motor activity in mania and schizophrenia","volume":"120","author":"Minassian A","year":"2010","journal-title":"J Affect Disord"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.psychres.2010.04.032","article-title":"Quantifying over-activity in bipolar and schizophrenia patients in a human open field paradigm","volume":"178","author":"Perry W","year":"2010","journal-title":"Psychiatry Res"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1016\/j.psychres.2016.04.078","article-title":"Diagnosis and characterization of mania: Quantifying increased energy and activity in the human behavioral pattern monitor","volume":"240","author":"Perry W","year":"2016","journal-title":"Psychiatry Res"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.jad.2012.07.001","article-title":"Activity monitoring in patients with depression: a systematic review","volume":"145","author":"Burton C","year":"2013","journal-title":"J Affect Disord"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1111\/acps.12625","article-title":"Distinct resting-state perfusion patterns underlie psychomotor retardation in unipolar vs. bipolar depression","volume":"134","author":"Cantisani A","year":"2016","journal-title":"Acta Psychiatr Scand"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/S0165-0327(01)00441-4","article-title":"Toward a refined phenomenology of mania: combining clinician-assessment and self-report in the French EPIMAN study","volume":"67","author":"Akiskal HS","year":"2001","journal-title":"J Affect Disord"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/S0165-0327(02)00318-X","article-title":"Proposed multidimensional structure of mania: beyond the euphoric-dysphoric dichotomy","volume":"73","author":"Akiskal HS","year":"2003","journal-title":"J Affect Disord"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1001\/archpsyc.1991.01810330031005","article-title":"Independent assessment of manic and depressive symptoms by self-rating. Scale characteristics and implications for the study of mania","volume":"48","author":"Bauer MS","year":"1991","journal-title":"Arch Gen Psychiatry"},{"key":"ref9","series-title":"Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR)","year":"2000"},{"key":"ref10","series-title":"Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)","year":"2013"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1192\/bjp.133.5.429","article-title":"A rating scale for mania: reliability, validity and sensitivity","volume":"133","author":"Young RC","year":"1978","journal-title":"Br J Psychiatry"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1136\/jnnp.23.1.56","article-title":"A rating scale for depression","volume":"23","author":"Hamilton MA","year":"1960","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1016\/j.psychres.2011.05.028","article-title":"Measuring motor activity in major depression: the association between the Hamilton Depression Rating Scale and actigraphy","volume":"190","author":"Razavi N","year":"2011","journal-title":"Psychiatry Res"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1590\/S1516-44462001000300008","article-title":"Confiabilidade da \u201cEntrevista Cl\u00ednica Estruturada para o DSM-IV - Vers\u00e3o Cl\u00ednica\u201d traduzida para o portugu\u00eas","volume":"23","author":"Del-Ben CM","year":"2001","journal-title":"Rev Bras Psiquiatr"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/S0165-1781(97)00123-6","article-title":"Modification of the Clinical Global Impressions (CGI) Scale for use in bipolar illness (BP): the CGI-BP","volume":"73","author":"Spearing MK","year":"1997","journal-title":"Psychiatry Res"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1177\/0013164492052004004","article-title":"A comparison of two methods of test equating in the Rasch model","volume":"52","author":"Smith RM","year":"1992","journal-title":"Educ Psychol Meas"},{"key":"ref17","first-page":"111","article-title":"Testing measurement invariance across groups: applications in cross-cultural research","volume":"3","author":"Fisher R","year":"2011","journal-title":"Int J Psychol Res"},{"key":"ref18","series-title":"Measuring model fit","author":"Kenny DA","year":"2005"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"2025","DOI":"10.1017\/S0033291716000520","article-title":"Item response theory and the measurement of psychiatric constructs: some empirical and conceptual issues and challenges","volume":"46","author":"Reise SP","year":"2016","journal-title":"Psychol Med"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1177\/014662169201600206","article-title":"A generalized partial credit model: application of an EM algorithm","volume":"16","author":"Muraki E","year":"1992","journal-title":"Appl Psychol Meas"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1016\/j.jad.2013.09.021","article-title":"Increased energy\/activity, not mood changes, is the core feature of mania","author":"Cheniaux E","year":"2014","journal-title":"J Affect Disord"},{"key":"ref22","series-title":"Schedule for Affective Disorders and Schizophrenia: change version","author":"Spitzer RL","year":"1978"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1001\/archpsyc.1971.01750150064009","article-title":"The Manic-State Rating Scale: scale construction, reliability and validity","volume":"25","author":"Beigel A","year":"1971","journal-title":"Arch Gen Psychiatry"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/0165-1781(94)90122-8","article-title":"Circadian pattern of motor activity in major depressed patients undergoing antidepressant therapy: relationship between actigraphic measures and clinical course","volume":"52","author":"Raoux N","year":"1994","journal-title":"Psychiatry Res"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/S0924-977X(02)00019-6","article-title":"24-hour motor activity after treatment with imipramine or fluvoxamine in major depressive disorder","volume":"12","author":"Volkers AC","year":"2002","journal-title":"Eur Neuropsychopharmacol"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1001\/archpsyc.1975.01760210019001","article-title":"Overview of recent research in depression. Integration of ten conceptual models into a comprehensive clinical frame","volume":"32","author":"Akiskal HS","year":"1975","journal-title":"Arch Gen Psychiatry"},{"key":"ref27","first-page":"19","article-title":"The measurement of retardation in depression","volume":"59","author":"Dantchev N","year":"1998","journal-title":"J Clin Psychiatry"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.jad.2010.12.007","article-title":"\u2018Bright side\u2019 and \u2018dark side \u2018hypomania are associated with differences in psychological functioning, sleep and physical activity in a non-clinical sample of young adults","volume":"131","author":"Brand S","year":"2011","journal-title":"J Affect Disord"},{"key":"ref29","doi-asserted-by":"crossref","DOI":"10.3389\/fpsyg.2017.02130","article-title":"\u201cAlways look on the bright side of life!\u201d - Higher hypomania scores are associated with higher mental toughness, increased physical activity, and lower symptoms of depression and lower sleep complaints","volume":"8","author":"Jahangard L","year":"2017","journal-title":"Front Psychol"},{"key":"ref30","series-title":"Ein Kurzes Lehrbuch der Psychiatrie","author":"Kraepelin E","year":"1891","edition":"4"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1097\/NMD.0b013e3181b3b3a0","article-title":"Validity and reliability of the Hamilton Depression Rating Scale (5 items) for manic and mixed bipolar disorders","volume":"197","author":"Gonzalez-Pinto A","year":"2009","journal-title":"J Nerv Ment Dis"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"2163","DOI":"10.1176\/appi.ajp.161.12.2163","article-title":"The Hamilton Depression Rating Scale: has the gold standard become a lead weight?","volume":"161","author":"Bagby RM","year":"2004","journal-title":"Am J Psychiatry"}],"container-title":["Trends in Psychiatry and Psychotherapy"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/trends\/v41n4\/2238-0019-trends-41-04-0401.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T00:19:58Z","timestamp":1596241198000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S2237-60892019000400401&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10]]},"references-count":32,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2019,10]]}},"alternative-id":["S2237-60892019000400401"],"URL":"https:\/\/doi.org\/10.1590\/2237-6089-2018-0116","relation":{},"ISSN":["2238-0019","2237-6089"],"issn-type":[{"value":"2238-0019","type":"electronic"},{"value":"2237-6089","type":"print"}],"subject":[],"published":{"date-parts":[[2019,10]]}}}