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Toward the delineation of mania subtypes in the French National EPIMAN-II Mille Cohort

Comparisons with prior cluster analytic investigations

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Abstract

Background

Knowledge about psychopathologic presentations of mania in current clinical practice has to be refined in order to improve diagnosis and treatment.

Methods

One thousand ninety manic patients included in the French National Study EPIMAN-II Mille were submitted to a cluster analysis on the basis of multiple variables related to the history of bipolar illness and symptoms of the current episode.

Results

Four clusters were identified: “classic mania” (29.3% of patients) with less severe mania; “psychotic mania” (22.7%) with psychotic symptoms, more severe mania, younger age and social impairment; “depressive mania” (30.4%) characterized by female gender, suicide attempts, high number of previous episodes and residual symptoms; and “dual mania” (17.6%) characterized by male gender, substance use, earlier onset and poor compliance. Patients groups also differed in manic symptoms, marital status, stressors preceding illness onset, prior diagnoses, first episode polarity and temperamental characteristics.

Limitations

Cross-sectional assessment of patients.

Conclusions

In comparing our findings with those of four prior cluster analytic studies, we integrate clinical characteristics of mania subtypes found in this very large representative French sample in contemporary practice, we suggest how such convergence of data may help improve earlier recognition, differential response to different treatments, and prevention of these subtypes. We finally suggest that such subtyping might provide clues to phenotype delineation suitable for pharmacogenetic investigations.

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Acknowledgments

Funding source: supported by a grant from Sanofi-Aventis, France

Author information

Authors and Affiliations

  1. Adult Psychiatry Department, Ste Marguerite Hospital, 270 Bd Sainte-Marguerite, 13274, Marseille Cedex 09, France

    Jean-Michel Azorin, Arthur Kaladjian & Marc Adida

  2. Adult Psychiatry Department, Mood Center, Pitié-Salpétrière Hospital, Paris, France

    Elie Hantouche

  3. Medical CNS Department, Sanofi-Aventis, Paris, France

    Ahcene Hameg

  4. Sylia-Stat, Bourg La Reine, France

    Sylvie Lancrenon

  5. International Mood Center, University of California at San Diego, La Jolla, USA

    Hagop Souren Akiskal

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  1. Jean-Michel Azorin
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Correspondence to Jean-Michel Azorin.

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Azorin, JM., Kaladjian, A., Adida, M. et al. Toward the delineation of mania subtypes in the French National EPIMAN-II Mille Cohort. Eur Arch Psychiatry Clin Neurosc 258, 497–504 (2008). https://doi.org/10.1007/s00406-008-0823-x

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  • DOI: https://doi.org/10.1007/s00406-008-0823-x

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