Elsevier

Journal of Affective Disorders

Volume 51, Issue 2, 1 November 1998, Pages 113-121
Journal of Affective Disorders

Research report
Young referred boys with DICA-P manic symptoms vs. two comparison groups

https://doi.org/10.1016/S0165-0327(98)00210-9Get rights and content

Abstract

A total of 23 boys met DICA-P manic symptom and clustering criteria in a diagnostic investigation of 233 outpatient boys between ages 6 and 10. In this manic-symptom group, the most frequently endorsed of an average of five manic symptoms were extreme mood changes, difficulty concentrating, feeling too `up' to sit still, and racing thoughts. Comparison groups were 23 non-manic boys seen next in the investigation and 23 non-manic boys matched to the manic-symptom boys on symptoms of three comorbid disruptive disorders (ADHD, ODD and CD). Manic-symptom boys differed significantly from next-seen boys, but not from matched comorbid boys, in number of oppositional symptoms and pervasiveness of problems. Manic-symptom boys differed significantly from next-seen boys on six of eight mother-rated RCBCL factors. In contrast, manic-symptom and matched comorbid boys did not differ on any of eight RCBCL factors, which suggests that the RCBCL differences can be attributed to shared ADHD, ODD and/or CD. However, manic-symptom and matched comorbid boys tended to differ on RCBCL Anxiety/Depression. On the teacher-rated TRF, manic-symptom boys were rated higher than next-seen boys on four internalizing factors, and higher than matched comorbid boys on two of those factors, including Anxiety/Depression. Thus, manic symptomatology also predicted substantial emotionality, which was not a controlled comorbidity. The findings of this and other studies suggest that there is a mania dimension or syndrome, which may be an indicator of true bipolar disorder—or simply a marker for disruptive comorbidity, behavioral and emotional multimorbidity, or general severity of psychopathology.

Section snippets

Methods

The data for this study were drawn from the diagnostic phase of the Long Island Follow-Up Study (LIFUS), an ongoing investigation of 6–10 year-old boys (n=250) with hyperactive, aggressive, and/or emotional psychopathology who were consecutively referred for diagnostic evaluation from a child psychiatry outpatient clinic (55%), from a support group for parents of children with ADHD (39%), or directly from parents, schools, or other professionals (6%). Parents gave informed consent, and boys

Results

All comparisons were made with simple t-tests or χ2 tests between pairs of groups in order to compare, first, the MANSX with the NEXT boys and, second, the MANSX with the COMORB boys. Tests included all 23 boys in each group unless otherwise noted. A liberal significance level of p=0.05 (two-tailed) was adopted in order to lower the probability of rejecting true differences. This decision of course also raised the probability that some purportedly significant differences occurred by chance.

Discussion

An average of almost five manic symptoms were reported by mothers in 9.9% of 233 6–10 year-old boys referred to a diagnostic study of behavioral and emotional problems. It is unclear how many of these boys would meet formal criteria for a manic episode. Nevertheless, compared to the non-manic comparison boys seen next in the investigation, the manic-symptom youngsters had more oppositional and depressive symptoms, and they were described by their mothers as significantly more emotional,

Acknowledgements

This work was supported by Grant No. MH44733 from the National Institute of Mental Health.

References (23)

  • American Psychiatric Association, 1987. Diagnostic and Statistical Manual (DSM-III-R), APA Press, Washington,...
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