The structure of affective symptoms in a sample of young adults

doi:10.1053/comp.2003.50025

Comprehensive Psychiatry

Volume 44, Issue 2, March–April 2003, Pages 110-116

https://doi.org/10.1053/comp.2003.50025 Get rights and content

Abstract

Symptoms of bipolar disorders include depression and mania. The term “bipolar” implies states that are opposite to each other. Construing scales that define mania and depression as opposite ends of one dimension cannot account for the existence of mixed symptoms. One self-report instrument, the Internal State Scale (ISS), combines both dimensions in one measure. However, the ISS only assesses internal subjective states and does not tap other typical and more objective symptoms of (hypo-) mania. To explore the factorial structure of affective symptoms in a general population sample, we extended the Center for Epidemiologic Studies-Depression Scale (CES-D), adding items to assess manic symptoms as described in DSM-IV. The scale was completed by 2,059 young adults. The results for the original CES-D are comparable to prior studies. Factor-analysis for the extended CES-D revealed two factors in women and men: most manic symptoms loaded high on a factor “euphoria-activation,” whereas the other factor included all typical dysphoric-depressive symptoms, but also included the “manic symptoms” of distractibility and irritability. Our results support a two-factor model of bipolar symptoms in the general population with irritability being more closely associated with dysphoria than euphoria. The implications and limitations of the present results are discussed. Copyright 2003, Elsevier Science (USA). All rights reserved.

Section snippets

Participants

Between fall 1998 and spring 1999, schools in the metropolitan area of Stuttgart to Tuebingen were asked to participate in a research project with the official permission of the Department of Education and Culture of the Baden-Wuerttemberg state. The participants were attending high school or college, or vocational schools providing job training (e.g., mail services, hair cutting, banking). The questionnaire consisted of an extended version of the CES-D (see below) as well as other questions

CES-D

For comparison with other studies using the original CES-D, we first present results for the depression scale only. As expected women had higher CES-D scores than men (t = 5.67, df = 1,406.9, P < .001; d = .29) (see Table 1), while age was not significantly related to depressive symptoms in this sample (F [5, 1,595] = 1.30, difference not significant). High, medium, or low education levels were significantly associated with depression (F [2, 1,461] = 12.66, P < .001). Although the effect size

Discussion

The goal of the present study was to investigate the factorial structure of self-rated affective symptoms. We used an extended version of the CES-D²⁶ that included items to assess (hypo-) manic symptoms as described in the DSM-IV. In this nonclinical sample of young adults, we found for both men and women that affective symptoms can be described with a two-factor model: one dimension covering dysphoric-depressive symptoms, and one covering mania. However, two of the DSM-IV (hypo-) manic

Acknowledgements

This work was made possible by the kind support of the Department of Culture and Education of the Baden-Wuerttemberg state and the cooperation of the schools within the area. We would like to express our gratitude to Sheri L. Johnson, Ph.D. (University of Miami) for helpful comments on a previous version of the manuscript.

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^☆: Supported by the Department of Culture and Education of the Baden-Wuerttemberg state.

^☆☆: Address reprint requests to Thomas D. Meyer, Ph.D., Eberhard Karls Universitaet, Psychologisches Institut, Abteilung fuer Klinische und Physiologische Psychologie, Christophstrasse 2, 72072 Tuebingen, Germany.

^★: 0010-440X/03/4402-0011$30.00/0

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The structure of affective symptoms in a sample of young adults☆,☆☆,★

Abstract

Section snippets

Participants

CES-D

Discussion

Acknowledgements

J Affect Disord

J Psychiatr Res

J Affect Disord

J Affect Disord

J Affect Disord

Compr Psychiatry

Gen Hosp Psychiatry

Biol Psychiatry

J Affect Disord

Person Individ Diff

J Affect Disord

Psychiatry Res

J Affect Disord

J Affect Disord

J Affect Disord

Die Gliederung der neuropsychischen Erkrankungen

Monatsschr Psychiatr Neurol

Aufteilung der endogenen Psychosen. [The Classification of Endogenous Psychosis]

Unipolar mania in non-Western cultures

Br J Psychiatry

Unipolar mania reconsidered. Evidence from an elderly cohort

Br J Psychiatry

Unipolar mania: a distinct clinical entity

Am J Psychiatry

Diagnostic and Statistical Manual of Mental Disorders. Ed. 4 (DSM-IV)

Manic-Depressive Illness