The structure of mania: An overview of factorial analysis studies

Summary & key facts

This paper reviewed 12 factor-analysis studies of mania that together included 3,039 adult patients assessed by clinicians. The authors found that mania has several dimensions rather than a single core symptom. Hyperactivity, increased speech, and thought disorder tended to be the clearest core features. Mood symptoms (elevated or irritable mood) varied across studies and often appeared with other features. Other recurring dimensions were depressive–anxious symptoms, irritability–aggression, altered sleep (often by itself), and psychosis linked to grandiosity and poor insight. The authors note some inconsistencies between studies and limits in the data, so findings describe patterns rather t

Key facts:

• The review included 12 studies and a total of 3,039 manic patients.
• Before analysis, researchers harmonized items across studies into a list of 37 clinical variables.
• Only six variables were assessed in all studies: elevated mood, hyperactivity, increased speech, irritability, thought disorder, and altered sleep.
• Hyperactivity appeared in the first factor in 9 of the 12 studies and was the highest-loading item in 6 studies.
• In many studies, hyperactivity clustered with increased speech and thought disorder more strongly than with mood changes.
• Elevated (euphoric) mood was the main first factor in 5 studies; irritability was the first factor in 3 studies.
• Depressive and anxious symptoms tended to covary and formed a main or secondary factor in several studies.
• Altered sleep frequently showed up as a separate, isolated factor in the analyses.
• Psychosis-related items tended to group with grandiosity, lack of insight, and poor judgment.
• The authors judged overall study quality as good but reported that many studies did not describe possible sources of bias or missing data.

Abstract

Operational definitions of mania are based on expert consensus rather than empirical data. The aim of this study is to identify the key domains of mania, as well as the relevance of the different signs and symptoms of this clinical construct. A ...

Topics

Bipolar Disorder and Treatment Restless Legs Syndrome Research Schizophrenia research and treatment

Categories

Health Sciences Medicine Psychiatry and Mental health

Tags

Anxiety Bipolar disorder Clinical psychology Grandiosity Irritability Mania Mood Narcissism Psychiatry Psychology Social psychology