Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX 78290-3900, USA.
Psychiatry Res. 2010 Feb 28;175(3):221-6. doi: 10.1016/j.psychres.2009.04.017. Epub 2009 Dec 21.
Current symptom rating scales and diagnostic categories for bipolar disorder (BD) do not provide dimensional profiles of the types of behavior disturbed in this complex disorder. To overcome these limitations we identified the principal domains of behavioral symptomatology in bipolar individuals, including all mood states, and used a more comprehensive rating scale for BD: the Bipolar Inventory of Signs and Symptoms Scale (BISS). A total of 246 patients with BD (196 with BD type I, and 50 with BD type II) were interviewed using the BISS. Exploratory factor analysis was performed on the BISS results using the maximum likelihood factor extraction method, followed by oblique rotation of the extracted factor loadings. We determined the strength of relationships between factor scores using the Pearson correlation coefficient. The following five factors were extracted: mania, depression, irritability, anxiety and psychosis. Anxiety was significantly correlated with depression and irritability. The mania factor score was only weakly associated with the other four factors. The domains of the BISS capture both the historical categories of depression and mania, plus irritability, psychosis, and an additional principal domain, anxiety. Despite the common occurrence of anxiety in BD, it has not been identified in most prior factor analyses, in part due to limited coverage of anxiety symptoms in the source scales.
目前的双相情感障碍（BD）症状评定量表和诊断类别并未提供该复杂障碍中行为紊乱类型的维度特征。为了克服这些局限性，我们确定了双相个体行为症状的主要领域，包括所有的情绪状态，并使用了一种更全面的 BD 评定量表：双相情感障碍症状和体征清单（BISS）。共有 246 名 BD 患者（196 名 I 型，50 名 II 型）接受了 BISS 访谈。使用最大似然因子提取法对 BISS 结果进行了探索性因子分析，然后对提取的因子负荷进行了斜交旋转。我们使用 Pearson 相关系数确定了因子得分之间的关系强度。提取了五个因子：躁狂、抑郁、易怒、焦虑和精神病。焦虑与抑郁和易怒显著相关。躁狂因子得分仅与其他四个因子弱相关。BISS 的各个领域既涵盖了抑郁和躁狂的历史类别，又涵盖了易怒、精神病和一个额外的主要领域，即焦虑。尽管焦虑在 BD 中很常见，但在大多数先前的因子分析中并未发现，部分原因是源量表对焦虑症状的涵盖有限。
