Education Development Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Department of Emergency, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Braz J Psychiatry. 2022 May-Jun;44(3):349-361. doi: 10.1590/1516-4446-2021-2334.
The present meta-analysis was conducted to determine the diagnostic accuracy of the bipolarity index (BI) and Rapid Mode Screener (RMS) as compared with the Bipolar Spectrum Diagnostic Scale (BSDS), the Hypomania Checklist (HCL-32), and the Mood Disorder Questionnaire (MDQ) in people with bipolar disorder (BD).
We systematically searched five databases using standard search terms, and relevant articles published between May 1990 and November 30, 2021 were collected and reviewed.
Ninety-three original studies were included (n=62,291). At the recommended cutoffs for the BI, HCL-32, BSDS, MDQ, and RMS, the pooled sensitivities were 0.82, 0.75, 0.71, 0.71, and 0.78, respectively, while the corresponding pooled specificities were 0.73, 0.63, 0.73, 0.77, and 0.72, respectively. However, there was evidence that the accuracy of the BI was superior to that of the other tests, with a relative diagnostic odds ratio (RDOR) of 1.22 (0.98-1.52, p < 0.0001). The RMS was significantly more accurate than the other tests, with an RDOR (95%CI) of 0.79 (0.67-0.92, p < 0.0001) for the detection of BD type I (BD-I). However, there was evidence that the accuracy of the MDQ was superior to that of the other tests, with an RDOR of 1.93 (0.89-2.79, p = 0.0019), for the detection of BD type II (BD-II).
The psychometric properties of two new instruments, the BI and RMS, in people with BD were consistent with considerably higher diagnostic accuracy than the HCL-32, BSDS, and MDQ. However, a positive screening should be confirmed by a clinical diagnostic evaluation for BD.
本荟萃分析旨在比较双相障碍诊断量表（BSDS）、躁狂清单 32 项（HCL-32）、心境障碍问卷（MDQ）和双相极性指数（BI）和快速模式筛查器（RMS）在双相障碍（BD）患者中的诊断准确性。
我们使用标准检索词系统地检索了五个数据库，并收集和回顾了 1990 年 5 月至 2021 年 11 月 30 日期间发表的相关文章。
纳入 93 项原始研究（n=62291）。在 BI、HCL-32、BSDS、MDQ 和 RMS 的推荐截断值下，汇总敏感性分别为 0.82、0.75、0.71、0.71 和 0.78，相应的汇总特异性分别为 0.73、0.63、0.73、0.77 和 0.72。然而，有证据表明 BI 的准确性优于其他测试，相对诊断优势比（RDOR）为 1.22（0.98-1.52，p<0.0001）。RMS 明显比其他测试更准确，其 RDOR（95%CI）为 0.79（0.67-0.92，p<0.0001），用于检测 I 型双相障碍（BD-I）。然而，有证据表明 MDQ 的准确性优于其他测试，RDOR 为 1.93（0.89-2.79，p=0.0019），用于检测 II 型双相障碍（BD-II）。
两种新工具，即 BI 和 RMS，在 BD 患者中的心理测量性能与明显更高的诊断准确性一致，优于 HCL-32、BSDS 和 MDQ。然而，阳性筛查结果应通过临床诊断评估来确认是否为 BD。
