Mixed Features Specifier in Mood Disorder: The Prevalence and Associated Factors

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Published: Mar 30, 2024
DOI: https://doi.org/10.47836/mjmhs.20.2.34
Keywords:
Mixed Features Specifiers (MFS), Major Mood Disorder, Quality of Life (QoL)

Main Article Content

Tesini M. Paramannantha Veloo
Hospital Bahagia Ulu Kinta, Jalan Besar, 31250 Tanjung Rambutan, Perak, Malaysia
Kai Shin Thong
M. Kandiah Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Jalan Sungai Long, Bandar Sungai Long, 43000 Kajang, Selangor, Malaysia
Weng Hou Siew
Department of Psychological Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
Chong Guan Ng
Department of Psychological Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia

Abstract




Introduction: Malaysia’s unique cultural landscape may influence the manifestation of mixed features differently than in global studies. We’ve conducted the first study on the prevalence of the Mixed Feature Specifier (MFS) in mood disorders in Malaysia, addresses crucial research gaps to potentially inform culturally sensitive treatment approaches in Malaysia. Methods: This cross-sectional prevalence study was conducted at a psychiatric hospital in Malaysia, using a researcher administered questionnaire, consisted of five parts which includes sociodemographic factors, clin- ical characteristics, MADRS score, YMRS score and QoL score. Data was analyzed using SPSS version 24.0. Results: 148 patients were recruited into this study. Overall prevalence of MFS among Major Mood Disorder was 29.8%. There were significant associations between ethnicity (X2=9.063; p=0.028), marital status (X2=18.738; p<0.001) and average monthly income (X2=31.534; p=<0.001) with MFS. In terms of clinical characteristics, there were significant associations between number of hospitalizations (X2=41.026; p<0.001), trials of medications (X2=29.540; p<0.001), total number of medications on (X2=42.338; p<0.001), history of ECT (X2=10.590; p=0.001), family history of mood disorder (X2=20.944; p<0.001), suicidal attempts (X2=26.570; p<0.001), history substance use (X2=19.249; p<0.001), compliance to treatment (X2=4.310; p=0.038), YMRS score (X2=16.799; p=0.001) and MADRS score (X2=43.525; p<0.001) with MFS. Conclusion: We identified predictors associated with MFS, such as amount of in- come, substance use and number of hospitalizations. Sociodemographic and clinical characteristics are significantly associated with MFS, with significant differences between the QoL of MFS and non-MFS patients. This could foster early detection of cases, hence addressing the psychological needs of both MFS and non-MFS patients.




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How to Cite
Paramannantha Veloo, T. M., Thong, K. S., Siew, W. H., & Ng, C. G. (2024). Mixed Features Specifier in Mood Disorder: The Prevalence and Associated Factors. Malaysian Journal of Medicine and Health Sciences, 20(2). https://doi.org/10.47836/mjmhs.20.2.34
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Vol. 20 No. 2 (2024)
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Original Articles
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References

McIntyre RS, Soczynska JK, Cha DS, Woldeyohannes HO, Dale RS, Alsuwaidan MT, et al. The prevalence and illness characteristics of DSM-5-defined “mixed feature specifier” in adults with major depressive disorder and bipolar disorder: Results from the International Mood Disorders Collaborative Project. J Affect Disord. 2015;172:259-64. doi: 10.1016/j.jad.2014.09.026.

Malhi GS, Lampe L, Coulston CM, Tanious M, Bargh DM, Curran G, et al. Mixed state discrimination: a DSM problem that won’t go away? J Affect Disord. 2014;158:8-10. doi: 10.1016/j.jad.2014.01.

Shim IH, Woo YS, Bahk WM. Prevalence rates and clinical implications of bipolar disorder “with mixed features” as defined by DSM-5. J Affect Disord. 2015;173:120-5. doi: 10.1016/j. jad.2014.10.061.

Solé E, Garriga M, Valentí M, Vieta E. Mixed features in bipolar disorder. CNS Spectr. 2017;22(2):134- 40. doi: 10.1017/S1092852916000869

Benazzi F. Bipolar disorder--focus on bipolar II disorder and mixed depression. Lancet. 2007;369(9565):935-45. doi: 10.1016/S0140- 6736(07)60453-X.

Tondo L, Vázquez GH, Pinna M, Vaccotto PA, Baldessarini RJ. Characteristics of depressive and bipolar disorder patients with mixed features. Acta Psychiatr Scand. 2018;138(3):243-52. doi: 10.1111/acps.12911.

Miller S, Suppes T, Mintz J, Hellemann G, Frye MA, McElroy SL, et al. Mixed Depression in Bipolar Disorder: Prevalence Rate and Clinical Correlates During Naturalistic Follow-Up in the Stanley Bipolar Network. Am J Psychiatry. 2016;173(10):1015-23. doi: 10.1176/appi.ajp.2016.15091119.

Ziegel ER, Lemeshow S, Hosmer DW, Klar J, Luanga SA, editors. Adequacy of Sample Size in Health Studies 1990.

Hasanah CI, Naing L, Rahman AR. World Health Organization Quality of Life Assessment: brief version in Bahasa Malaysia. Med J Malaysia. 2003;58(1):79-88.

Shim IH, Lee J, Kim MD, Jung YE, Min KJ, Kwon YJ, et al. The prevalence and diagnostic classification of mixed features in patients with major depressive episodes: A multicenter study based on the DSM- 5. Int J Methods Psychiatr Res. 2019;28(3):e1773. doi: 10.1002/mpr.1773.

Fagiolini A, Coluccia A, Maina G, Forgione RN, Goracci A, Cuomo A, et al. Diagnosis, Epidemiology and Management of Mixed States in Bipolar Disorder. CNS Drugs. 2015;29(9):725-40. doi: 10.1007/s40263-015-0275-6.

Himmelhoch JM, Mulla D, Neil JF, Detre TP, Kupfer DJ. Incidence and signficiance of mixed affective states in a bipolar population. Arch Gen Psychiatry. 1976;33(9):1062-6. doi: 10.1001/archpsyc.1976.01770090052004.

Kessing LV. The prevalence of mixed episodes during the course of illness in bipolar disorder. Acta Psychiatr Scand. 2008;117(3):216-24. doi: 10.1111/j.1600-0447.2007.01131.x.

Aun LH. Unemployment among Malaysia’s Youth: Structural Trends and Current Challenges. 2020;65(2020).

Kupfer DJ, Frank E, Grochocinski VJ, Houck PR, Brown C. African-American participants in a bipolar disorder registry: clinical and treatment characteristics. Bipolar Disord. 2005;7(1):82-8. doi: 10.1111/j.1399-5618.2004.00163.x.

McIntyre RS. Mixed features and mixed states in psychiatry: from calculus to geometry. CNS Spectr. 2017;22(2):116-7. doi: 10.1017/ S1092852916000559

Rizvi SJ, Cyriac A, Grima E, Tan M, Lin P, Gallaugher LA, et al. Depression and employment status in primary and tertiary care settings. Can J Psychiatry. 2015;60(1):14-22. doi: 10.1177/070674371506000105.

Vázquez GH, Lolich M, Cabrera C, Jokic R, Kolar D, Tondo L, et al. Mixed symptoms in major depressive and bipolar disorders: A systematic review. J Affect Disord. 2018;225:756-60. doi: 10.1016/j.jad.2017.09.006.

Taha AB, Lee, P. Y., Lin, K., Siti, R. G., & Hassan, S. Anxiety and depression in the primary health care clinics and the use of complementary and alternative medicine. International Medical Journal. 2005;2(2):93-7.

Musliner KL, Østergaard SD. Patterns and predictors of conversion to bipolar disorder in 91 587 individuals diagnosed with unipolar depression. Acta Psychiatr Scand. 2018;137(5):422-32. doi: 10.1111/acps.12869.

Bartels SJ, Forester B, Miles KM, Joyce T. Mental health service use by elderly patients with bipolar disorder and unipolar major depression. Am J Geriatr Psychiatry. 2000;8(2):160-6.

Bolton JM, Pagura J, Enns MW, Grant B, Sareen J. A population-based longitudinal study of risk factors for suicide attempts in major depressive disorder. J Psychiatr Res. 2010;44(13):817-26. doi: 10.1016/j. jpsychires.2010.01.003.

Goldberg JF, Brooks JO, 3rd, Kurita K, Hoblyn JC, Ghaemi SN, Perlis RH, et al. Depressive illness burden associated with complex polypharmacy in patients with bipolar disorder: findings from the STEP-BD. J Clin Psychiatry. 2009;70(2):155-62. doi: 10.4088/jcp.08m04301.

Medda P, Perugi G, Zanello S, Ciuffa M, Rizzato S, Cassano GB. Comparative response to electroconvulsive therapy in medication- resistant bipolar I patients with depression and mixed state. J ect. 2010;26(2):82-6. doi: 10.1097/ YCT.0b013e3181b00f1e.

Song JY, Yu HY, Kim SH, Hwang SS, Cho HS, Kim YS, et al. Assessment of risk factors related to suicide attempts in patients with bipolar disorder. J Nerv Ment Dis. 2012;200(11):978-84. doi: 10.1097/NMD.0b013e3182718a07.

Valtonen HM, Suominen K, Mantere O, Leppämäki S, Arvilommi P, Isometsä E. Suicidal behaviour during different phases of bipolar disorder. J Affect Disord. 2007;97(1-3):101-7. doi: 10.1016/j. jad.2006.05.033.

Azorin JM, Aubrun E, Bertsch J, Reed C, Gerard S, Lukasiewicz M. Mixed states vs. pure mania in the French sample of the EMBLEM study: results at baseline and 24 months--European mania in bipolar longitudinal evaluation of medication. BMC Psychiatry. 2009;9:33. doi: 10.1186/1471- 244X-9-33.

Goldberg JF, Perlis RH, Bowden CL, Thase ME, Miklowitz DJ, Marangell LB, et al. Manic symptoms during depressive episodes in 1,380 patients with bipolar disorder: findings from the STEP-BD. Am J Psychiatry. 2009;166(2):173-81. doi: 10.1176/ appi.ajp.2008.08050746.

IsHak WW, Greenberg JM, Balayan K, Kapitanski N, Jeffrey J, Fathy H, et al. Quality of life: the ultimate outcome measure of interventions in major depressive disorder. Harv Rev Psychiatry. 2011;19(5):229-39. doi: 10.3109/10673229.2011.614099.

Vojta C, Kinosian B, Glick H, Altshuler L, Bauer MS. Self-reported quality of life across mood states in bipolar disorder. Compr Psychiatry. 2001;42(3):190-5. doi: 10.1053/ comp.2001.23143.

Gazalle FK, Hallal PC, Andreazza AC, Frey BN, Kauer-Sant’Anna M, Weyne F, et al. Manic symptoms and quality of life in bipolar disorder. Psychiatry Res. 2007;153(1):33-8. doi: 10.1016/j. psychres.2006.07.007.