Observational studyThe American journal of psychiatry2017
Increased Activity or Energy as a Primary Criterion for the Diagnosis of Bipolar Mania in DSM-5: Findings From the STEP-BD Study.
Observational study in The American journal of psychiatry, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed.
- Symptomatic treatment for Alzheimer disease: current evidence and future directions.Nature reviews. Neurology · 2026Review
- Psychometric Properties of the Mixed State Severity Index for Patients With Mood Disorder.Psychiatry investigation · 2026Article
- Article
- Neuroanatomical and Functional Correlates in Bipolar Disorder (BD): A Narrative Review.Journal of clinical medicine · 2025Review
- Day-to-day variability in activity levels detects transitions to depressive symptoms in bipolar disorder earlier than changes in sleep and mood.International journal of bipolar disorders · 2025Article
- Day-to-day variability in sleep and activity predict the onset of a hypomanic episode in patients with bipolar disorder.Journal of affective disorders · 2025Observational
- Machine learning-driven simplification of the hypomania checklist-32 for adolescent: a feature selection approach.International journal of bipolar disorders · 2024Article
- Adaptive Hyperactivity and Biomarker Exploration: Insights from Elders in the Blue Zone of Sardinia.Journal of clinical medicine · 2024Article
- Focusing on mitochondria in the brain: from biology to therapeutics.Translational neurodegeneration · 2024Review
- Mood or energy/activity symptoms in bipolar mania: which are the most informative?Trends in psychiatry and psychotherapy · 2024Article
- Bipolar disorder in the International Classification of Diseases-Eleventh version: A review of the changes, their basis, and usefulness.World journal of psychiatry · 2022Review
- The relationship between physical activity states and depressive symptoms: Using ambulatory assessment to characterize day-to-day associations among individuals with and without bipolar spectrum disorder.Depression and anxiety · 2022Article
- Impact of modification to DSM-5 criterion A for hypomania/mania in newly diagnosed bipolar patients: findings from the prospective BIO study.International journal of bipolar disorders · 2021Article
- How Does Adding the DSM-5 Criterion Increased Energy/Activity for Mania Change the Bipolar Landscape?Frontiers in psychiatry · 2021Review
- Correlates, Course, and Outcomes of Increased Energy in Youth with Bipolar Disorder.Journal of affective disorders · 2020Article
- Anxiety, irritability, and agitation as indicators of bipolar mania with depressive symptoms: a post hoc analysis of two clinical trials.International journal of bipolar disorders · 2017Article
- Update on the Epidemiology, Diagnosis, and Treatment of Mania in Older-Age Bipolar Disorder.Current psychiatry reports · 2017Review
- Emotion Recognition in the Real-World: Passively Collecting and Estimating Emotions from Natural Speech Data of Individuals with Bipolar Disorder.IEEE transactions on affective computingArticle
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7 authors.
Funding
Abstract
objectiveDSM-5 describes "a distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy" as a primary criterion for mania. Thus, increased energy or activity is now considered a core symptom of manic and hypomanic episodes. Using data from the Systematic Treatment Enhancement Program for Bipolar Disorder study, the authors analyzed point prevalence data obtained at the initial visit to assess the diagnostic validity of this new DSM-5 criterion. The study hypothesis was that the DSM-5 criterion would alter the prevalence of mania and/or hypomania.
methodThe authors compared prevalence, clinical characteristics, validators, and outcome in patients meeting the DSM-5 criteria (i.e., DSM-IV criteria plus the DSM-5 criterion of increased activity or energy) and those who did not meet the new DSM-5 criterion (i.e., who only met DSM-IV criteria).
resultsAll 4,360 participants met DSM-IV criteria for bipolar disorder, and 310 met DSM-IV criteria for a manic or hypomanic episode. When the new DSM-5 criterion of increased activity or energy was added as a coprimary symptom, the prevalence of mania and hypomania was reduced. Although minor differences were noted in clinical and concurrent validators, no changes were observed in longitudinal outcomes.
conclusionsThe findings confirm that including increased activity or energy as part of DSM-5 criterion A decreases the prevalence of manic and hypomanic episodes but does not affect longitudinal clinical outcomes.
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