Validity of the WHIPLASHED as a tool to identify bipolar disorder in women.

J Affect Disord 2019 03 17;246:69-73. Epub 2018 Dec 17.

Department of Psychiatry and Behavioral Sciences, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, USA; Department of Obstetrics and Gynecology, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, USA.

Background: The aim of this study was to investigate the validity of the WHIPLASHED clinician-administered interview, a mnemonic of questions on clinical factors and illness course used to screen for bipolar disorder, as a self-report questionnaire.

Methods: Participants (n = 82) were females recruited from an outpatient academic women's mental health clinic. Relevant symptom data were extracted from a self-report questionnaire designed to parallel the WHIPLASHED interview questions. A score of ≥5 on WHIPLASHED was defined as a positive screen for bipolar spectrum disorder by its developer. We examined the capacity of self-reported WHIPLASHED scores ≥5 to differentiate bipolar from unipolar depression in women. Diagnostic assessments were conducted with the Mini International Neuropsychiatric Interview.

Results: Women were diagnosed with unipolar (n = 54) and bipolar (n = 28) depression. The majority of subjects were white (67%), employed (68%) and married (57%) with a mean age of 36.8 years. The receiver operating characteristic curve demonstrated that WHIPLASHED had strong predictive ability (AUC = 0.877) in differentiating bipolar from unipolar depression. A cutoff score of ≥5 generated 96% sensitivity and 52% specificity, while raising the threshold to 6 generated 89% sensitivity and 76% specificity for a bipolar disorder diagnosis.

Limitations: Our sample was small and composed of female patients at a single treatment center.

Conclusions: In this sample, WHIPLASHED was a valid screening tool to differentiate bipolar from unipolar depression. While existing instruments focus on primary symptoms of bipolar disorder, the WHIPLASHED is useful in exploring subtypes of bipolar disorder in which depression dominates the clinical course.

Download full-text PDF

Source Listing
March 2019
Save 15% Survey

Similar Publications

Distinguishing bipolar major depression from unipolar major depression with the screening assessment of depression-polarity (SAD-P).

J Clin Psychiatry 2006 Mar;67(3):434-42

Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA.

Background: Patients with bipolar I or II major depression are often misdiagnosed with unipolar major depression. The goal of this study was to develop and validate a brief instrument to screen for bipolar disorder in patients actively ill with major depression.

Method: The sample consisted of subjects who enrolled in the National Institute of Mental Health-Collaborative Program on the Psychobiology of Depression-Clinical Studies from 1978 to 1981 during an episode of major depression and included 91 subjects with bipolar I major depression, 52 with bipolar II major depression, and 338 with unipolar major depression diagnosed according to Research Diagnostic Criteria. Read More

View Article and Full-Text PDF
March 2006

Screening for bipolar disorder in a Spanish sample of outpatients with current major depressive episode.

J Affect Disord 2009 Apr 13;114(1-3):299-304. Epub 2008 Aug 13.

Medical Department, AstraZeneca, Madrid, Spain.

Objective: Bipolar spectrum disorders often go unrecognised and undiagnosed or misdiagnosed. One of the underlying reasons is the poor recognition of bipolar disorder among patients presenting depressive episodes. The specific aim of this study was to estimate the Mood Disorder Questionnaire (MDQ) rate of positive screens for bipolar disorder in a Spanish sample of outpatients with a current major depressive episode and compare it with their current psychiatric diagnosis. Read More

View Article and Full-Text PDF
April 2009

Cross validation with the mood disorder questionnaire (MDQ) of an instrument for the detection of hypomania in Spanish: the 32 item hypomania symptom check list (HCL-32).

J Affect Disord 2007 Aug 26;101(1-3):43-55. Epub 2006 Dec 26.

Bipolar Disorder Programme, Institut Clínic de Neurociencies, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Barcelona Stanley Foundation Centrem, Villarroel, 170, 08036 Barcelona, Spain.

Background: The detection and diagnosis of present or past hypomanic episodes is of key importance for the differential diagnosis between depressive disorders and type II bipolar disorder. However, there are few instruments available to satisfactorily screen for the latter condition. The Hypomania Symptom Checklist-32 (HCL-32) is a self-applied questionnaire with 32 hypomania items and 8 severity and functional impact items which is being developed in several European countries for this purpose. Read More

View Article and Full-Text PDF
August 2007

Validation of the Mood Disorder Questionnaire for screening for bipolar disorder in a UK sample.

J Affect Disord 2008 Sep 7;110(1-2):180-4. Epub 2008 Feb 7.

School of Psychological Sciences, Clinical and Health Psychology, The University of Manchester, Manchester, UK.

Background: The Mood Disorder Questionnaire (MDQ) was designed as a screening questionnaire for bipolar disorder. Previous research has raised questions about the suitability of the MDQ structure for screening for bipolar II disorder. This study investigated the optimal sensitivity and specificity cut-off thresholds for the MDQ in bipolar I and bipolar II patients in a UK sample. Read More

View Article and Full-Text PDF
September 2008