Evidence for three distinct classes of ‘typical’, ‘psychotic’ and ‘dual’ mania: results from the EMBLEM study
Article first published online: 5 DEC 2005
Acta Psychiatrica Scandinavica
Volume 113, Issue 2, pages 112–120, February 2006
How to Cite
Haro, J. M., van Os, J., Vieta, E., Reed, C., Lorenzo, M., Goetz, I. and the EMBLEM Advisory Board (2006), Evidence for three distinct classes of ‘typical’, ‘psychotic’ and ‘dual’ mania: results from the EMBLEM study. Acta Psychiatrica Scandinavica, 113: 112–120. doi: 10.1111/j.1600-0447.2005.00692.x
- Issue published online: 5 DEC 2005
- Article first published online: 5 DEC 2005
- Accepted for publication October 3, 2005
- bipolar disorder;
- cluster analysis
Objective: To describe patients included in the European Mania in Bipolar Longitudinal Evaluation of Medication (EMBLEM) study and to assess and clinically validate the presence of clinical subtypes of patients with acute mania.
Method: The EMBLEM study is a 2-year prospective, observational study on the treatment and outcome of patients who are treated for a manic or mixed episode. Latent Class Analysis was used to define discrete groups of patients at baseline.
Results: Three groups were identified: ‘typical mania’ (59% of patients); ‘psychotic mania’ (27%) with more severe mania and presence of psychotic symptoms; and ‘dual mania’ (13%) with a high proportion of substance abuse. Patient groups differed in age of onset, social functioning and service needs.
Conclusion: Dual mania represents a distinct and not infrequent subgroup of patients with mania. The exclusion of patients with comorbid substance problems from clinical trials creates a gap in our knowledge on treatment effectiveness.