Confirmatory test of two factors and four subtypes of bipolar disorder based on lifetime psychiatric co-morbidity

P O Monahan; T Stump; W H Coryell; J Harezlak; G A Marcoulides; H Liu; C M Steeger; P B Mitchell; H C Wilcox; L A Hulvershorn; A L Glowinski; Bipolar Disorder Genome Study (BiGS) Consortium; Bipolar High Risk Study Group; P A Iyer-Eimerbrink; M McInnis; J I Nurnberger Jr

doi:10.1017/S0033291715000185

Back

Confirmatory test of two factors and four subtypes of bipolar disorder based on lifetime psychiatric co-morbidity

Journal article

Peer reviewed

Confirmatory test of two factors and four subtypes of bipolar disorder based on lifetime psychiatric co-morbidity

P O Monahan, T Stump, W H Coryell, J Harezlak, G A Marcoulides, H Liu, C M Steeger, P B Mitchell, H C Wilcox, L A Hulvershorn, …

Psychological medicine, Vol.45(10), pp.2181-2196

07/2015

DOI: 10.1017/S0033291715000185

PMID: 25823794

Files and links (1)

url

http://handle.unsw.edu.au/1959.4/unsworks_40823View

Open Access

Abstract

The first aim was to use confirmatory factor analysis (CFA) to test a hypothesis that two factors (internalizing and externalizing) account for lifetime co-morbid DSM-IV diagnoses among adults with bipolar I (BPI) disorder. The second aim was to use confirmatory latent class analysis (CLCA) to test the hypothesis that four clinical subtypes are detectible: pure BPI; BPI plus internalizing disorders only; BPI plus externalizing disorders only; and BPI plus internalizing and externalizing disorders. A cohort of 699 multiplex BPI families was studied, ascertained and assessed (1998-2003) by the National Institute of Mental Health Genetics Initiative Bipolar Consortium: 1156 with BPI disorder (504 adult probands; 594 first-degree relatives; and 58 more distant relatives) and 563 first-degree relatives without BPI. Best-estimate consensus DSM-IV diagnoses were based on structured interviews, family history and medical records. MPLUS software was used for CFA and CLCA. The two-factor CFA model fit the data very well, and could not be improved by adding or removing paths. The four-class CLCA model fit better than exploratory LCA models or post-hoc-modified CLCA models. The two factors and four classes were associated with distinctive clinical course and severity variables, adjusted for proband gender. Co-morbidity, especially more than one internalizing and/or externalizing disorder, was associated with a more severe and complicated course of illness. The four classes demonstrated significant familial aggregation, adjusted for gender and age of relatives. The BPI two-factor and four-cluster hypotheses demonstrated substantial confirmatory support. These models may be useful for subtyping BPI disorders, predicting course of illness and refining the phenotype in genetic studies.

Comorbidity

United States

Family - psychology

Genetic Predisposition to Disease

Humans

Middle Aged

Models, Psychological

Male

Factor Analysis, Statistical

Bipolar Disorder - psychology

Young Adult

National Institute of Mental Health (U.S.)

Adolescent

Internal-External Control

Aged, 80 and over

Adult

Female

Aged

Cohort Studies

Details

Title: Subtitle: Confirmatory test of two factors and four subtypes of bipolar disorder based on lifetime psychiatric co-morbidity
Creators: P O Monahan - Department of Biostatistics,Indiana University School of Medicine,Indianapolis,IN,USA
T Stump - Department of Biostatistics,Indiana University School of Medicine,Indianapolis,IN,USA
W H Coryell - Department of Psychiatry,Roy J. and Lucille A. Carver College of Medicine,University of Iowa,Iowa City,IA,USA
J Harezlak - Department of Biostatistics,Indiana University School of Medicine,Indianapolis,IN,USA
G A Marcoulides - Research Methods & Statistics Program,Graduate School of Education,University of California-Riverside,Riverside,CA,USA
H Liu - Department of Biostatistics,Indiana University School of Medicine,Indianapolis,IN,USA
C M Steeger - Department of Psychology,College of Arts and Letters,University of Notre Dame,Notre Dame,IN,USA
P B Mitchell - School of Psychiatry,University of New South Wales,Sydney,NSW,Australia
H C Wilcox - Department of Psychiatry and Behavioral Sciences,Johns Hopkins School of Medicine,Baltimore,MD,USA
L A Hulvershorn - Department of Psychiatry,Indiana University School of Medicine,Indianapolis,IN,USA
A L Glowinski - Department of Psychiatry,Washington University School of Medicine,St Louis,MO,USA
Bipolar Disorder Genome Study (BiGS) Consortium
Bipolar High Risk Study Group
P A Iyer-Eimerbrink - Department of Psychiatry,Indiana University School of Medicine,Indianapolis,IN,USA
M McInnis - Department of Psychiatry,School of Medicine,University of Michigan,Ann Arbor,MI,USA
J I Nurnberger Jr - Department of Psychiatry,Indiana University School of Medicine,Indianapolis,IN,USA
Resource Type: Journal article
Publication Details: Psychological medicine, Vol.45(10), pp.2181-2196
DOI: 10.1017/S0033291715000185
PMID: 25823794
NLM abbreviation: Psychol Med
ISSN: 0033-2917
eISSN: 1469-8978
Publisher: England
Grant note: U01 MH46274 / NIMH NIH HHS R01 MH059556 / NIMH NIH HHS R01 MH59553 / NIMH NIH HHS R01 MH60068 / NIMH NIH HHS U01 MH46282 / NIMH NIH HHS R01 MH59567 / NIMH NIH HHS R01 MH059548 / NIMH NIH HHS R01 MH59545 / NIMH NIH HHS R01 MH059534 / NIMH NIH HHS 1Z01MH002810-01 / NIMH NIH HHS R01 MH068009 / NIMH NIH HHS UO1 MH46280 / NIMH NIH HHS Intramural NIH HHS R01 MH59533 / NIMH NIH HHS R01 MH59535 / NIMH NIH HHS
Language: English
Date published: 07/2015
Academic Unit: Psychiatry
Record Identifier: 9984003949002771

Metrics

17 Record Views

8 Times Cited - Web of Science