Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/S2237-60892013000200008
Trends in Psychiatry and Psychotherapy
Original Article

Mood self-assessment in bipolar disorder: a comparison between patients in mania, depression, and euthymia

Autoavaliação do estado de humor no transtorno bipolar: uma comparação entre pacientes em mania, depressão, e eutimia

Rafael de Assis da Silva; Daniel C. Mograbi; Luciana Angélica Silva Silveira; Ana Letícia Santos Nunes; Fernanda Demôro Novis; Paola Anaquim Cavaco; J. Landeira-Fernandez; Elie Cheniaux

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Abstract

BACKGROUND: Some studies indicate that mood self-assessment is more severely impaired in patients with bipolar disorder in a manic episode than in depression. OBJECTIVES: To investigate variations in mood self-assessment in relation to current affective state in a group of individuals with bipolar disorder. METHODS: A total of 165 patients with a diagnosis of bipolar disorder type I or type II had their affective state assessed using the Clinical Global Impressions Scale for use in bipolar illness (CGI-BP), the Positive and Negative Syndrome Scale (PANSS), and the Global Assessment of Functioning (GAF). In addition, participants completed a self-report visual analog mood scale (VAMS). Patients were divided into three groups (euthymia, mania, and depression) and compared with regard to VAMS results. RESULTS: Manic patients rated their mood similarly to patients in euthymia in 14 out of 16 items in the VAMS. By contrast, depressed patients rated only two items similarly to euthymic patients. CONCLUSION: Patients with bipolar disorder in mania, but not those in depression, poorly evaluate their affective state, reinforcing the occurrence of insight impairment in the manic syndrome.

Keywords

Insight, mood, self-assessment, bipolar disorder

Resumo

CONTEXTO: Alguns estudos indicam que a capacidade de autoavaliação do estado de humor está mais comprometida em pacientes com transtorno bipolar na mania do que na depressão. OBJETIVO: Estudar variações na autoavaliação do humor em relação ao estado afetivo atual em indivíduos com transtorno bipolar. MÉTODO: Um total de 165 pacientes com diagnóstico de transtorno bipolar tipo I ou tipo II tiveram seu estado afetivo avaliado utilizando os instrumentos Clinical Global Impressions Scale for use in bipolar illness (CGI-BP), Positive and Negative Syndrome Scale (PANSS) e Global Assessment of Functioning (GAF). Além disso, foi aplicada um instrumento de autoavaliação, a escala visual analógica do humor (EVAH). Os pacientes foram divididos em três grupos (eutimia, mania e depressão) e comparados quanto aos resultados da EVAH. RESULTADOS: Dos 16 itens da EVAH, 14 foram avaliados pelos pacientes em mania de forma semelhante aos pacientes em eutimia. Em contraste, em apenas dois itens, os deprimidos mostraram escores semelhantes aos eutímicos. CONCLUSÃO: Pacientes bipolares em mania, mas não os deprimidos, avaliam de forma não fidedigna seu estado afetivo, o que reforça o comprometimento do insight na síndrome maníaca.

Palavras-chave

Insight, humor, autoavaliação, transtorno bipolar

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