Racing thoughts revisited: A key dimension of activation in bipolar disorder

Luisa Weiner, Paolo Ossola, Jean Baptiste Causin, Martin Desseilles, Ineke Keizer, Jean Yves Metzger, Elena Garcia Krafes, Charles Monteil, Alexandre Morali, Sonia Garcia, Carlo Marchesi, Anne Giersch, Gilles Bertschy, Sébastien Weibel

Research output: Contribution to journalArticle

Abstract

Background: Racing and crowded thoughts are frequently reported respectively in manic and mixed episodes of bipolar disorder (BD). However, questionnaires assessing this symptom are lacking. Here we aimed investigate racing thoughts across different mood episodes of BD through a self-report questionnaire that we developed, the 34-item Racing and Crowded Thoughts Questionnaire (RCTQ). In addition to assessing its factor structure and validity, we were interested in the RCTQ's ability to discriminate mixed and non-mixed depression. Methods: 221 BD patients and 120 controls were clinically assessed via the YMRS (mania) and the QIDS-C16 (depression), then fulfilled the RCTQ, rumination, worry, and anxiety measures. Three depression groups were operationalized according to YMRS scores: YMRS scores 2 > 6 and YMRS scores = 1 or 2, for respectively mixed and non-pure depression, and YMRS = 0 for pure-depression. Results: Confirmatory factor analysis showed that the three-factor model of the RCTQ yielded the best fit indices, which improved after the removal of redundant items, resulting in a 13-item questionnaire. Hypomanic and anxiety symptoms were the main predictors of scores; rumination was not a significant predictor. RCTQ results were similar between mixed groups and non-pure depression, and both were higher than in pure-depression. Limitations: Patients’ pharmacological treatment might have influenced the results. Conclusions: The 13-item RCTQ captures different facets of racing thoughts heightened in hypomanic and mixed states, but also in depression with subclinical hypomanic/activation symptoms (e.g. non-pure depression characterized by enhanced subjective irritability), suggesting that it is particularly sensitive to activation symptoms in BD, and could become a valuable tool in the follow-up of patients.

Original languageEnglish
Pages (from-to)69-76
Number of pages8
JournalJournal of affective disorders
Volume255
DOIs
Publication statusPublished - 1 Aug 2019

Keywords

  • Bipolar disorder
  • Crowded thoughts
  • Mixed depression
  • Racing thoughts

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    Weiner, L., Ossola, P., Causin, J. B., Desseilles, M., Keizer, I., Metzger, J. Y., Krafes, E. G., Monteil, C., Morali, A., Garcia, S., Marchesi, C., Giersch, A., Bertschy, G., & Weibel, S. (2019). Racing thoughts revisited: A key dimension of activation in bipolar disorder. Journal of affective disorders, 255, 69-76. https://doi.org/10.1016/j.jad.2019.05.033