TY - JOUR
T1 - Racing thoughts revisited
T2 - A key dimension of activation in bipolar disorder
AU - Weiner, Luisa
AU - Ossola, Paolo
AU - Causin, Jean Baptiste
AU - Desseilles, Martin
AU - Keizer, Ineke
AU - Metzger, Jean Yves
AU - Krafes, Elena Garcia
AU - Monteil, Charles
AU - Morali, Alexandre
AU - Garcia, Sonia
AU - Marchesi, Carlo
AU - Giersch, Anne
AU - Bertschy, Gilles
AU - Weibel, Sébastien
N1 - Publisher Copyright:
© 2019 Elsevier B.V.
PY - 2019/8/1
Y1 - 2019/8/1
N2 - 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.
AB - 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.
KW - Bipolar disorder
KW - Crowded thoughts
KW - Mixed depression
KW - Racing thoughts
UR - http://www.scopus.com/inward/record.url?scp=85066089432&partnerID=8YFLogxK
U2 - 10.1016/j.jad.2019.05.033
DO - 10.1016/j.jad.2019.05.033
M3 - Article
AN - SCOPUS:85066089432
SN - 0165-0327
VL - 255
SP - 69
EP - 76
JO - Journal of affective disorders
JF - Journal of affective disorders
ER -