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The Reliability of Self-assessment of Affective State in Different Phases of Bipolar Disorder

de Assis da Silva, Rafael MD*†; Mograbi, Daniel C. PhD‡§; Silveira, Luciana Angélica Silva MD; Nunes, Ana Letícia Santos MD; Novis, Fernanda Demôro MD, MSc; Landeira-Fernandez, J. PhD‡∥; Cheniaux, Elie PhD†¶

The Journal of Nervous and Mental Disease: May 2014 - Volume 202 - Issue 5 - p 386–390
doi: 10.1097/NMD.0000000000000136
Original Articles

Some studies have indicated that the capacity of self-assessment of affective state is more compromised during mania than during depression. In the present study, we investigated whether the reliability of self-assessment in bipolar disorder varies as a function of actual affective state (i.e., euthymia, mania, or depression). Sixty-five patients with a diagnosis of type I and type II bipolar disorder were evaluated with regard to the occurrence of an affective syndrome using the Clinical Global Impressions Scale for use in bipolar illness, the Positive and Negative Syndrome Scale, and the Global Assessment of Functioning scale. In parallel, we applied the Analog Visual Mood Scale, a self-assessment tool to evaluate mood changes. The same individual prospectively completed the self-assessment scale in different affective states. During depression, the patients’ evaluation was significantly different from when they were in manic or euthymic mood states. However, when in mania, the patients evaluated their mood state similarly to when they were euthymic. The bipolar patients in mania but not in depression did not reliably evaluate themselves with regard to their affective state.

*Instituto Municipal Philippe Pinel, Rio de Janeiro, Brazil; †Instituto de Psiquiatria–Universidade Federal do Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, Brazil; ‡Pontifícia Universidade Católica do Rio de Janeiro (PUC-Rio), Rio de Janeiro, Brazil; §Institute of Psychiatry, King’s College London, London, UK; ∥Universidade Estácio de Sá (UNESA), Rio de Janeiro, Brazil; and ¶School of Medical Sciences, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil.

Send reprint requests to Rafael de Assis da Silva, MD, Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro (IPUB/UFRJ), Laboratório de Transtorno Bipolar do Humor, Avenida Venceslau Brás, 71, Fundos, Botafogo, Rio de Janeiro, RJ, CEP 22290-140, Brazil. E-mail:

© 2014 by Lippincott Williams & Wilkins