Mixed states are highly prevalent in patients with bipolar disorder and require comprehensive scales. Considering this, the current study aims to develop a measure to assess the full spectrum of clinical manifestations of bipolar disorder. A sample of 88 patients was evaluated; the Hamilton Depression Scale (HAM-D), Montgomery-Asberg Depression Scale (MADRS), and the Young Mania Rating Scale (YMRS) were applied, together with the preliminary version of the Scale for the Assessment of Episodes in Bipolar Disorder (SAEBD). After analyzing the appropriateness and statistical properties of the items, discriminant analysis and analysis of diagnostic capacity were performed. The discriminant functions correctly classified 100% of the cases in euthymia, predominant depressive symptoms or mixed symptoms, as well as 92.3% of the cases with predominant manic symptoms. Overall, the functions correctly classified 98.9% of the cases. The area under the curve (0.935) showed high capacity to discriminate between clinical and non-clinical cases (i.e., in euthymia). The SAEBD sensitivity was 0.95, specificity was 0.71, the Positive Predictive Value (PPV) was 0.88, the Negative Predictive Value (NPV) was 0.87, the Positive Likelihood Ratio (+LR) was 3.33, and the Negative Likelihood Ratio (-LR) was 0.07. In conclusion, the SAEBD is a promising scale that shows high reliability and validity, as well as diagnostic utility as a screening tool for use in diverse health care settings.
Keywords: SAEBD; assessment; bipolar disorder; primary health care; rating scales; receiver-operating-characteristics curve; sensitivity and specificity.