The Performance of DSM-III-R Major Depression Criteria in the Diagnosis of Bipolar Mixed States

237 manic patients diagnosed by DSM-III-R criteria as either purely mania (204) or mixed bipolar (33) were reviewed for analysis of the diagnostic performance of the DSM-III-R criteria required to diagnose the mixed bipolar state. The sensitivity, specificity, positive predictive value, negative predictive value, & diagnostic efficiency of each of the 9 DSM-III-R criteria for major depression were calculated for this cohort. Four symptoms: anhedonia, fatigue, feelings of worthlessness or guilt, & recurrent thoughts of death or suicidal ideation had acceptable utility for the diagnosis of mixed states. (3 refs.)