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Signs and symptoms of acute mania a factor analysis 英文参考文献.doc

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Signs and symptoms of acute mania a factor analysis 英文参考文献

HanwellaanddeSilvaBMCPsychiatry2011,11:137 /1471-244X/11/137 RESEARCH ARTICLE OpenAccess Signsandsymptomsofacutemania: afactoranalysis RaveenHanwella*?andVaruniAdeSilva? Abstract Background:Themajordiagnosticclassificationsconsidermaniaasauni-dimensionalillness.Factoranalytic studiesofacutemaniaarefewercomparedtoschizophreniaanddepression.Evidencefromfactoranalysis suggestsmorecategoriesorsubtypesthanwhatisincludedintheclassificationsystems.Studieshavefoundthat thesefactorscanpredictdifferencesintreatmentresponseandprognosis. Methods:The sample included 131 patients consecutively admitted to an acute psychiatry unit over aperiod of one year. It included 76 (58%) males. The mean age was 44.05 years (SD = 15.6). Patients met International Classification of Diseases-10 (ICD-10) clinical diagnostic criteria for amanic episode. Patients with adiagnosis of mixed bipolar affective disorder were excluded. Participants were evaluated using the Young Mania Rating Scale (YMRS). Exploratory factor analysis (principal component analysis) was carried out and factors with an eigenvalue 1 were retained. The significance level for interpretation of factor loadings was 0.40. The unrotated component matrix identified five factors. Oblique rotation was then carried out to identify three factors which were clinically meaningful. Results:Unrotatedprincipalcomponentanalysisextractedfivefactors.Thesefivefactorsexplained65.36%ofthe totalvariance.Obliquerotationextracted3factors.Factor1correspondingto‘irritablemania’hadsignificant loadingsofirritability,increasedmotoractivity/energyanddisruptiveaggressivebehaviour.Factor2corresponding to‘elatedmania’hadsignificantloadingsofelevatedmood,languageabnormalities/thoughtdisorder,increased sexualinterestandpoorinsight.Factor3correspondingto‘psychoticmania’hadsignificantloadingsof abnormalitiesinthoughtcontent,appearance,poorsleepandspeechabnormalities. Conclusions:Ourfindingsidentifiedthreeclinicallymeaningfulfactorscorrespondingto‘elatedmania’