Clinical validation of the BDSx scale with bipolar disorder outpatients

Purpose The BDSx (Bipolar Disorder Symptom Scale) is a brief self-report instrument designed for repeated measurement of bipolar disorder (BD) symptoms over time. Previous research indicates that the BDSx measures two depression (cognitive and somatic symptoms) and two hypo/mania factors (affrontive symptoms and elation/loss of insight). The purpose of this study was to validate BDSx responses relative to diagnoses of BD mood episodes. Methods Sixty BD outpatients attending routine clinic appointments completed the BDSx, the Hamilton Rating Scale for Depression, the Altman Self-Rating Mania Scale, and the Satisfaction with Life Scale. Blind to scale responses by patients, a clinic psychiatrist determined if patients were currently symptomatic. Results BDSx depression and hypo/mania subscales showed good construct validity vis-a-vis clinical diagnoses, and concurrent/discriminant validity with other self-report scales. And though not designed as a screening measure, sensitivity for the depression subscale is high at 88% (6+, 76% specificity), yet lower at 57% for the hypo/mania subscale (5+, 90% specificity). Conclusions The results of this study indicate that BDSx responses distinguish patients experiencing depressive and hypo/manic mood episodes. Findings support the psychometric properties of the Hebrew version of this scale. The BDSx enables those with bipolar disorder to monitor their symptoms, gauge symptom variability, and identify factors that proceed and sustain BD symptoms over time.