Validation by Rasch analysis of the Mania Scale (EMUN) for measuring manic symptions

Ricardo Sánchez, Juliana Velásquez, Álvaro Navarro, .

Keywords: Psychiatric status rating scales, validation studies, bipolar disorder/diagnosis, psychometrics/statistics and numerical data, reproducibility of results, interview, psychological

Abstract

Introduction. The Mania Scale (EMUN) developed at the Universidad Nacional de Colombia was designed to measure the severity of manic symptoms, but has been validated only using classical psychometric theory.
Objectives. The psychometric properties and measuring characteristics of the EMUN scale were determined using an analysis based on item response theory.
Materials and methods. Two hundred sixty-four patients with manic, hypomanic or mixed episode symptoms were assessed using the EMUN scale. The psychometric characteristics of the scale were analyzed using a Rasch model for partial credit scoring.
Results. The analysis based on the item response theory showed that reliability and separation indexes for persons are low in contrast to items. This suggested a narrow representation of the construct evaluated in this sample. Reduced need to sleep has been the most easily detectable symptom in mania. Excepting depressive affect and distractibility, the majority of items fit the model's expectation The rating scale diagnostics showed that the average measures increase monotonically across the rating scale. Two items showed redundancy and can be omitted in future versions of the scale. The person-item map suggested that the syndrome is not fully evaluated by the scale, probably because some depressive symptoms are not included.
Conclusion. In this first study to use Rasch analysis to assess the psychometric properties of the EMUN scale, misfit and redundancy of items have been detected. The manic syndrome is not fully evaluated by the scale. The instrument can be improved by adding depressive symptoms.

Downloads

Download data is not yet available.
  • Ricardo Sánchez Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia
  • Juliana Velásquez Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia
  • Álvaro Navarro Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia

References

1. Gutiérrez-Rojas L, Gurpegui M, Ayuso-Mateos JL, Gutiérrez-Ariza JA, Ruiz-Veguilla M, Jurado D. Quality of life in bipolar disorder patients: A comparison with a general population sample. Bipolar Disord. 2008;10:625-34.
2. Gutiérrez-Rojas L, Jurado D, Gurpegui M. Factors associated with work, social life and family life disability in bipolar disorder patients. Psychiatry Res. 2011;186:254-60.
3. Ketter TA. Diagnostic features, prevalence, and impact of bipolar disorder. J Clin Psychiatry. 2010;71:e14.
4. Goodwin FK, Fireman B, Simon GE, Hunkeler EM, Lee J, Revicki D. Suicide risk in bipolar disorder during treatment with lithium and divalproex. JAMA. 2003;290:1467-73.
5. Ministerio de la Protección Social, Fundación FES Social. Estudio Nacional de Salud Mental en Colombia. Bogotá, 2003. Fecha de consulta: 20 de octubre de 2010. Disponible en: http://mps.minproteccionsocial.gov.co/vbecontent/library/documents/DocNewsNo14822DocumentNo1466.pdf.
6. López J, Baca E, Botillo C, Quintero J, Navarro R, Negueruela M, et al. Diagnostic errors and temporal stability in bipolar disorder. Actas Esp Psiquiatr. 2008;36:205-9.
7. Tiller JW, Schweitzer I. Bipolar disorder: Diagnostic issues. Med J Aust. 2010;193(Suppl.):S5-9.
8. Young AH. Bipolar disorder: Diagnostic conundrums and associated comorbidities. J Clin Psychiatry. 2009;70:e26.
9. Moniwa E, Lee TW, Lofchy J. Revisiting the diagnostic challenges of secondary mania and bipolar disorder in a patient with borderline hyperthyroidism. Can J Psychiatry. 2004;49:863-4.
10. Grunze HC. Switching, induction of rapid cycling, and increased suicidality with antidepressants in bipolar patients: Fact or overinterpretation? CNS Spectr. 2008;13:790-5.
11. Geller B, Fox LW, Fletcher M. Effect of tricyclic antidepressants on switching to mania and on the onset of bipolarity in depressed 6- to 12-year-olds. J Am Acad Child Adolesc Psychiatry. 1993;32:43-50.
12. Bauer MS, Wisniewski SR, Marangell LB, Chessick CA, Allen MH, Dennehy EB, et al. Are antidepressants associated with new-onset suicidality in bipolar disorder? A prospective study of participants in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). J Clin Psychiatry. 2006;67:48-55.
13. Sánchez R, Rosero N. Revision crítica de escalas de medición de manía. Avances en Medición. 2003;1:37-70.
14. Shugar G, Schertzer S, Toner BB, Di Gasbarro I. Development, use, and factor analysis of a self-report inventory for mania. Compr Psychiatry. 1992;33:325-31.
15. Braunig P, Shugar G, Kruger S. An investigation of the Self-Report Manic Inventory as a diagnostic and severity scale for mania. Compr Psychiatry. 1996;37:52-5.
16. Bernstein IH, Rush AJ, Suppes T, Trivedi MH, Woo A, Kyutoku Y, et al. A psychometric evaluation of the clinician-rated Quick Inventory of Depressive Symptomatology (QIDS-C16) in patients with bipolar disorder. Int J Methods Psychiatr Res. 2009;18:138-46.
17. Dennehy EB, Suppes T, Crismon ML, Toprac M, Carmody TJ, Rush AJ. Development of the Brief Bipolar Disorder Symptom Scale for patients with bipolar disorder. Psychiatry Res. 2004;127:137-45.
18. Ruggero CJ, Johnson SL, Cuellar AK. Spanish-language measures of mania and depression. Psychol Assess. 2004;16:381-5.
19. Sánchez R, Jaramillo L, Gómez C. Desarrollo y validación de una escala para medir síntomas maníacos. Escala para manía de la Universidad Nacional de Colombia (EMUN). Revista Colombiana de Psiquiatría. 2008;37:516-37.
20. Hambleton RK, Swaminathan H, Rogers HJ. Fundamentals of item response theory. Newbury Park: Sage Publications; 1991.
21. Linden WJ, Hambleton RK. Handbook of modern item response theory. New York: Springer; 1997.
22. Bond TG, Fox CM. Applying the Rasch model: Fundamental measurement in the human sciences. 2nd edition. Mahwah, N.J.: Lawrence Erlbaum Associates Publishers; 2007.
23. Wright BD, Linacre JM. Observations are always ordinal; measurements, however, must be interval. Arch Phys Med Rehabil. 1989;70:857-60.
24. Wright B. Reasonable mean-square fit values. Rasch Measurement Transactions. 2002;8:370.
25. Linacre JM. Optimizing rating scale category effectiveness. J Appl Meas. 2002;3:85-106.
26. DeMars C. Item response theory. Oxford: Oxford University Press; 2010.
27. Liu X, Boone WJ. Applications of Rasch measurement in science education. Maple Grove: JAM Press; 2006.
28. Cassidy F, Murry E, Forest K, Carroll BJ. Signs and symptoms of mania in pure and mixed episodes. J Affect Disord. 1998;50:187-201.
29. American Psychiatric Association. Diagnostic criteria from DSM-IV-TR. Washington, D.C.: American Psychiatric Association; 2000.
30. Rangel O, Sánchez R. Estudio de la estructura latente del síndrome maníaco mediante técnicas de escalamiento multidimensional. Revista Colombiana de Psiquiatría. 2010;39:240-50.
31. Cassidy F, Ahearn E, Carroll BJ. Concordance of self-rated and observer-rated dysphoric symptoms in mania. J Affect Disord. 2009;114:294-8.
32. Cassidy F, Carroll BJ. Frequencies of signs and symptoms in mixed and pure episodes of mania: Implications for the study of manic episodes. Prog Neuropsychopharmacol Biol Psychiatry. 2001;25:659-65.
How to Cite
1.
Sánchez R, Velásquez J, Navarro Álvaro. Validation by Rasch analysis of the Mania Scale (EMUN) for measuring manic symptions. biomedica [Internet]. 2011 Mar. 31 [cited 2024 May 16];31(3):410-8. Available from: https://revistabiomedica.org/index.php/biomedica/article/view/385
Section
Original articles

Altmetric

Article metrics
Abstract views
Galley vies
PDF Views
HTML views
Other views
Crossref Cited-by logo
QR Code