The Bipolar Affective Disorder Dimension Scale (BADDS) -- a dimensional scale for rating lifetime psychopathology in Bipolar spectrum disorders

Craddock, Nick; Jones, Ian; Kirov, George; Jones, Lisa
January 2004
BMC Psychiatry;2004, Vol. 4, p19
Academic Journal
Background: Current operational diagnostic systems have substantial limitations for lifetime diagnostic classification of bipolar spectrum disorders. Issues include: (1) It is difficult to operationalize the integration of diverse episodes of psychopathology, (2) Hierarchies lead to loss of information, (3) Boundaries between diagnostic categories are often arbitrary, (4) Boundaries between categories usually require a major element of subjective interpretation, (5) Available diagnostic categories are relatively unhelpful in distinguishing severity, (6) "Not Otherwise Specified (NOS)" categories are highly heterogeneous, (7) Subclinical cases are not accommodated usefully within the current diagnostic categories. This latter limitation is particularly pertinent in the context of the increasing evidence for the existence of a broader bipolar spectrum than has been acknowledged within existing classifications. Method: We have developed a numerical rating system, the Bipolar Affective Disorder Dimension Scale, BADDS, that can be used as an adjunct to conventional best-estimate lifetime diagnostic procedures. The scale definitions were informed by (a) the current concepts of mood syndrome recognized within DSMIV and ICD10, (b) the literature regarding severity of episodes, and (c) our own clinical experience. We undertook an iterative process in which we initially agreed scale definitions, piloted their use on sets of cases and made modifications to improve utility and reliability. Results: BADDS has four dimensions, each rated as an integer on a 0 - 100 scale, that measure four key domains of lifetime psychopathology: Mania (M), Depression (D), Psychosis (P) and Incongruence (I). In our experience it is easy to learn, straightforward to use, has excellent inter-rater reliability and retains the key information required to make diagnoses according to DSMIV and ICD10. Conclusions: Use of BADDS as an adjunct to conventional categorical diagnosis provides a richer description of lifetime psychopathology that (a) can accommodate sub-clinical features, (b) discriminate between illness severity amongst individuals within a single conventional diagnostic category, and (c) demonstrate the similarity between the illness experience of individuals who have been classified into different disease categories but whose illnesses both fall near the boundaries between the two categories. BADDS may be useful for researchers and clinicians who are interested in description and classification of lifetime psychopathology of individuals with disorders lying on the bipolar spectrum.


Related Articles

  • Screening for Bipolar Disorder in Children.  // Journal of Psychosocial Nursing & Mental Health Services;Dec2004, Vol. 42 Issue 12, p12 

    The article provides information on the Child Mania Rating Scale-Parent Version developed by Mani Pavuluri, director of the Pediatric Mood Disorders Clinic at the University of Illinois, used for screening bipolar disorder in children. The rating scale is based on information gathered from...

  • Understanding the Transience or Persistence of Depression. Westermeyer, Joseph // American Journal of Public Health;Sep82, Vol. 72 Issue 9, p982 

    The article discusses research being done on depression. A brief history on research into depression is given. It presents information on a number of clinical rating scales that are used for quantifying depressive symptoms. It also cites instruments for studying depression that are gradually...

  • Bipolar spectrum disorders in primary care: optimising diagnosis and treatment. Smith, Daniel J.; Thapar, Ajay; Simpson, Sharon // British Journal of General Practice;May2010, Vol. 60 Issue 574, p322 

    The authors call for improvements in the diagnosis and treatment of bipolar spectrum disorders in British primary care setting. They say based on studies, people who are at risk to develop these disorders are those who have unipolar depression, have family history and are resistant to...

  • La escala de Manía de Manchester: su adaptación a nuestro medio.  // Actas Espanolas de Psiquiatria;ene-feb2002, Vol. 30 Issue 1, p49 

    No abstract available.

  • Development of a placebo effect model combined with a dropout model for bipolar disorder. Sun, Wan; Laughren, Thomas; Zhu, Hao; Hochhaus, Guenther; Wang, Yaning // Journal of Pharmacokinetics & Pharmacodynamics;Jun2013, Vol. 40 Issue 3, p359 

    The aim of this study was to develop a placebo model for bipolar disorder to help optimize clinical trial designs for studies targeting manic episodes in bipolar disorder. A bipolar disease database was built based on individual longitudinal data collected from over 3,000 patients in 11 clinical...

  • Reward Dysregulation and Mood Symptoms in an Adolescent Outpatient Sample. Gruber, June; Gilbert, Kirsten; Youngstrom, Eric; Youngstrom, Jennifer; Feeny, Norah; Findling, Robert // Journal of Abnormal Child Psychology;Oct2013, Vol. 41 Issue 7, p1053 

    Research on bipolar spectrum disorders (BPSD) in adolescence has burgeoned in the last decade, but continued work is needed to identify endophenotypic markers associated with illness onset and course. The present study examined reward dysregulation-measured via the behavioral activation system...

  • The Carroll rating scale for depression. III. Comparison with other rating instruments. Feinberg, Michael; Carroll, Bernard J.; Smouse, Peter E.; Rawson, Sarah G.; Feinberg, M; Carroll, B J; Smouse, P E; Rawson, S G // British Journal of Psychiatry;Mar81, Vol. 138, p205 

    Patients in an effective disorders out-patient clinic were studied with four depression rating scales: the Hamilton rating scale (HRS) the Carroll rating scale (CRS) a clinical global rating of depression (CGRD) and the visual analogue scale (VAS). The overall correlations between the self...

  • Reliability and Validity of the Bipolar Depression Rating Scale on an Iranian Sample. Shabani, Amir; Akbari, Mehdi; Dadashi, Mohsen // Archives of Iranian Medicine (AIM);May2010, Vol. 13 Issue 3, p217 

    Background: The Bipolar Depression Rating Scale is an instrument to measure depression severity in patients diagnosed with bipolar disorder. This study has reevaluated the psychometric values of the Bipolar Depression Rating Scale through assessing an Iranian sample of patients with bipolar...

  • Ä°ki Uçlu Bozukluk Manik ve Ä°yileÅŸme Dönemlerindeki BiliÅŸsel Ä°ÅŸlevler: Bir Ä°zlem Çalışması. Yazıhan, Nakşidil; Doruk, Ali; Balıkçı, Adem; Erdem, Murat // Journal of Mood Disorders;2015, Vol. 5 Issue 2, p62 

    Objective: Patients with bipolar disorder often suffer from persistent cognitive impairments. However, it is not described fully that these impairments are associated with episodes of the disorder. We aimed to study cognitive functions in same bipolar patients during their manic episodes and...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics