Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatr. Mar 22, 2015; 5(1): 126-137
Published online Mar 22, 2015. doi: 10.5498/wjp.v5.i1.126
Mood Spectrum Model: Evidence reconsidered in the light of DSM-5
Antonella Benvenuti, Mario Miniati, Antonio Callari, Michela Giorgi Mariani, Mauro Mauri, Liliana Dell’Osso
Antonella Benvenuti, Mario Miniati, Antonio Callari, Michela Giorgi Mariani, Mauro Mauri, Liliana Dell’Osso, Department of Clinical and Experimental Medicine, University of Pisa, 56100 Pisa, Italy
Author contributions: All authors provided substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; contributions to drafting the article or revising it critically for important intellectual content; and approved to the final version to be published.
Ethics approval: No basic research, clinical researches or case reports have been performed for this paper. All data are available and already published in international peer-reviewed journals. No additional analyses were performed. No meta-analyses were conducted. No databases were requested to the authors of the reviewed papers.
Informed consent: No new clinical researches or case reports involving humans were performed for this paper. All reviewed studies were already published after the approvals of informed consents and ethical issues, when appropriate.
Conflict-of-interest: None.
Data sharing: No basic research and clinical research studies that require a data sharing statement were performed for this paper. All data derived from already published papers.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Antonella Benvenuti, MD, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy. antonellabenvenuti@virgilio.it
Telephone: +39-050-999616 Fax: +39-050-2219787
Received: September 27, 2014
Peer-review started: September 28, 2014
First decision: November 19, 2014
Revised: January 7, 2015
Accepted: January 18, 2015
Article in press: January 20, 2015
Published online: March 22, 2015
Processing time: 176 Days and 23 Hours
Abstract

AIM: to investigate studies conducted with the Mood Spectrum Structured Interviews and Self-Report versions (SCI-MOODS and MOODS-SR).

METHODS: We conducted a review of studies published between 1997 and August 2014. The search was performed using Pubmed and PsycINFO databases. Analysis of the papers followed the inclusion and exclusion criteria recommended by the PRISMA Guidelines, namely: (1) articles that presented a combination of at least two terms, “SCI-MOODS” [all fields] or “MOODS-SR” [all fields] or “mood spectrum” [all fields]; (2) manuscript in English; (3) original articles; and (4) prospective or retrospective original studies (analytical or descriptive), experimental or quasi-experimental studies. Exclusion criteria were: (1) other study designs (case reports, case series, and reviews); (2) non-original studies including editorials, book reviews and letters to the editor; and (3) studies not specifically designed and focused on SCI-MOODS or MOODS-SR.

RESULTS: The search retrieved 43 papers, including 5 reviews of literature or methodological papers, and 1 case report. After analyzing their titles and abstracts, according to the eligibility criteria, 6 were excluded and 37 were chosen and included. The SCI-MOODS and the MOODS-SR have been tested in published studies involving 52 different samples across 4 countries (Italy, United States, Spain and Japan). The proposed mood spectrum approach has demonstrated its usefulness mainly in 3 different areas: (1) Patients with the so-called “pure” unipolar depression that might manifest hypomanic atypical and/or sub-threshold aspects systematically detectable with the mood questionnaire; (2) Spectrum features not detected by other instruments are clinically relevant, because they might manifest in waves during the lifespan, sometimes together, sometimes alone, sometimes reaching the severity for a full-blown disorder, sometimes interfering with other mental disorders or complicating the course of somatic diseases; and (3) Higher scores on the MOODS-SR factors assessing “psychomotor disturbances”, “mixed instability” and “suicidality” delineate subtypes of patients characterized by the more severe forms of mood disorders, the higher risk for psychotic symptoms, and the lower quality of life after the remission of the full-blown-episode.

CONCLUSION: The mood spectrum model help researchers and clinicians in the systematic assessment of those areas of psychopathology that are still neglected by the Diagnostic and Statistical Manual of Mental Disorders 5 classification.

Keywords: Mood disorders, Dimensional, Categorical, Unipolar, Spectrum, Bipolar, Diagnostic and Statistical Manual of Mental Disorders 5

Core tip: Data emerging from the proposed mood spectrum approach suggest the existence of a continuum from “pure mania” to “pure depression”, without a clear cut-off between the two realms. As a whole, the experience with the mood spectrum model enforces past and recent claims towards the need for a unitary dimensional approach to mood disorders.