AI Insight
This study validated a Thai version of the Rapid Mood Screener (RMS-T), a six-item tool designed to help distinguish bipolar disorder from unipolar depression. Testing on 140 psychiatric outpatients (109 with major depressive disorder, 31 with bipolar disorder) showed the RMS-T had good discriminative ability with an area under the curve of 0.805, performing comparably to the existing Thai Mood Disorder Questionnaire. The optimal cutoff score of 4 or higher achieved 64.5% sensitivity and 78.9% specificity for detecting bipolar disorder.
Why it matters
Bipolar disorder is often misdiagnosed as unipolar depression, leading to inappropriate treatments that can worsen patient outcomes. This validated Thai screening tool provides clinicians with a quick, practical method to identify patients who may have bipolar disorder when they present with depressive symptoms, potentially improving diagnostic accuracy and treatment decisions in Thai healthcare settings.
Understand the Science
by Chayanis Som-On, Chawisa Suradom, Roger S. McIntyre, Sirijit Suttajit, Suttipong Kawilapat, Sutrak Pilakanta, Manit Srisurapanont
Purpose
Bipolar disorder (BD) is frequently misdiagnosed as unipolar depression, leading to inappropriate treatment and adverse outcomes. The Rapid Mood Screener (RMS) was developed to improve BD detection, a prerequisite for improving health outcomes in BD. This study aimed to translate and culturally adapt the RMS into Thai (RMS-T) and to evaluate its psychometric properties in Thai adults with bipolar I disorder (BD-I) and bipolar II disorder (BD-II).
Methods
The RMS was translated using forward–backward translation and cultural adaptation. Participants included outpatients at a tertiary psychiatric clinic with diagnosed major depressive disorder (MDD; n = 109) and BD (n = 31; BD-I = 21, BD-II = 10). Psychometric properties included internal consistency, item-total correlations, test–retest reliability, and criterion validity against the Mini International Neuropsychiatric Interview (MINI-5). Receiver operating characteristic (ROC) analyses compared RMS-T with the Thai Mood Disorder Questionnaire (T-MDQ), and optimal cutoffs were determined using Youden’s index.
Results
Internal consistency was acceptable for a brief six-item screening tool (Cronbach’s alpha = 0.610; McDonald’s Omega = 0.632). RMS-T demonstrated good discriminative ability for BD (AUC = 0.805), comparable to T-MDQ. Optimal cutoffs were ≥ 4 for BD (sensitivity 64.5%, specificity 78.9%, Youden’s index 0.43). Test–retest reliability was strong.
Conclusion
The RMS-T is a valid, practical, and time-efficient screening tool for BD patients presenting with depressive episodes. Further research should investigate end-user satisfaction, the impact on health outcomes, clinical utility, and cost-effectiveness in broader settings and populations.
Source: Reliability and validity of the Thai version of the Rapid Mood Screener (RMS-T)