A Mania for Diagnosing Bipolar Disorder

Over diagnosis of bipolar disorder has costs.

Tom has been diagnosed with bipolar disorder.

Patients with SCID diagnosed bipolar disorder had a significantly higher risk of bipolar disorder in their immediate family members than patients who self reported a previous diagnosis of bipolar disorder that was not confirmed by the SCID.

Less than half of those who reported that they had been previously diagnosed with bipolar disorder were diagnosed with bipolar disorder based on the SCID.

Our findings, validated by family history, thus suggest that bipolar disorder was over diagnosed.

Thus, over diagnosing bipolar disorder can unnecessarily expose patients to serious side effects of medication.

Slightly more than 20 (145 patients) in our sample reported that they had been previously diagnosed as having bipolar disorder, significantly higher than the 12.9 rate based on the SCID. Less than half of those who reported that they had been previously diagnosed with bipolar disorder were diagnosed with bipolar disorder based on the SCID.

To be sure, we have also seen patients seeking treatment for depression who really did have bipolar disorder.

We therefore conducted a study to examine empirically how often bipolar disorder might be over and under diagnosed.

The results of our study are consistent with prior studies suggesting possible problems with the diagnosis of bipolar disorder.

Sociocultural aspects Kay Redfield Jamison and others have explored the possible links between mood disorders especially bipolar disorder and creativity.

She's bipolar.

I'm bipolar.

But only in illnesses like schizophrenia, bipolar disorder, obsessive compulsive disorder, and depression do we find disease processes that directly and profoundly transform a person s self, identity, and place in the community.

Many mental illnesses, such as schizophrenia and bipolar disorder, can cause auditory hallucinations that command the patient to commit acts of violence.

Direct to consumer advertisements that refer individuals to screening questionnaires can result in patients suggesting to their doctors that they have bipolar disorder.

The impact of marketing efforts by pharmaceutical companies and publicity probably plays a role in the emerging tendency to over diagnose bipolar disorder.

Direct to consumer advertisements that refer individuals to screening questionnaires can result in patients suggesting to their doctors that they have bipolar disorder.

The results of our study are consistent with prior studies suggesting possible problems with the diagnosis of bipolar disorder. With the greater number of medications approved for the treatment of bipolar disorder, along with multiple reports cautioning clinicians against under diagnosis, it appears that over diagnosis has become a greater problem than under diagnosis.

Even patients who are diagnosed with bipolar disorder often wait more than 10 years after initially seeking treatment for the correct diagnosis to be made.

They are also widely used to treat social anxiety disorder, post traumatic stress disorder, generalized anxiety disorder, obsessive compulsive disorder, eating disorders, sexual compulsions, and premenstrual dysphoric disorder.

We therefore conducted a study to examine empirically how often bipolar disorder might be over and under diagnosed. Seven hundred psychiatric outpatients were interviewed with the Structured Clinical Interview for DSM IV (SCID) and completed a self administered questionnaire that asked whether they had been previously diagnosed by a health care professional with bipolar or manic depressive disorder.

Childhood bipolar children as young as four are being labeled bipolar because they have temper tantrums, which scores them high on their bipolar checklist.

Exchange Rate Disorder

Thailand s Democratic Disorder

To be sure, we have also seen patients seeking treatment for depression who really did have bipolar disorder. However, there seemed to be more over diagnosis than under diagnosis.

Those opposed to such rampant use of drugs note that diagnostic rates for bipolar disorder, in particular, have skyrocketed by 4,000 and that overmedication is impossible without over diagnosis.

The New Monetary Disorder

Genetic disorder often misdiagnosed

This bias is reinforced by the marketing message of pharmaceutical companies to physicians, which has emphasized research on delayed diagnosis and under recognition of bipolar disorder, possibly sensitizing clinicians accordingly.

In my own practice, my colleagues and I have encountered patients who reported that they were previously diagnosed with bipolar disorder, despite lacking a history of manic or hypomanic episodes.

Slightly more than 20 (145 patients) in our sample reported that they had been previously diagnosed as having bipolar disorder, significantly higher than the 12.9 rate based on the SCID.

But, perhaps as a consequence of concerted efforts to improve the recognition of bipolar disorder, during the past few years we have observed the emergence of an opposite phenomenon over diagnosis.

The room was in disorder.

Disorder prevails in the street.

The country fell into disorder.

Worldwide, annual investments in scientific research to cure devastating mental pathologies such as bipolar disorder, schizophrenia, and clinical depression are huge comparable to spending on finding a cure for any other disease.

Osgood, C. E., May, W. H., and Miron, M. S. (1975) Cross Cultural Universals of Affective Meaning.

Worrying too much is anxiety disorder.

In other words, life promotes disorder.

I have post traumatic stress disorder.

My father has a personality disorder.

The clinical implications of the failure to recognize bipolar disorder in depressed patients include the under prescription of mood stabilizing medications, and an increased risk of rapid cycling swings between manic and depressive phases.

A person in the manic phase of bipolar disorder has, in addition to serious, even life threatening lapses in judgment, an extraordinary sense of well being that the mentally well rarely, if ever, experience.