Bipolar disorder is often misdiagnosed
According to a recent study published in the Journal of Clinical Psychiatry, bipolar disorder is often misdiagnosed. In many the disorder has gone unrecognized; however, according to Mark Zimmerman, M.D., of Brown University, a gross amount are diagnosed who do not have the condition. According to the study, out of 145 psychiatric outpatients who had been previously diagnosed with bipolar disorder 56.6% were judged as not having the disorder after undergoing a Structured Clinical Interview per the DSM-IV. Additionally, out of 555 other patients that had not been diagnosed with bipolar, 27 actually had the condition. The following is an excerpt of an article from Medpage Today that attempts to shed light on why bipolar disorder is so often misdiagnosed:
Dr. Zimmerman blamed the overdiagnosis of bipolar disorder on drug companies and others seeking to reduce under-diagnosis, which he said was also a real problem.
“I think there has been a marketing campaign and it has had an impact,” Dr. Zimmerman said.
Noting the frequency with which patients ask if they are bipolar, he added, “I’ve never had a patient come into my office and ask, ‘Do I have borderline personality disorder?'”
The study was part of a larger investigation in which 2,500 patients presenting at an outpatient psychiatric clinic filled out questionnaires. For the most recent 700 patients, the questionnaire asked whether the patient had previously received a diagnosis of bipolar disorder.
Dr. Zimmerman acknowledged that the reliance on self-reports, without review of clinical records, was a limitation of the study.
All patients were subsequently evaluated with the Structured Clinical Interview for DSM-IV and other validated instruments.
The evaluation confirmed the diagnosis of bipolar disorder in only 63 of the 145 patients reporting a previous bipolar diagnosis.
The investigators examined family histories of those who did not have a bipolar diagnosis. They found no differences in the prevalence of bipolar disorder in first-degree relatives between those never diagnosed with the condition and those whose initial diagnosis was overturned in the structured interview.