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Proving that a patient has bipolar disorder

Author/s
Mark Agius, Helen Murphy
Citation
Issue 3 Summer 2013
CEPiP.2013;1:174-180
Abstract

Bipolar disorder (BPD) is commonly misdiagnosed; this article concisely outlines the sub-types of BPD, important criteria essential for diagnosis and then demonstrates the most effective method of extracting the necessary information. Using the twenty-nine questions provided, health professionals can be confident they have checked sufficiently for symptomatology that is often missed; this should help to confirm whether a patient has BPD. The aim should remain to reduce morbidity and mortality due to misdiagnosis, by improving the sensitivity of screening, enabling faster access to the correct treatment for these vulnerable patients.

Keywords: bipolar disorder, diagnosis

Cite as: Cutting Edge Psychiatry in Practice 2013, 3(1):174-180; https://doi.org/10.65031/dyrs3858

References

  1. Merikangas KR, Akiskal HS, Angst J, Greenberg PE, Hirschfeld RM, Petukhova M, Kessler RC. Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey replication. Arch Gen Psychiatry 2007;64 (5):543-552. https://doi.org/10.1001/archpsyc.64.5.543
  2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (4th ed., text rev.). doi:10.1176/appi.books.9780890423349; 2000
  3. Baldessarini RJ, Tondo L Suicide risk and treatments for patients with bipolar disorder. JAMA 2003;290 (11):1517-1519. https://doi.org/10.1001/jama.290.11.1517
  4. Kupfer DJ The increasing medical burden in bipolar disorder. JAMA 2005;293 (20):2528-2530. https://doi.org/10.1001/jama.293.20.2528
  5. Khantzian EJ The self-medication hypothesis of addictive disorders: focus on heroin and cocaine dependence. Am J Psychiatry 1985;142 (11):1259-1264. https://doi.org/10.1176/ajp.142.11.1259
  6. McElroy SL, Frye M, Denicoff K, Altshuler L, Nolen W, Kupka R, Suppes T, Keck PE, Leverich GS, Kmetz GF, Post RM. Olanzapine in treatment-resistant bipolar disorder. J Affect Disord 1998;49 (2):119-122. https://doi.org/10.1016/s0165-0327(98)00002-0
  7. Judd L L, Akiskal HS, Schettler PJ, Coryell W, Maser J, Rice JA, Solomon DA, Keller MB. The comparative clinical phenotype and long term longitudinal episode course of bipolar I and II: a clinical spectrum or distinct disorders? J Affect Disord 2003;73 (1-2):19-32. https://doi.org/10.1016/s0165-0327(02)00324-5
  8. Benazzi F and Akiskal HS Refining the evaluation of bipolar II: beyond the strict SCID-CV guidelines for hypomania. J Affect Disord 2003;73 (1-2):33-38. https://doi.org/10.1016/s0165-0327(02)00327-0
  9. Hirschfeld RM, Calabrese JR, Weissman MM, Reed M, Davies MA, Frye MA, Keck PE, Lewis L, McElroy SL, McNulty JP, Wagner KD. Screening for bipolar disorder in the community. J Clin Psychiatry 2003;64 (1):53-59. https://doi.org/10.4088/jcp.v64n0111
  10. Ghaemi SN, Boiman EE, Goodwin FK. Diagnosing bipolar disorder and the effect of antidepressants: a naturalistic study. J Clin Psychiatry 2000;61 (10):804-808; quiz 809. https://doi.org/10.4088/jcp.v61n1013
  11. Akiskal HS, Djenderedjian AM, Rosenthal RH, Khani MK. Cyclothymic disorder: validating criteria for inclusion in the bipolar affective group. Am J Psychiatry 1977;134 (11):1227-1233. https://doi.org/10.1176/ajp.134.11.1227
  12. Angst J, Gamma A. A new bipolar spectrum concept: a brief review. Bipolar Disord 2002;4 Suppl 1:11-14. https://doi.org/10.1034/j.1399-5618.4.s1.1.x
  13. World Health Organisation. ICD-10 Classifications of Mental and Behavioural Disorder: Clinical Descriptions and Diagnostic Guidelines. Geneva. World Health Organisation; 1992 https://doi.org/10.1177/146642409311300118
  14. Goldberg JF, Harrow M, Whiteside JE. Risk for bipolar illness in patients initially hospitalized for unipolar depression. Am J Psychiatry 2001;158 (8):1265-1270. https://doi.org/10.1176/appi.ajp.158.8.1265
  15. Agius M, Murphy CL, Zaman R. Under-diagnosis of bipolar affective disorder in A bedford CMHT. Psychiatr Danub 2010;22 Suppl 1:S36-37.           
  16. Balázs J, Benazzi F, Rihmer Z, Rihmer A, Akiskal KK, Akiskal HS. The close link between suicide attempts and mixed (bipolar) depression: Implications for suicide prevention. Journal of affective disorders 2006;91 (2):133-138. https://doi.org/10.1016/j.jad.2005.12.049
  17. Rihmer Z. Polyglottism and depression. Br J Psychiatry 1982;140:550.              
  18. Weissman MM, Bland RC, Canino GJ, Faravelli C, Greenwald S, Hwu HG, Joyce PR, Karam EG, Lee CK, Lellouch J, Lépine JP, Newman SC, Rubio-Stipec M, Wells JE, Wickramaratne PJ, Wittchen H, Yeh EK. Cross-national epidemiology of major depression and bipolar disorder. JAMA 1996;276 (4): 293-299. https://doi.org/10.3109/10673229709034719
  19. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001;16 (9):606-613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x
  20. Ruiz MA, Zamorano E, Garcia-Campayo J, Pardo A, Freire O, Rejas J. Validity of the GAD-7 scale as an outcome measure of disability in patients with generalized anxiety disorders in primary care. J Affect Disord 2011;128 (3):277-286. https://doi.org/10.1016/j.jad.2010.07.010
  21. Mitchell PB, Goodwin GM, Johnson GF, Hirschfeld RM. Diagnostic guidelines for bipolar depression: a probabilistic approach. Bipolar Disord 2008;10 (1 Pt 2):144-152. https://doi.org/10.1111/j.1399-5618.2007.00559.x
  22. Shapira A, Shiloh R, Potchter O, Hermesh H, Popper M, Weizman A Admission rates of bipolar depressed patients increase during spring/summer and correlate with maximal environmental temperature. Bipolar Disord 2004;6 (1):90-93. https://doi.org/10.1046/j.1399-5618.2003.00081.x