Problems in Diagnosing Bipolar Problems in Diagnosing Bipolar Disorder Disorder

Abstract

Angst (2007) provides more balanced views Angst (2007) provides more balanced views on the much publicised concerns about the on the much publicised concerns about the underdiagnosis of bipolar disorder. Psychi-underdiagnosis of bipolar disorder. Psychiatric diagnoses are not robust entities atric diagnoses are not robust entities (Baca-Garcia (Baca-Garcia et al et al, 2007) and most recent , 2007) and most recent research in mood disorders has arisen from research in mood disorders has arisen from redefining and often rigidly applying the redefining and often rigidly applying the DSM criteria, which has proved a hin-DSM criteria, which has proved a hindrance to research. The problem in mood drance to research. The problem in mood disorder research lies in our failure to de-disorder research lies in our failure to define the core features of mania/hypomania fine the core features of mania/hypomania and bipolar depression. Surprisingly, hardly and bipolar depression. Surprisingly, hardly any advance has been made in our under-any advance has been made in our understanding of and our ability to accurately standing of and our ability to accurately diagnose an active hypomanic/manic epi-diagnose an active hypomanic/manic episode (excluding retrospective accounts), sode (excluding retrospective accounts), and we are guided by epidemiological stu-and we are guided by epidemiological studies and expert opinions rather than basing dies and expert opinions rather than basing diagnosis on a new phenomenological un-diagnosis on a new phenomenological understanding. Moreover, we rely on a range derstanding. Moreover, we rely on a range of self-report checklists. Unfortunately, of self-report checklists. Unfortunately, there are few advocates for people with there are few advocates for people with wrongly diagnosed bipolar disorder. It is wrongly diagnosed bipolar disorder. It is like initiating antihypertensive treatment like initiating antihypertensive treatment for suspected hypertension. Unless they for suspected hypertension. Unless they have clinical consequences, temperament have clinical consequences, temperament and vegetative lability, like blood pressure and vegetative lability, like blood pressure and heart rate, should not be considered and heart rate, should not be considered pathological. The success of future research pathological. The success of future research lies in a greater understanding of the phe-lies in a greater understanding of the phe-nomenology of episodes of depression and nomenology of episodes of depression and in bipolar disorder and the differences in in bipolar disorder and the differences in biological depression that result from psy-biological depression that result from psy-chosocial factors. chosocial factors. (2007) Diagnostic stability of Diagnostic …