Quality of Life: Misdiagnosed Bipolar Disorder vs Depression and Bipolar Disorder

Abstract

 Approximately 14% of patients with MDD have exhibited symptoms of mania in the past year and may be misdiagnosed. This is consistent with other studies that suggest a 1%-8% prevalence rate of bipolar in the US population, and that 25%-50% of all major depression cases are bipolar. 2,3  Patients with misdiagnosed bipolar disorder report significantly lower quality of life as measured by the SF-8 and PGWB.  When controlling for confounding variables such as age, education, and gender, misdiagnosed status continues to be the primary driver of lower quality of life, followed by education level.  Because of the negative impact on quality of life, clinicians should question depressed patients about symptoms of mania to avoid misdiagnosis.  Though based on DSM-IV-TR™ criteria, 7 the classification of patients as having misdiagnosed bipolar disorder was not done using a validated instrument. Additionally, all data were self-reported and were not validated against health records.  The Bipolar Disorder Project includes respondents from an advocacy organization and community mental health centers. The sample cannot be generalized to the diagnosed bipolar population treated by private psychiatrists or those currently institutionalized.  Data collection methodology differed for the two surveys. While the demographic profiles of patients in both surveys are similar, inherent and unknown differences between those surveyed via Internet and those surveyed via mail cannot be ruled out.  Finally, as with all surveys, a self-selection bias may occur, as respondents to these surveys can differ from nonrespondents.