Bipolar Disorder on the Rise? Maybe Not So Much

Now we just need another study on the overdiagnosis of bipolar in kids, and we’ll have two studies pointing us in the right direction. From the Projo:

A major swing in diagnosing bipolar disorder

By Felice J. Freyer, Journal Medical Writer

A few years ago, Dr. Mark Zimmerman, a psychiatrist at Rhode Island Hospital, started noticing that many patients were coming to his practice seeking treatment for bipolar disorder. They’d received the diagnosis elsewhere, and they “were invested in it,� he said.

But as Zimmerman and his colleagues talked to these patients, it seemed to them that a significant proportion didn’t meet the definition of bipolar disorder, a mental illness characterized by dramatic mood swings.

So Zimmerman, director of outpatient psychiatry at Rhode Island Hospital and a psychiatry professor at the Warren Alpert Medical School of Brown University, decided to put his observations to a rigorous test. He conducted a study — and found that fewer than half those who were told they had bipolar disorder actually did.

His findings, if replicated in other studies, could upend the traditional notion that bipolar disorder is under-diagnosed and show that, in fact, it’s widely over-diagnosed.

Such errors can put patients at risk for the side effects of drugs that won’t help them, and deprive them of the treatment they truly need.

Zimmerman’s group assessed 700 patients between May 2001 and March 2005 with a structured three-hour interview that is considered the gold standard in psychiatric research. Those 700 patients were also asked whether they had received a diagnosis of bipolar disorder. Of them, 145 said they had. But fewer than half of the 145 — 43.4 percent — actually met the criteria for bipolar disorder.

To verify his findings, Zimmerman also looked at family history, because bipolar disorder is known to have a genetic component. The researchers compared three groups of patients: those who had never had a diagnosis of bipolar disorder and whom the researchers also didn’t think had it; patients who had been diagnosed with bipolar disorder but whose diagnosis was not confirmed by the structured interview; and patients diagnosed as bipolar whose illness was confirmed in the interview. [full text]

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One response

  1. It seems like there are fads in mental illness diagnosis. Remember when there was an epidemic of multiple personality disorder? But mental illness is real, undertreated and a drain on people’s lives and our economy.

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