Clinical Correlates of False Positive Assignment in Bipolar Screening Measures Across Psychiatric Diagnoses among Patients without Bipolar Disorder

Abstract

Objective In this study, we aimed to determine clinical correlates of false positive assignment (FPA) on commonly used bipolar screening questionnaires.Methods A retrospective chart review was conducted to a total of 3885 psychiatric outpatients. After excluding patients who have bipolar spectrum illnesses, patients who were assigned as having hypomania on the mood disorder questionnaire (MDQ) or the hypomania checklist-32 (HCL-32) were identified as patients who had FPA. Psychiatric diagnoses and severity of emotional symptoms were compared between patients with and without FPA.Results Patients with FPA on the MDQ showed significant associations with presence of major depressive disorder, generalized anxiety disorder, and alcohol-use disorder, while patients with FPA on the HCL-32 showed associations with presence of panic disorder and agoraphobia. FPA on the MDQ was also associated with greater emotional symptoms and lifetime history of suicide attempts. Logistic regression analysis showed that male sex, younger age, presence of alcohol-use disorder, and severity of depression and obsessive-compulsive symptoms were significantly associated with FPA on the MDQ.Conclusion The FPA for the MDQ was associated with clinical factors linked to trait impulsivity, and the FPA for both the MDQ and the HCL-32 could be related to increased anxiety.

Is there a ‘bipolar iceberg’ in UK primary care psychological therapy services?

“…We did not assess other potential comorbidities, such as ADHD and personality disorders other than BPD. Exceeding HCL thresholds may, instead of a bipolar spectrum diathesis, indicate one of these – or other assessed – illnesses (Baek, Kim, Nierenberg, Jeon, & Hong, 2020 ). Regarding comorbidity more broadly, participants indicated to have multiple comorbidities on the measures we administered may, in a comprehensive assessment by a qualified clinician, indicate a single (or fewer) diagnosis.…”

Association of Resting Heart Rate and Heart Rate Variability With Proximal Suicidal Risk in Patients With Diverse Psychiatric Diagnoses

“…The psychologist who conducted the evaluation had more than 2 years of clinical experience. Detailed psychological measures included in the evaluation process were described elsewhere (17). Patients suspected of psychosis or intellectual disability or those who required emergency admission were not referred for the evaluation.…”

Does the Dysregulation of Social Rhythms Syndrome (DYMERS) be Considered an Essential Component of Panic Disorders?

“…It is known that panic disorder has frequent co-morbidity with bipolar disorder [ 12 ]. Panic disorder is one of the diagnoses that was found frequently in people who tested (false) positive on the paper and pencil screening in the absence of bipolar disorder [ 13 ], thus starting the debate on two opposing hypotheses, namely that the paper and pencil screening tests were not accurate [ 14 ] and that these instruments identified the entire spectrum of bipolar disorders far below what was (erroneously) believed to be the clinical threshold [ 15 - 18 ].…”

“…As an alternative to both of the two previous hypotheses, our group has advanced a third that the DYMERS could be a substrate of vulnerability common to many disorders and that this substrate could provide the basis for a bipolar onset in the case of co-presence of a hyperactivity profile. Hyperactivity, also with genetic features [ 11 ], could have presented not only in a pathological form but also with maladaptive connotations [ 12 , 13 ].…”