Systematic clinical methodology for validating bipolar-II disorder: data in mid-stream from a French national multi-site study (EPIDEP)

Would Broadening the Diagnostic Criteria for Bipolar Disorder Do More Harm Than Good? Implications From Longitudinal Studies of Subthreshold Conditions

“…[13][14][15][16][17][18][19][20][21][22] For patients diagnosed with bipolar disorder, the lag between initial treatment-seeking and the correct diagnosis is often more than 10 years. 23,24 The treatment and clinical implications of the failure to recognize bipolar disorder in depressed patients include the underprescription of mood stabilizing medications, an increased risk of rapid cycling, and increased costs of care.…”

“…A number of studies have found that the rate of missed diagnoses of bipolar disorder is fairly high, especially when a broader definition of hypomania is used than the one specified in DSM-IV. 15,16,21,[28][29][30] As a clinician, it is often the case that early in the course of treatment I am not sure if a currently depressed patient has bipolar disorder. This uncertainty occurs despite an extensive evaluation that includes the administration of a semistructured interview, a review of prior records, and an interview with an informant.…”

Lowering the Diagnostic Threshold for Bipolar Disorder: The Wrong Stuff?

“…[13][14][15][16][17][18][19][20][21][22] For patients diagnosed with bipolar disorder, the lag between initial treatment-seeking and the correct diagnosis is often more than 10 years. 23,24 The treatment and clinical implications of the failure to recognize bipolar disorder in depressed patients include the underprescription of mood stabilizing medications, an increased risk of rapid cycling, and increased costs of care.…”

“…A number of studies have found that the rate of missed diagnoses of bipolar disorder is fairly high, especially when a broader definition of hypomania is used than the one specified in DSM-IV. 15,16,21,[28][29][30] As a clinician, it is often the case that early in the course of treatment I am not sure if a currently depressed patient has bipolar disorder. This uncertainty occurs despite an extensive evaluation that includes the administration of a semistructured interview, a review of prior records, and an interview with an informant.…”

Transtorno bipolar do humor e gênero

“…Inúmeros estudos indicam que o curso da enfermidade variaria nos dois gêneros. Assim, há evidências de que mulheres bipolares apresentariam, com mais probabilidade do que os homens, uma evolução com ciclagem rápida, mais episódios depressivos, mais mania disfórica e estados mistos de tipo II (depressão e hipomania), fato que se observa na hipomania mista Hantouche et al, 1998;Koukopoulos, 1999;Angst e Marneros, 2001;Benazzi e Akiskal, 2001;Perugi et al, 2001), embora não se encontre unanimidade (Szadoczky et al, 1998;Burt e Hendrick, 2005) e homens bipolares se suicidem mais freqüentemente.…”