Bipolar Research Today is a free monthly online journal that collates and summarizes the latest research about Bipolar, including details on bipolar disorder, symptoms, treatment, depression, medication. | ||||||||
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Diagnostic stability and evolution of bipolar disorder in clinical practice: a prospective cohort study.Baca-Garcia E, Perez-Rodriguez MM, Basurte-Villamor I, López-Castromán J, Fernandez del Moral AL, Jimenez-Arriero MA, Gronzalez de Rivera JL, Saiz-Ruiz J, Leiva-Murillo JM, de Prado-Cumplido M, Santiago-Mozos R, Artés-Rodríguez A, Oquendo MA, de Leon J Department of Psychiatry, Fundacion Jimenez Diaz University Hospital, Autonoma University of Madrid, Madrid, Spain. ebacgar2@yahoo.es OBJECTIVE: To evaluate the long-term stability of International Classification of Diseases-10th revision bipolar affective disorder (BD) in multiple settings. METHOD: A total of 34 368 patients received psychiatric care in the catchment area of a Spanish hospital (1992-2004). The analyzed sample included patients aged > or =18 years who were assessed on > or =10 occasions and received a diagnosis of BD at least once (n = 1153; 71,543 assessments). Prospective and retrospective consistencies and the proportion of subjects who received a BD diagnosis in > or =75% of assessments were calculated. Factors related to diagnostic shift were analyzed with traditional statistical methods and Markov's models. RESULTS: Thirty per cent of patients received a BD diagnosis in the first assessment and 38% in the last assessment. Prospective and retrospective consistencies were 49% and 38%. Twenty-three per cent of patients received a BD diagnosis during > or =75% of the assessments. CONCLUSION: There was a high prevalence of misdiagnosis and diagnostic shift from other psychiatric disorders to BD. Temporal consistency was lower than in other studies. Published 14 May 2007 in Acta Psychiatr Scand, 115(6): 473-80.
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