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Diagnosing bipolar disorder : how can we do it better?
journal contribution
posted on 2006-05-01, 00:00 authored by Michael BerkMichael Berk, Lesley BerkLesley Berk, Seetal DoddSeetal Dodd, K Moss, G Malhi• Accurate diagnosis of bipolar disorder is essential for effective treatment.
• The diagnosis of bipolar disorder is particularly complex, resulting in lengthy delays between first presentation and initiation of appropriate therapy. Inappropriate therapy destabilises the course and outcome of the disease.
• Although the defining features of bipolar disorder are manic or hypomanic episodes, patients typically present for treatment of depression and commonly deny symptoms of mood elevation.
• A correct diagnosis can easily be masked by comorbidities, personality issues and complex phenomenology.
• A diagnosis of bipolar disorder can be assisted by:
→ asking about symptoms of mania or hypomania in every patient presenting with symptoms of depression.
→ recognising mixed states in which manic and depressive symptoms occur simultaneously.
→ identifying the features of bipolar depression that distinguish it from unipolar depression.
• There is a risk of over-diagnosis of bipolar disorder among patients who are histrionic, show abnormal illness behaviour MJA 2006; 184: 459–462 and/or have issues of secondary gain.
• The diagnosis of bipolar disorder is particularly complex, resulting in lengthy delays between first presentation and initiation of appropriate therapy. Inappropriate therapy destabilises the course and outcome of the disease.
• Although the defining features of bipolar disorder are manic or hypomanic episodes, patients typically present for treatment of depression and commonly deny symptoms of mood elevation.
• A correct diagnosis can easily be masked by comorbidities, personality issues and complex phenomenology.
• A diagnosis of bipolar disorder can be assisted by:
→ asking about symptoms of mania or hypomania in every patient presenting with symptoms of depression.
→ recognising mixed states in which manic and depressive symptoms occur simultaneously.
→ identifying the features of bipolar depression that distinguish it from unipolar depression.
• There is a risk of over-diagnosis of bipolar disorder among patients who are histrionic, show abnormal illness behaviour MJA 2006; 184: 459–462 and/or have issues of secondary gain.
History
Journal
Medical journal of AustraliaVolume
184Issue
9Pagination
459 - 462Publisher
Australasian Medical Publishing CompanyLocation
Strawberry Hills, N. S. W.ISSN
0025-729XeISSN
1326-5377Language
engPublication classification
C1.1 Refereed article in a scholarly journalCopyright notice
2006, Australasian Medical Publishing CompanyUsage metrics
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