The authors of this paper do not have any commercial associations that might pose a conflict of interest in connection with this manuscript.
Is bipolar disorder overdiagnosed among patients with substance abuse?
Version of Record online: 5 SEP 2007
Volume 9, Issue 6, pages 646–648, September 2007
How to Cite
Stewart, C. and El-Mallakh, R. S. (2007), Is bipolar disorder overdiagnosed among patients with substance abuse?. Bipolar Disorders, 9: 646–648. doi: 10.1111/j.1399-5618.2007.00465.x
- Issue online: 5 SEP 2007
- Version of Record online: 5 SEP 2007
- Received 20 December 2005, revised and accepted for publication 15 December 2006
- alcohol abuse;
- alcohol dependence;
- bipolar disorder;
- dual diagnosis;
- substance abuse - substance dependence
Background: Bipolar illness is frequently misdiagnosed. Several studies have focused on the underdiagnosis of this condition and the frequent long delay in its recognition. However, the illness is difficult to diagnose and many of its symptoms are shared by other conditions. In order to determine the accuracy of the diagnosis of bipolar illness among subjects with substance abuse, we carried out a study in patients with a previous diagnosis of bipolar disorder (BD) and known history of substance abuse or dependence, who were currently engaged in treatment for substance abuse.
Methods: Individuals participating in a community-based substance treatment program and who had a previous diagnosis of BD were invited to undergo a structured clinical interview for diagnosis performed by a psychiatrist. In addition to the interview, previous hospital records were reviewed whenever possible. Diagnosis was made following strict DSM-IV criteria.
Results: Only 9 of 21 (42.9%) subjects met diagnostic criteria for BD. Seven were BD type II and two were BD I.
Conclusions: Bipolar disorder is frequently misdiagnosed following strict DSM-IV criteria. Among subjects with substance abuse, it may be overdiagnosed by psychiatrists.