The authors of this paper do not have any conflicts of interest regarding the findings or the publication of this manuscript, financial or otherwise.
Ten-year diagnostic consistency of bipolar disorder in a first-admission sample
Article first published online: 24 JAN 2010
© 2010 The Authors. Journal compilation © 2010 John Wiley & Sons A/S
Volume 12, Issue 1, pages 21–31, February 2010
How to Cite
Ruggero, C. J., Carlson, G. A., Kotov, R. and Bromet, E. J. (2010), Ten-year diagnostic consistency of bipolar disorder in a first-admission sample. Bipolar Disorders, 12: 21–31. doi: 10.1111/j.1399-5618.2009.00777.x
- Issue published online: 24 JAN 2010
- Article first published online: 24 JAN 2010
- Received 9 March 2009, revised and accepted for publication 6 October 2009
- bipolar disorder;
- childhood behavior problems;
- first-admission sample;
Ruggero CJ, Carlson GA, Kotov R, Bromet EJ. Ten-year diagnostic consistency of bipolar disorder in a first-admission sample. Bipolar Disord 2010: 12: 21–31. © 2010 The Authors. Journal compilation © 2010 John Wiley & Sons A/S.
Objectives: A number of reports have examined the stability of the diagnosis of schizophrenia, but fewer studies have considered the long-term consistency of a bipolar diagnosis or factors that influence the likelihood of a diagnostic change. The present study sought to estimate how consistently a bipolar diagnosis was made across a 10-year period and factors associated with consistency, particularly demographic and clinical characteristics, childhood-related factors, and illness course.
Methods: The sample included 195 first-admission patients presenting with psychosis who were assessed soon after hospitalization and at 6-month, 2-year, and 10-year follow-up and diagnosed with bipolar disorder on at least one of these assessments. Diagnoses were made using best-estimate procedures and were blind to all previous consensus diagnoses. Respondents who were consistently diagnosed with bipolar disorder were compared to those whose diagnosis shifted across assessments.
Results: Overall, 50.3% (n = 98) of the 195 respondents were diagnosed with bipolar disorder at every available assessment, but 49.7% (n = 97) had a diagnostic shift to a non-bipolar disorder at least once over the course of the 10-year study. Childhood psychopathology and poorer illness course were among the few variables associated with increased odds of a change in diagnosis.
Conclusions: Even with optimal assessment practices, misdiagnosis of bipolar disorder is common, with complex clinical presentations often making it difficult to consistently diagnose the disorder over the long term.