Diagnostic stability and evolution of bipolar disorder in clinical practice: a prospective cohort study
Article first published online: 8 FEB 2007
Acta Psychiatrica Scandinavica
Volume 115, Issue 6, pages 473–480, June 2007
How to Cite
Baca-Garcia, E., Perez-Rodriguez, M. M., Basurte-Villamor, I., López-Castromán, J., Fernandez del Moral, A. L., Jimenez-Arriero, M. A., Gronzalez de Rivera, J. L., Saiz-Ruiz, J., Leiva-Murillo, J. M., De Prado-Cumplido, M., Santiago-Mozos, R., Artés-Rodríguez, A., Oquendo, M. A. and De Leon, J. (2007), Diagnostic stability and evolution of bipolar disorder in clinical practice: a prospective cohort study. Acta Psychiatrica Scandinavica, 115: 473–480. doi: 10.1111/j.1600-0447.2006.00984.x
- Issue published online: 5 APR 2007
- Article first published online: 8 FEB 2007
- Accepted for publication November 28, 2006
- bipolar disorder;
- International Classification of Diseases;
- reproducibility of results;
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 ≥18 years who were assessed on ≥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 ≥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 ≥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.