Diagnostic stability and evolution of bipolar disorder in clinical practice: a prospective cohort study

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 i...

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Published in:	Acta Psychiatrica Scandinavica Vol. 115; no. 6; pp. 473 - 480
Main Authors:	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., De Leon, J.
Format:	Journal Article
Language:	English
Published:	Oxford, UK Blackwell Publishing Ltd 01-06-2007 Blackwell
Subjects:	Adolescent Adult Adult and adolescent clinical studies Biological and medical sciences Bipolar disorder Bipolar Disorder - diagnosis Bipolar Disorder - psychology Bipolar disorders classification Cohort Studies diagnosis Diagnosis, Differential Diagnostic and Statistical Manual of Mental Disorders Disease Progression Female Humans International Classification of Diseases Male Medical diagnosis Medical sciences Mood disorders Practice Patterns, Physicians Prospective Studies Psychiatry Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry reproducibility of results Mood disorder reproducibility of results International Classification of Diseases Follow up study Cohort study Professional practice Classification Evolution Bipolar disorder Diagnosis
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Summary:	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.
Bibliography:	ark:/67375/WNG-D48W2DQ0-N istex:F38A28D964DA5AE36A9714753C2E9CF0E98FAC08 ArticleID:ACPS984 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0001-690X 1600-0447 0065-1591
DOI:	10.1111/j.1600-0447.2006.00984.x