Signs and symptoms An lithograph captioned 'Melancholy passing into mania' Both mania and depression are characterized by disruptions in normal moodpsychomotor activity, circadian rhythmand cognition. Mania can present with varying levels of mood disturbance, ranging from euphoria that is associated with "classic mania" to dysphoria and irritability. The core symptom of mania involves an increase in energy of psychomotor activity. Mania can also present with increased self-esteem or grandiosityrapid speech, the subjective feeling of rapid thoughts, disinhibited social behavior, or impulsivity.
This An introduction to the analysis of bipolar disorder an open access article distributed under the Creative Commons Attribution Licensewhich permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Bipolar disorder BD is considered one of the most disabling mental conditions, with high rates of morbidity, disability, and premature death from suicide. Although BD is often misdiagnosed as major depressive disorder, some attention has recently been drawn to the possibility that BD could be overdiagnosed in some settings.
The present paper focuses on a critical analysis of the overdiagnosis issue among bipolar patients. It includes a review of the available literature findings, followed by some recommendations aiming at optimizing the diagnosis of BD and increasing its reliability. Introduction Bipolar disorder BD is a chronic, recurrent mental illness first described by Jules Falret in as Folie Circulaire circular insanity.
Later, it was renamed as manic-depressive Psychosis. Nowadays, BD is considered one of the most disabling mental conditions, with high rates of morbidity, disability, and premature death from suicide [ 1 ]. Although the traditionally accepted prevalence of BD ranges from 0.
These discrepancies in prevalence point to a lack of consensus on the current definitions of BD, which may favor the overdiagnosis of major depressive disorder MDD in detriment of BD [ 2 ].
Over the last decade, however, BD has been progressively incorporated by culture. Patients with BD are now commonly displayed in the media, and allusions to this condition are frequently found not only in the scientific literature but also in autobiographical books and fictional writing.
This trend has drawn attention to the possibility that, regardless of well-demonstrated rates of underdiagnosis, BD could be overdiagnosed in some settings. The potential downsides of overdiagnosing BD are several.
They include the negative effects of unnecessary labeling, the risk of harm related to unnecessary treatments, and the misuse of health care resources, with important human and financial implications [ 6 — 8 ].
The present paper comprises a critical analysis of the overdiagnosis issue among bipolar patients. We begin with a review of the available literature findings, followed by some recommendations aiming at optimizing the diagnosis of BD and increasing its reliability.
The papers obtained were manually screened, aiming at identifying original articles, reviews, and case reports focusing on the overdiagnosis of BD. Rates of Overdiagnosis of BD: The results of these studies point to considerable variability in the rates of overdiagnosis, which seems to range from 4.
Most of the studies identified focused on outpatient populations and addressed the misdiagnosis of BD among patients with other psychiatric conditions e. Studies addressing the overdiagnosis of bipolar disorder. Two of those studies [ 913 ] utilized the structured clinical interview for DSM-IV disorders SCID as a gold standard and included that on the positive and negative predictive value of the diagnosis of BD made by clinicians.
In other words, if a psychiatrist had not diagnosed a patient with BD, most likely the patient did not have that diagnosis as per the SCID, whereas if a clinician diagnosed a patient with BD, the chance that the patient effectively met criteria for that diagnosis according to the SCID was modest.
The implications of those findings are addressed in Section 5 of the present paper. Factors Involved in the Overdiagnosis of Bipolar Disorder 4. Personality Disorders as a Possible Confounder in the Diagnosis of Bipolar Disorder The phenomenological distinction between BD and some personality disorders may be challenging, not only because of the overlap between some personality disorder features and the diagnostic criteria for mood episodes but also because of the lack of reliability of the time criteria for BD.
For example grandiosity is a common feature in narcissistic personality disorder, and patients with histrionic personality traits can be mistakenly diagnosed with mania [ 12 ]. Anger and impulsivity, often present in patients with antisocial personality disorder, may be misinterpreted as irritable mood [ 15 ].
Maybe the most important debate regarding the interface between BD and personality disorders is related to the issue of differential diagnosis versus comorbidity. That is particularly true when it involves patients with borderline personality disorder BPD. While the cooccurrence of BPD and BD seems to be quite common [ 16 ], the similarity between borderline personality and bipolar disorder may contribute to the diagnostic confusion involving these two conditions.
Moreover, impulsivity, a hallmark of BPD, is also increased among bipolar patients, even during periods of euthymia [ 1718 ]. On the other hand, the multiple similarities between the two disorders have raised the issue that BD and BPD actually belong to the same spectrum, therefore representing different presentations of the same basic condition [ 19 ].
Substance Use Disorders and the Diagnosis of Bipolar Disorder The rates of comorbidity between substance use disorders and BD are extremely high [ 21 ]. On the other hand, the behavioral effects of several psychoactive substances can easily mimic the mood symptoms usually found in patients with bipolar disorder.Bipolar disorder, previously known as manic depression, is a mental disorder that causes periods of depression and periods of abnormally elevated mood.
The elevated mood is significant and is known as mania or hypomania, depending on its severity, or whether symptoms of psychosis are present. During mania, an individual behaves or feels abnormally energetic, happy, or irritable. The Scientific World Journal is a peer-reviewed, Open Access journal that publishes original research, reviews, and clinical studies covering a wide range of subjects in science, technology, and medicine.
Overdiagnosis of Bipolar Disorder: A Critical Analysis of the Literature. Introduction. Bipolar disorder (BD) is a chronic, recurrent.
This advisory gives an introduction to bipolar disorder and co-occurring substance use disorder. It discusses types of bipolar disorders along with the challenges in screening and treatments.
Bipolar disorder (also known as manic depressive illness) is a severe mental disorder, primarily characterised by extreme mood swings and episodes of depression and hypomania/mania.
It has a highly recurrent course and a strong hereditary basis (Goodwin and Jamison, ). Nov 20, · Overdiagnosis of Bipolar Disorder: A Critical Analysis of the Literature Introduction.
Bipolar disorder (BD) is a chronic, recurrent mental illness first described by Jules Falret in as Folie Circulaire (circular insanity). analysis of neuropsychological findings among bipolar patients, genetic analysis, and several.
Analysis of Bipolar Disorder Stereotypes in Television Programming by Declan O’Hern — 67 Keywords: I.
Introduction television shows were chosen for this analysis, all depicting a bipolar protagonist or bipolar sub-character.