Friday, November 09, 2012

Overdiagnosing bipolar disorder

An article in Acta Psychiatrica Scandinavica, of which one of the authors is Nassir Ghaemi (whom I have mentioned before eg. see post), says that the claim of overdiagnosis of bipolar disorder is mistaken. True, the paper which is commonly quoted to substantiate this point also found considerable underdiagnosis. Of 145 patients who reported they had had a previous diagnosis of bipolar disorder, only 63 were diagnosed as such using the Structured Clinical Interview for DSM-IV (SCID). But there were also another 27 patients picked up on SCID that had not had that diagnosis.

The article uses these figures to argue that bipolar disorder is mainly underdiagnosed. This is motivated by the authors' belief that antidepressants are not very effective in bipolar depression and these people would do better on mood stabilisers. However, the dispute about the significance of the figures misses the main point about the validity of bipolar II disorder. Has the diagnosis of bipolar disorder been extended too far to include people who would not necessarily have been seen on that spectrum (see previous post)?


Anonymous said...

About as scientific as claiming sexual orientation disorder was overdiagnosed or underdiagnosed.

Or drapetomania.

Or hysteria.

Or whatever.

There is no over/under diagnosed when the profession in question has pilfered its legitimacy entirely from the real doctors who should be the only ones who have the right to even use the concept of medical diagnosis.

Faith in the quack art of psychopathologizing should be immediate grounds for penury and obscurity, unfortunately, once it has been cleaved to, quacks can make a living dispensing this name calling, even if millions have to be held hostage and thrown to the wolves as grist for the mill in the long and endless pathetic quest for psychiatry to paint itself as just another equal of neurology.

Over/Under diagnosed, the "debate" continues among the class of med school third raters who threw their lives away to go and become quacks in psychiatry.

Joel Hassman, MD said...

I am tired of the overdiagnosis as well. Made mention of it at my site as well, although, sense many readers will not be happy to read about the role of Axis 2 to this situation.

But, mood lability does not equal Bipolar Disorder. Unless you work for or own stock in a Big Pharma company. Pity, because the more you medicate primary characterological causes to mood lability, usually the worse the patient may become. Just my opinion.

Anonymous said...

Soon we'll all be labelled bipolar one, two or three or four, anyway. Because we all have mood swings, it's what life's about, the ups and downs. Unless of course you're on psychiatric drugs then it's a flat existence. I say this, having been there.

nisrine kambris said...

About bipolar .sadness and happiness at the same time and if it is not so much it is normal. All we can have in the life sadness and happiness but the case anormal is that so much