The British Journal of Psychiatry (2007) 190: 537. doi: 10.1192/bjp.190.6.537
© 2007 The Royal College of Psychiatrists
This Article
Right arrow Full Text (PDF)
Right arrow Submit an eLetter
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Gangdev, P. S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Gangdev, P. S.

Correspondence

Problems in diagnosing bipolar disorder

P. S. Gangdev

Mood Disorders Program, Regional Mental Health Care London (P2 Wing), 850 Highbury Avenue, London, Ontario N6A 4H1, Canada.

Correspondence: Email: prakash.gangdev{at}sjhc.london.on.ca

EDITED BY KIRIAKOS XENITIDIS and COLIN CAMPBELL

Angst (2007) provides more balanced views on the much publicised concerns about the underdiagnosis of bipolar disorder. Psychiatric diagnoses are not robust entities (Baca-Garcia et al, 2007) and most recent research in mood disorders has arisen from redefining and often rigidly applying the DSM criteria, which has proved a hindrance to research. The problem in mood disorder research lies in our failure to define the core features of mania/hypomania and bipolar depression. Surprisingly, hardly any advance has been made in our understanding of and our ability to accurately diagnose an active hypomanic/manic episode (excluding retrospective accounts), and we are guided by epidemiological studies and expert opinions rather than basing diagnosis on a new phenomenological understanding. Moreover, we rely on a range of self-report checklists. Unfortunately, there are few advocates for people with wrongly diagnosed bipolar disorder. It is like initiating antihypertensive treatment for suspected hypertension. Unless they have clinical consequences, temperament and vegetative lability, like blood pressure and heart rate, should not be considered pathological. The success of future research lies in a greater understanding of the phenomenology of episodes of depression and in bipolar disorder and the differences in biological depression that result from psychosocial factors.

REFERENCES

  1. Angst, J. (2007) The bipolar spectrum. British Journal of Psychiatry, 190, 189 –191.[Abstract/Free Full Text]
  2. Baca-Garcia, E., Perez-Rodriguez, M. M., Basurte-Villamor, I., et al (2007) Diagnostic stability of psychiatric disorders in clinical practice. British Journal of Psychiatry, 190, 210 –216.[Abstract/Free Full Text]




This Article
Right arrow Full Text (PDF)
Right arrow Submit an eLetter
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Gangdev, P. S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Gangdev, P. S.