Literature DB >> 17498159

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

E Baca-Garcia1, M M Perez-Rodriguez, I Basurte-Villamor, J López-Castromán, A L Fernandez del Moral, M A Jimenez-Arriero, J L Gronzalez de Rivera, J Saiz-Ruiz, J M Leiva-Murillo, M de Prado-Cumplido, R Santiago-Mozos, A Artés-Rodríguez, M A Oquendo, J de Leon.   

Abstract

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 > or =18 years who were assessed on > or =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 > or =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 > or =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.

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Year:  2007        PMID: 17498159     DOI: 10.1111/j.1600-0447.2006.00984.x

Source DB:  PubMed          Journal:  Acta Psychiatr Scand        ISSN: 0001-690X            Impact factor:   6.392


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