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

  • Baca-Garcia E
  • Perez-Rodriguez M
  • Basurte-Villamor I
 et al. 
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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.

Author-supplied keywords

  • Bipolar disorder
  • Classification
  • Diagnosis
  • International Classification of Diseases
  • Reproducibility of results

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  • M. M. Perez-Rodriguez

  • I. Basurte-Villamor

  • J. López-Castromán

  • A. L. Fernandez Del Moral

  • M. A. Jimenez-Arriero

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