학술논문

Diagnostic stability and evolution of bipolar disorder in clinical practice: a prospective cohort study.
Document Type
Article
Source
Acta Psychiatrica Scandinavica. Jun2007, Vol. 115 Issue 6, p473-480. 8p. 1 Chart, 4 Graphs.
Subject
*DIAGNOSIS of bipolar disorder
*COHORT analysis
*MENTAL health services
*MARKOV processes
*DEPRESSED persons
*PSYCHOLOGY
PSYCHIATRIC research
Language
ISSN
0001-690X
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 ≥18 years who were assessed on ≥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 ≥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 ≥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. [ABSTRACT FROM AUTHOR]