Bipolar disorders Diagnostic issues

While classical bipolar disorder with episodes of euphoric mania interspersed with episodes of depression is one of the clearest clinical syndromes in psychiatry, the boundaries of bipolar disorder remain contested. As case definition is central to epidemiology, all the contested boundaries of bipolar disorder could influence prevalence rates and our understanding of risk factors. Some of the major boundary issues for bipolar disorder include the overlap of bipolar disorder with psychotic features, with schizoaffective disorder and schizophrenia, and the overlap of bipolar disorder with unipolar major depression when patients who present primarily with depression have brief or mild episodes of hypomania. There is also the overlap of bipolar disorder with apparent personality disorder, especially Cluster B personality disorders such as borderline and narcissistic, and the issue of when hyperthymic personality merges into bipolar disorder. (23)

Another important issue in determining caseness of bipolar disorder for epidemiological surveys is symptom pattern. A number of the diagnostic instruments for assessing bipolarity in population surveys limit the questions on mania to a type of symptom profile characterized by euphoria, grandiosity, increased energy, and decreased sleep. Whether the commonly used epidemiology interviews adequately detect those individuals who have manic episodes characterized by irritability, anger, and activation is very debatable. Furthermore, as insight is sometimes impaired in hypomania and mania, and as these are uncommon disorders, the accuracy of case detection of bipolar disorders in populations remains an issue for further research. (4)

BiPolar Explained

BiPolar Explained

Bipolar is a condition that wreaks havoc on those that it affects. If you suffer from Bipolar, chances are that your family suffers right with you. No matter if you are that family member trying to learn to cope or you are the person that has been diagnosed, there is hope out there.

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