Would broadening the diagnostic criteria for bipolar disorder do more harm than good? Implications from longitudinal studies of subthreshold conditions

The Journal of Clinical Psychiatry
Mark Zimmerman

Abstract

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), is a categorical system that provides descriptive diagnostic criteria for psychiatric syndromes. These syndrome descriptions are imperfect representations of an underlying behavioral, psychological, or biological dysfunction; thus, the criteria could be conceptualized as a type of test for the etiologically defined illnesses. Accordingly, as with any other diagnostic test, diagnoses based on DSM-IV criteria produce some false positive and some false negative results. That is, some patients who meet the criteria will not have the illness (ie, false positives), and some who do not meet the criteria because their symptoms fall below the diagnostic threshold will have the illness and incorrectly not receive the diagnosis (ie, false negatives). In this context, I consider the controversy over whether the diagnostic threshold for bipolar disorder should be lowered. Longitudinal studies of the prognostic significance of subthreshold bipolar disorder are considered. Subthreshold bipolarity is a risk factor for the future emergence of bipolar disorder, but the majority of individuals with subthreshold bipolarity do not develop a future manic or hypomanic...Continue Reading

Citations

Nov 21, 2013·Current Psychiatry Reports·Mark Zimmerman, Theresa A Morgan
May 7, 2014·Der Nervenarzt·E Severus, M Bauer
Dec 3, 2014·Revista de psiquiatrí́a y salud mental·Consuelo de DiosEduard Vieta
Jan 1, 2013·International Journal of Bipolar Disorders·Emanuel Severus, Michael Bauer
Feb 13, 2016·The International Journal of Neuropsychopharmacology·Tzu-Yun WangRu-Band Lu
Sep 22, 2015·Lancet·Iria GrandeEduard Vieta
Dec 24, 2014·The Journal of Nervous and Mental Disease·Mark Zimmerman
Dec 25, 2013·The Australian and New Zealand Journal of Psychiatry·Michael J Gitlin, David J Miklowitz
Jul 24, 2018·Journal of Personality Disorders·Mark ZimmermanJacob Martin
Dec 5, 2017·Indian Journal of Psychological Medicine·M S ReddySwetha Reddy
Jan 1, 2014·International Journal of Bipolar Disorders·Emanuel Severus, Michael Bauer

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Bipolar disorder is characterized by manic and/or depressive episodes and associated with uncommon shifts in mood, activity levels, and energy. Discover the latest research this illness here.