Comparison of women with confirmed versus presumably misdiagnosed bipolar disorder

D. Jeffrey Newport, Ross J. Baldessarini, Bettina T. Knight, Susana V. Fernandez, Natalie J. Morris, Adele C. Viguera, Zachary N. Stowe

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Objective: Because bipolar disorder can be difficult to diagnose, we compared characteristics of women with confirmed versus presumably misdiagnosed bipolar disorder. Method: This cohort study was conducted from July 2005 to January 2010 in the outpatient clinic of the Emory Women's Mental Health Program, Atlanta, Georgia. Young adult women (mean age = 32 years) who were either pregnant or planning to conceive and who reported having previous clinical diagnoses of bipolar disorder completed 2 independent diagnostic assessments: the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) and an evaluation by a perinatal mooddisorder expert who was masked to the SCID findings. We compared clinical characteristics of women with confirmed versus presumably misdiagnosed bipolar disorder by bivariate testing followed by multivariate logistic regression modeling. Results: Of 199 participants, 141 (70.9%) had confirmed DSM-IV bipolar disorder on the basis of concordant assessments, 23 (11.6%) were considered misdiagnosed, and 35 (17.6%) who had discordant diagnostic assessments were excluded from further analysis. Multivariate modeling indicated that confirmed bipolar disorder was associated with a history of antidepressant-associated mania/hypomania (OR = 13.30; 95% CI, 3.32-53.20; P = .0003), psychotic symptoms (OR = 12.40; 95% CI, 2.14- 71.10; P = .005), and sustained euthymia during mood-stabilizer treatment (OR = 4.53; 95% CI, 1.32-15.60; P = .02); presumably misdiagnosed bipolar disorder was associated with childhood physical abuse (OR = 8.73; 95% CI, 2.33-32.70; P = .001) and comorbid obsessive-compulsive disorder (OR = 7.26; 95% CI, 1.86-28.30; P = .004). Conclusions: Several clinical factors found to distinguish women with confirmed versus presumably misdiagnosed bipolar disorder may help to refine clinical diagnosis.

Original languageEnglish (US)
Pages (from-to)242-246
Number of pages5
JournalJournal of Clinical Psychiatry
Volume73
Issue number2
DOIs
StatePublished - Feb 2012
Externally publishedYes

ASJC Scopus subject areas

  • Psychiatry and Mental health

Fingerprint Dive into the research topics of 'Comparison of women with confirmed versus presumably misdiagnosed bipolar disorder'. Together they form a unique fingerprint.

  • Cite this

    Newport, D. J., Baldessarini, R. J., Knight, B. T., Fernandez, S. V., Morris, N. J., Viguera, A. C., & Stowe, Z. N. (2012). Comparison of women with confirmed versus presumably misdiagnosed bipolar disorder. Journal of Clinical Psychiatry, 73(2), 242-246. https://doi.org/10.4088/JCP.11m06936