Influence of misdiagnosis on the course of bipolar disorder

V. Knežević, A. Nedić

Clinic of Psychiatry, Clinical Centre “Vojvodina”, Novi Sad, Serbia. vladak@nspoint.net

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• Psychiatry

BACKGROUND: It is very common that the diagnosis of bipolar disorder comes with several years of delay. This premise is supported by the fact that this diagnosis is almost always set after longitudinal monitoring of symptoms and by the fact that this disorder is often unrecognized or misdiagnosed.

AIM: The aim of this study was to determine the incidence of misdiagnosed bipolar disorder and to explore its influence on the further course of the disorder.

PATIENTS AND METHODS: The research was provided as a naturalistic study, which included 65 bipolar patients admitted to the Hospital. We examined medical records of the first episode and five-year follow-up of the course of the disease. The average number of episodes was compared between the group with properly diagnosed first episode and the group with wrongly diagnosed first episode in the observed five-year period. T-test was used in this study, in addition to descriptive parameters, mean, median, standard deviation and coefficient of variation.

RESULTS: In the sample over which the survey was conducted 52% of the first episodes of bipolar disorder were wrongly diagnosed. We found a statistically significant difference (t = 1.84; p < 0.05) in the number of episodes that followed the first episode between patients whose first episode was appropriately diagnosed and patients whose first episode has not been properly diagnosed.

CONCLUSIONS: There is a high number of unrecognized and misdiagnosed bipolar disorders. Inadequate diagnosis leads to inadequate treatment of the disorder. Number of next episodes in period of follow up is statistically significantly connected with the adequacy of diagnose.

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