spodosaurus <spodosaurus@_yahoo_.com> wrote:
>JMW wrote:
>>
>> In reality, some of the greatest opponents of bipolar diagnoses are the
>> manic-depressives themselves, who refuse to accept that their manic
>> episodes are dysfunctional and want ride the highs as long as they can.
>
>And this has what to do with misdiagnosing someone as having bipolar
>disorder on the basis of a drug reaction?
>
>> After all, they're having a good time, and they don't want to consider
>> the fact that their prolonged mania may lead to severe cycling, not to
>> mention the classic noncompliance with medication that frequently
>> occurs during manic episodes.
>
>What does this have to do with misdiagnosis of bipolar disorder? Or are
>you just trying to impress me with crapping on (and on and on) about
>things that are irrelevant to the topic of misdiagnosis?
I'm making the point that bipolar affective disorder is much more
often misdiagnosed as unipolar depression than the other way around.
And I'm making that point by noting that there are plenty of people
who insist that they were misdiagnosed as bipolar when they're really
just depressed and are perfectly OK when their mood is "up."
Knowing your past arguments, I assume that your anecdotal experiences
tell you just the opposite, but the literature agrees with me:
"Bipolar disorder is a serious, recurrent, and sometimes chronic
psychiatric illness that is far more prevalent than many physicians
realize. It often is unrecognized and misdiagnosed, particularly in
patients presenting with depression." Hirschfeld RM, Vornik LA.
Recognition and diagnosis of bipolar disorder. J Clin Psychiatry.
2004;65 Suppl 15:5-9.
"Research over the past decade indicates that the prevalence of
bipolar disorder is similar to that of major depression. *** Because
DSM-IV criteria require a manic or hypomanic episode for a diagnosis
of bipolar disorder, many patients are initially diagnosed and treated
as having major depression." Bowden CL. Strategies to reduce
misdiagnosis of bipolar depression. Psychiatr Serv. 2001
Jan;52(1):51-5.
And given your rant about antidepressant-induced hypomania *not* being
bipolar affective disorder, I'm sure you're really going to hate the
conclusions in this review:
"OBJECTIVES: To determine if the classification of
'antidepressant-induced hypomania' in DSM-IV is supported by available
data. METHODS: We reviewed the available scientific literature to
examine the incidence of mania and hypomania in non-bipolar patients
who were treated with antidepressants. RESULTS: Eighty-nine per cent
of studies of antidepressants in major depressive disorder patients
reported no cases of treatment-induced hypomania. No instances of
treatment-induced hypomania were reported in three large studies of
patients with chronic forms of depression. CONCLUSIONS: The rate of
antidepressant-induced hypomania in major depressive disorder is
within the rate of misdiagnosis of bipolar depression as unipolar.
Depressed patients who experience antidepressant-associated hypomania
are truly bipolar." Chun BJ, Dunner DL. A review of
antidepressant-induced hypomania in major depression: suggestions for
DSM-V. Bipolar Disord. 2004 Feb;6(1):32-42.
That same review reports several studies which indicate that bipolar
disorder is misdiagnosed as unipolar depression 25-40% of the time.
Not that I expect that to change your opinion or anything.
--
JMW
http://www.rustyiron.net