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首页> 外文期刊>The journal of clinical psychiatry >Psychiatric diagnoses in patients previously overdiagnosed with bipolar disorder.
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Psychiatric diagnoses in patients previously overdiagnosed with bipolar disorder.

机译：先前被过度诊断为双相情感障碍的患者的精神病学诊断。

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OBJECTIVE: In a previous article from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we reported that bipolar disorder is often overdiagnosed in psychiatric outpatients. An important question not examined in that article was what diagnoses were given to the patients who had been overdiagnosed with bipolar disorder. In the present report from the MIDAS project, we examined whether there was a particular diagnostic profile associated with bipolar disorder overdiagnosis. METHOD: Eighty-two psychiatric outpatients reported having been previously diagnosed with bipolar disorder that was not confirmed when they were interviewed with the Structured Clinical Interview for DSM-IV (SCID). Psychiatric diagnoses were compared in these 82 patients and in 528 patients who were not previously diagnosed with bipolar disorder. Patients were interviewed by a highly trained diagnostic rater who administered a modified version of the SCID for DSM-IV Axis I disorders and the Structured Interview for DSM-IV Personality for DSM-IV Axis II disorders. This study was conducted from May 2001 to March 2005. RESULTS: The most frequent lifetime diagnosis in the 82 patients previously diagnosed with bipolar disorder was major depressive disorder (82.9%, n = 68). The patients overdiagnosed with bipolar disorder were significantly more likely to be diagnosed with borderline personality disorder compared to patients who were not diagnosed with bipolar disorder (24.4% vs 6.1%; P < .001). A previous diagnosis of bipolar disorder was also associated with significantly higher lifetime rates of major depressive disorder (P < .01), posttraumatic stress disorder (P < .05), impulse control disorders (P < .05), and eating disorders (P < .05), although only the association with impulse control disorders remained significant after controlling for the presence of borderline personality disorder. CONCLUSIONS: Psychiatric outpatients overdiagnosed with bipolar disorder were characterized by more Axis I and Axis II diagnostic comorbidity in general, and borderline personality disorder in particular.
机译：目的：在罗德岛改善诊断评估和服务方法（MIDAS）项目的上一篇文章中，我们报告了精神病患者的双相情感障碍经常被过度诊断。那篇文章中未检查的一个重要问题是，对双相情感障碍过度诊断的患者做了哪些诊断。在MIDAS项目的本报告中，我们检查了是否存在与双相情感障碍过度诊断有关的特定诊断特征。方法：八十二名精神科门诊患者先前曾被诊断出患有双相情感障碍，在接受DSM-IV（SCID）结构性临床访谈时并未得到证实。比较了这82例患者和528例先前未诊断出双相情感障碍的患者的精神科诊断。患者接受了训练有素的诊断评分员的采访，该诊断评分员对DSM-IV Axis I障碍患者使用了SCID的改进版，并对DSM-IV Axis II疾病患者进行了DSM-IV人格的结构化访谈。该研究于2001年5月至2005年3月进行。结果：在先前诊断为躁郁症的82例患者中，最常见的终生诊断是重度抑郁症（82.9％，n = 68）。与未被诊断为双相情感障碍的患者相比，被过度诊断为双相情感障碍的患者被诊断为边缘性人格障碍的可能性明显更高（24.4％vs 6.1％; P <.001）。先前对躁郁症的诊断还与严重抑郁症（P <.01），创伤后应激障碍（P <.05），冲动控制障碍（P <.05）和进食障碍（P <.05），尽管在控制边缘人格障碍的存在之后，与冲动控制障碍的关联仍然很明显。结论过度诊断为双相情感障碍的精神科门诊患者的特征通常是更多的Axis I和Axis II诊断合并症，尤其是边缘性人格障碍。

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