Is it MDD or Bipolar Depression?

Learning Objectives

1. Interpret the DSM-5-TR diagnostic criteria for bipolar disorder, including the spectrum of bipolar presentations;
2. Identify high sensitivity and specificity bipolar screening tools;
3. Identify strategies for differentiating unipolar and bipolar depression; and
4. Categorize and compare the unique characteristics of bipolar treatments.

Literature References

1. Arch. Gen. Psychiatry 68, 241–251 (2011); Bipolar Disord 17, 184–193 (2015); Psychol. Med 41, 33–40 (2011); Arch Gen Psychiatry, 64 (2007), pp. 543-552; J Clin Psychiatry 64:161–174 (2003)             

Abstract             

Bipolar disorders are prevalent and highly disabling, with a lifetime prevalence of approximately 2.5%. Despite being the most heritable psychiatric disorders (along with ADHD), they are very commonly mis-diagnosed or the diagnosis is completely missed. The lifetime prevalence of psychiatric and medical disorders is ~90%. Anxiety disorders and ADHD are particularly common comorbidities, adding to the diagnostic challenges. However, if accurately diagnosed and treated, patients can mitigate or even avoid the negative mental and physical health, social and financial burdens that so often accompany these disorders. By employing validated clinical scales, fostering awareness through education, and leaving personality disorder diagnoses aside until other more treatment responsive disorders are ruled out or managed, we give our patients the best opportunity to be accurately diagnosed, optimally treated and less stigmatized within our healthcare system.