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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Phillipa on June 4, 2010, at 21:25:41
Simple way to determine if a person is bipolar or depressed only. Phillipa
Bipolar Disorder Misdiagnosed as Depression
Researchers Pinpoint 5 Factors That Can Help Improve Diagnosis of Bipolar Disorder
By Charlene Laino
WebMD Health NewsReviewed by Laura J. Martin, MDJune 1, 2010 (New Orleans) -- About one in three people diagnosed with major depression may actually have bipolar disorder, researchers report.Five characteristics, including extreme mood swings and psychiatric symptoms at a young age, may help pinpoint which patients actually have bipolar disorder, they say.
Bipolar disorder covers a spectrum of disorders in which patients may be sad and down one day and feeling on top of the world, hyperactive, creative, and grandiose the next.
The extreme mood swings may be more or less frequent and more or less severe, says study head Charles Bowden, MD, of the University of Texas Health Science Center in San Antonio. Bowden has consulted for Sanofi-Aventis, which funded the study.
"As a result, bipolar disorder can be difficult to diagnose, even by experienced psychiatrists," he tells WebMD.
Recent studies suggest as many as 40% of patients receive another diagnosis first and that it can take years before they're correctly diagnosed, Swanson says. Many are diagnosed with major depression, resulting in inappropriate use of antidepressants, he says.
Not only do antidepressants fail to help, "but patients can get worse, their mood can become more unstable, and some even get more manic," says Donald Hilty, MD, co-chair of the committee that chose which studies to highlight at the meeting and professor of psychiatry at the University of California, Davis.
These patients should be on a mood-stabilizing drug, he tells WebMD.
The current study involved 5,635 patients with major depression from 18 countries in Europe, Asia, and North Africa.
The researchers sought to determine which patients fit the criteria for bipolar depression using various tools, and see which factors best predicted a diagnosis of bipolar disorder.
Slideshow: Bipolar Disorder Overview
5 Factors Associated With Bipolar Disorder
The findings were presented at the annual meeting of the American Psychiatric Association."What we found," Swanson says, "is that five items are associated with bipolar disorder."
They are:
Family history of mania
Having at least two mood episodes in the past
Occurrence of first psychiatric symptoms before the age of 30
A switch to extreme mood swings
Mixed states in which symptoms of mania and depression occur together
About 29% of the patients in the study were determined to have bipolar disorder, Swanson says.Using the DSM-IV, the bible for psychiatric diagnoses, 31% fulfilled criteria for bipolar disorder.
And using new criteria that takes into the five risk factors proposed by Swanson, 47% had bipolar disorder.
"Our findings suggest that about one-third of people with major depression have [undiagnosed bipolar disorder]," Swanson says. "Currently patients have to have elevated mood or irritability before we can even consider a diagnosis of bipolar disease. Our findings suggest that may not always be the case."
"This is an excellent study that is clinically useful, giving us information we can use right away," Hilty says.
"It's really important that we understand predictors of bipolar disorder as it is still underdiagnsoed as regular depression, he tells WebMD.
This study was presented at a medical conference. The findings should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.
Posted by Emily Elizabeth on June 7, 2010, at 5:46:02
In reply to Is It Depression or Bipolar?, posted by Phillipa on June 4, 2010, at 21:25:41
This is an interesting article. I liked thinking about some of the "red flags." One thing caught my eye:
"Our findings suggest that about one-third of people with major depression have [undiagnosed bipolar disorder]," Swanson says. "Currently patients have to have elevated mood or irritability before we can even consider a diagnosis of bipolar disease. Our findings suggest that may not always be the case."
I found that both shocking and a bad idea! Dx'ing BP w/o evidence of a manic episode would really change things. Now, here is cynical me: med companies stand to benefit from more dx of BP. Of course, Lithium is cheap, but the new antipsychotics are $$$ and are often used to treat BP issues.
They have been kicking around the idea for a while now that folks w/ depression that don't respond to typical antidepressants and do respond to mood stabilizers/AP's (e.g., me!) actually have some variant of BP. That too would change our current conceptualization of diagnosis (i.e. coming up w/ dx from medication response).
There is also the thought that depression and BP are more alike than different and should always be considered part of the same spectrum.
I'm interested to know what others think about this.
Best,
EE
Posted by Phillipa on June 7, 2010, at 21:14:17
In reply to Re: Is It Depression or Bipolar?, posted by Emily Elizabeth on June 7, 2010, at 5:46:02
EE personally I don't buy it. Just an article. Thought someone would find interesting. It's to me the same as anxiety is depression and I know in me it's not. Good to see you btw. Phillipa
Posted by herpills on June 8, 2010, at 19:41:25
In reply to Re: Is It Depression or Bipolar?, posted by Emily Elizabeth on June 7, 2010, at 5:46:02
I agree just because you have a certain reaction to a medication shouldn't be a factor in diagnosis...
herpills
Posted by Tony P on June 13, 2010, at 14:59:54
In reply to Re: Is It Depression or Bipolar? » Emily Elizabeth, posted by herpills on June 8, 2010, at 19:41:25
I had a pdoc who tended to see almost all depression in terms of "bipolar spectrum" (including mine). I responded fairly well to high doses of Lamictal - 400 mg/day - but I could never quite see myself in the bipolar picture. My mood swings were drastic, but extremely rapid (days or even hours), and almost always were clearly related to an outside event or something I did like staying up all night.
According to a short article I just read, this kind of lability is a principal characteristic of "atyical" depression, which turns out to be much commoner than previously thought.
So I'm now very sceptical of the trend on some pdocs part to see everyone with dysthymia or mood swings as BP.
Posted by Huxley on June 15, 2010, at 1:40:56
In reply to Re: Is It Depression or Bipolar?, posted by Tony P on June 13, 2010, at 14:59:54
Are SSRIs turning people with depression into Bipolar?
My doctor for several years tried to convince me I was bipolar. Never had mania.
Here is an interesting quote from anatomy of an epidemic.
"
The propensity of Prozac and other SSRIs to trigger mania or psychosis is undoubtedly the biggest problem with these drugs. The American Psychiatric Association warns that manic or hypomanic episodes are estimated to occur in 8% to 20 % of patients treated with anti-depressants.
Anti-depressant-induced mania is not simply a temporary and reversible phenomenon, but a complex biochemical mechanism of illness deterioration. Yale researchers reported that 8.1% of all admissions to a psychiatric hospital they studied were due to SSRI-induced mania or psychosis"Are these drugs creating bipolar disorders?
If you want to read more on this check out
http://www.thepeoplesvoice.org/TPV3/Voices.php/2009/10/30/excerpts-from-robert-whitaker-s-anatomy-
Posted by Phillipa on June 15, 2010, at 19:52:52
In reply to Re: Is It Depression or Bipolar?, posted by Huxley on June 15, 2010, at 1:40:56
Link didn't work scarey. Phillipa
Posted by Huxley on June 15, 2010, at 22:01:08
In reply to Re: Is It Depression or Bipolar? » Huxley, posted by Phillipa on June 15, 2010, at 19:52:52
> Link didn't work scarey. Phillipa
Whoops sorry about that. the - at the end of the link did not get included in the link.
will try again,
http://www.thepeoplesvoice.org/TPV3/Voices.php/2009/10/30/excerpts-from-robert-whitaker-s-anatomy-
If that doesnt work just copy and paste it into your browser.
The whole book is quite scary. I am struggling with what to believe. He makes a pretty good case.
Posted by Phillipa on June 15, 2010, at 22:12:12
In reply to Re: Is It Depression or Bipolar?, posted by Huxley on June 15, 2010, at 22:01:08
Says website can't be found??? Phillipa
Posted by Huxley on June 16, 2010, at 4:40:08
In reply to Re: Is It Depression or Bipolar? » Huxley, posted by Phillipa on June 15, 2010, at 22:12:12
> Says website can't be found??? Phillipa
hmmm
for some reason I can't link to it. Must be a dynamic URL or something.Anyway
http://psychrights.org/articles/EHPPPsychDrugEpidemic(Whitaker).pdf
try that. It is not the same link but contains the same information.
I really suggest reading the book.
Posted by Dr. Bob on June 17, 2010, at 0:54:48
In reply to Re: Is It Depression or Bipolar?, posted by Huxley on June 15, 2010, at 22:01:08
> Whoops sorry about that. the - at the end of the link did not get included in the link.
Those links should work now. FYI, the server doesn't expect URLs to end in punctuation.
Bob
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