Can the MiniSCID improve the detection of bipolarity in private practice?

Nasr, Suhayl; Popli, Anand; Wendt, Burdette

doi:10.1016/j.jad.2005.01.008

Cited by 5 publications

(4 citation statements)

References 15 publications

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“…From detecting enemy planes to assessing the efficiency of a diagnostic test, signal detection theory has produced many interesting applications (our personal preference is for nonmilitary applications, but that's another story). Increasingly, ROC analysis is being adopted in psychiatry to evaluate the accuracy of field-based methods for identifying cases of disorder in population studies 21,22 and for screening for disorder in clinical settings, 23 to give just 2 examples. With the attendant limitations we have identified, ROC analysis is nevertheless a useful tool for what has always been a dilemma for clinical medicine (whether some clinicians choose to recognize it or not): the trade-off between being right or wrong and the costs of making mistakes in either direction.…”

Section: Discussionmentioning

confidence: 99%

What's under the ROC? An Introduction to Receiver Operating Characteristics Curves

2007

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Highlights· ROC analysis is used to select the optimal cut point to dichotomize a continuous scale. · The usual choice of cut points minimizes the overall number of false positive and false negative errors. · The cut point may be shifted if the cost of false positives is higher than that of false negatives, or vice versa. · The accuracy of ROC analysis depends on the quality of the gold standard, which is usually far from perfect in psychiatry. · Changing the purpose of the test (for example, from diagnosis to screening) requires a shift in cut points. · A cut point that is ideal for one group may be less than ideal for another.

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Section: Discussionmentioning

confidence: 99%

What's under the ROC? An Introduction to Receiver Operating Characteristics Curves

2007

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“…Given that a considerable proportion of depressed patients may be bipolar (1,2,25,26), clinicians should be aware of the need for prospective and retrospective longitudinal evaluation of mood disorder with every major depressive patient, even in outpatient settings, and special attention should be paid to those with hypomanic and mixed symptoms (9,30). The use and development of different diagnostic screens (19,(31)(32)(33)(34)(35)(36)(37) for BD and bipolar spectrum disorder are thus useful not only for the purposes of research, but also to clinically improve correct and early diagnosis of BD and to direct diagnostic attention toward patients at the highest risk for BD. Some specific characteristics, such as family history of BD, mood lability, hypomanic symptoms in depression and agitated depression, might indicate a higher probability of BD II (2,30,26,38).…”

Section: Discussionmentioning

confidence: 99%

Clinical predictors of unrecognized bipolar I and II disorders

et al. 2008

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Correct diagnosis of BD I is related to the severe phases of illness leading to hospitalizations. In BD II, the illness factors may not be as important as time elapsed in treatment, a factor that often leads to a delay in diagnosis or none at all. Excessive reliance on typical and cross-sectional presentations of illness likely explain the non-recognition of BD. The challenge for correctly diagnosing bipolar patients is in outpatient settings.

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“…Angst et al, 2011;Benazzi & Akiskal, 2001;Ghaemi, Boiman, & Goodwin, 2000;Ghaemi, Sachs, Chiou, Pandurangi, & Goodwin, 1999;Hantouche et al, 1998;Nasr, Popli, & Wendt, 2005). In addition to the studies suggesting that bipolar disorder is underdiagnosed, there have also been commentaries and review articles exhorting clinicians to improve their recognition of bipolar disorder (Bowden, 2001;Dunner, 2003;Hirschfeld, 2001Hirschfeld, , 2013Hirschfeld & Vornik, 2004;Katzow, Hsu, & Ghaemi, 2003;Yatham, 2005).…”

Section: Diagnostic Recognition and Underdiagnosismentioning

confidence: 99%

Improving the Recognition of Borderline Personality Disorder in a Bipolar World

Zimmerman

2016

Journal of Personality Disorders

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Both bipolar disorder and borderline personality disorder (BPD) are serious mental health disorders resulting in significant psychosocial morbidity, reduced health-related quality of life, and excess mortality. Yet research on BPD has received much less funding from the National Institute of Health (NIH) than has bipolar disorder during the past 25 years. Why hasn't the level of NIH research funding for BPD been commensurate with the level of psychosocial morbidity, mortality, and health expenditures associated with the disorder? In the present article, the author illustrates how the bipolar disorder research community has done a superior job of "marketing" their disorder. Studies of underdiagnosis, screening, diagnostic spectra, and economics are reviewed for both bipolar disorder and BPD. Researchers of bipolar disorder have conducted multiple studies highlighting the problem with underdiagnosis, developed and promoted several screening scales, published numerous studies of the operating characteristics of these screening measures, attempted to broaden the definition of bipolar disorder by advancing the concept of the bipolar spectrum, and repeatedly demonstrated the economic costs and public health significance of bipolar disorder. In contrast, researchers of BPD have almost completely ignored each of these four issues and research efforts. Although BPD is as frequent as (if not more frequent than) bipolar disorder, as impairing as (if not more impairing than) bipolar disorder, and as lethal as (if not more lethal than) bipolar disorder, it has received less than one-tenth the level of funding from the NIH and has been the focus of many fewer publications in the most prestigious psychiatric journals. The researchers of BPD should consider adopting the strategy taken by researchers of bipolar disorder before the diagnosis is eliminated in a future iteration of the DSM or the ICD.

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Can the MiniSCID improve the detection of bipolarity in private practice?

Cited by 5 publications

References 15 publications

What's under the ROC? An Introduction to Receiver Operating Characteristics Curves

What's under the ROC? An Introduction to Receiver Operating Characteristics Curves

Clinical predictors of unrecognized bipolar I and II disorders

Improving the Recognition of Borderline Personality Disorder in a Bipolar World

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