Quality of Life Among Bipolar Disorder Patients Misdiagnosed With Major Depressive Disorder

Abstract

Objective: Bipolar disorder is frequently misdiagnosed as major depressive disorder (MDD). We aim to quantify the prevalence of misdiagnosed bipolar disorder among the depression population and evaluate the quality-of-life (QOL) impact of misdiagnoses.Method: Data were collected from 2 selfadministered, cross-sectional studies in 2003. Patients participating in The Bipolar Disorder Misdiagnosis Study (N = 1156) were previously diagnosed with depression, experienced a depressive episode within the past year, and had no previous diagnosis of bipolar disorder or schizophrenia. Patients who experienced a manic episode in the past year, based on DSM-IV criteria, were classified as misdiagnosed. Patients participating in The Bipolar Disorder Project (N = 1214) selfreported a diagnosis of bipolar disorder and were recruited through community mental health centers and support groups. Quality of life was assessed via the Psychological General Well-Being (PGWB) Index and Medical Outcomes Study 8-Item Short-Form Health Survey (SF-8). Demographic differences between groups were controlled using linear regression models.Results: Of the diagnosed MDD sample, 14.3% met criteria for misdiagnosed bipolar disorder. When controlling for demographic differences, the PGWB overall score for the misdiagnosed averaged 12.77 (p < .001) points lower than that of MDD patients and 9.55 (p < .001) points lower than that of diagnosed bipolar disorder patients. The average SF-8 mental component summary score for the misdiagnosed was 5.85 (p < .001) points lower than that of MDD patients and 3.18 (p = .002) points lower than that of diagnosed bipolar disorder patients.Conclusion: Misdiagnosis is associated with poorer QOL than MDD or diagnosed bipolar disorder, which are recognized as having a considerable impact on QOL.(Prim Care Companion J Clin Psychiatry 2007;9:195-202) ipolar disorder, a chronic affective disorder characterized by depression and at least 1 manic episode,

Psychological well‐being outcomes in disease‐free survivors of mid‐low rectal cancer following curative surgery

“…The PGWBI is an instrument that is used to measure the balance between negative and positive emotional and affective conditions while avoiding references to physical symptoms of emotional distress. It has been widely tested in previous research in cardiovascular disease 36–40, 43 and in psychiatric patient populations 35, 41, 42, but has not been previously used to evaluate adults with rectal cancer.…”

“…The Psychological General Well Being Index (PGWBI)34 questionnaire is a validated instrument used to evaluate psychological distress in patients with non‐cancerous diseases 3, 35–43 and in those with cancer 44–46.…”

Systematic review of the neural basis of social cognition in patients with mood disorders

“…This is particularly pertinent to the study of bipolar disorder, given that patients with this illness experience depression more than hypomania or mania, 35,36 which may result in the misdiag nosis of bipolar depression as MDD, 37,38 suboptimal treatment and poor outcome. 39,40 Elucidating the neural correlates of social cognition may also assist in identifying the neuroanatomical basis of vulnerability to these disorders. Improved knowledge of the underlying neural mechanisms and nature of social cognitive deficits in patients with mood disorders may also assist in clarifying the nature of social dysfunction in patients with MDD and bipolar disorder and may aid in the development of psychologic interventions aimed at improving social perception and adjustment in these patient populations.…”

Validation of the Chinese version of the Mood Disorder Questionnaire in a psychiatric population in Hong Kong

“…A recent study showed that patients with bipolar disorder, misdiagnosed with major depressive disorder, had a lower quality of life than patients correctly diagnosed with either major depressive disorder or bipolar disorder. 4 Previous studies have shown that patients with bipolar disorder, who had been misdiagnosed, received inappropriate and costly treatment regimens. 5,6 They also had higher medical costs than those recognized to have the condition.…”