Classification of bipolar disorder in psychiatric hospital. a prospective cohort study

BMC Psychiatry

Research Article

Mary Nivison¹  Ingunn Skre²  Line Østensen³  Knut W Sørgaard⁴  Terje Øiesvold⁵  Vidje Hansen⁶ 

[1] Clinic for substance abuse and specialized psychiatry, University Hospital of Northern Norway, Tromsø, Norway;Department of Psychology, Faculty of Health Science, University of Tromsø, Tromsø, Norway;Division of General Psychiatry, Nordland Hospital, Bodø, Norway;Institute of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway;Division of General Psychiatry, Nordland Hospital, Bodø, Norway;Institute of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, and Division of general psychiatry, Nordland Hospital, Bodø, Norway;Institute of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, and Division of general psychiatry, University Hospital of Northern Norway, Tromsø, Norway;

关键词: Bipolar Disorder;    Affective Disorder;    Primary Diagnosis;    Psychiatric Hospital;    Bipolar Depression;   

DOI  :  10.1186/1471-244X-12-13

 received in 2011-09-27, accepted in 2012-02-29,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundThis study has explored the classification of bipolar disorder in psychiatric hospital. A review of the literature reveals that there is a need for studies using stringent methodological approaches.Methods480 first-time admitted patients to psychiatric hospital were found eligible and 271 of these gave written informed consent. The study sample was comprised of 250 patients (52%) with hospital diagnoses. For the study, expert diagnoses were given on the basis of a structured diagnostic interview (M.I.N.I.PLUS) and retrospective review of patient records.ResultsAgreement between the expert's and the clinicians' diagnoses was estimated using Cohen's kappa statistics. 76% of the primary diagnoses given by the expert were in the affective spectrum. Agreement concerning these disorders was moderate (kappa ranging from 0.41 to 0.47). Of 58 patients with bipolar disorder, only 17 received this diagnosis in the clinic. Almost all patients with a current manic episode were classified as currently manic by the clinicians. Forty percent diagnosed as bipolar by the expert, received a diagnosis of unipolar depression by the clinician. Fifteen patients (26%) were not given a diagnosis of affective disorder at all.ConclusionsOur results indicate a considerable misclassification of bipolar disorder in psychiatric hospital, mainly in patients currently depressed. The importance of correctly diagnosing bipolar disorder should be emphasized both for clinical, administrative and research purposes. The findings questions the validity of psychiatric case registers. There are potential benefits in structuring the diagnostic process better in the clinic.

【 授权许可】

CC BY   
© Øiesvold et al; licensee BioMed Central Ltd. 2012