Is it really bipolar disorder?

March 25, 2010

A study from Rhode Island Hospital has shown that a widely-used screening tool for bipolar disorder may incorrectly indicate borderline personality disorder rather than bipolar disorder. In the article that appears online ahead of print in the Journal of Clinical Psychiatry, the researchers question the effectiveness of the Mood Disorder Questionnaire (MDQ).

The MDQ is the most widely-used and studied screening tool for bipolar disorder. It is a brief questionnaire that assesses whether a patient displays some of the characteristic behaviors of bipolar disorder. It can be administered by clinicians or taken by patients on their own to determine if they screen positively for bipolar disorder. For the purposes of this study, the MDQ was scored by researchers.

Bipolar and borderline personality disorders share some clinical features, including fluctuations in mood and impulsive actions. The treatments, however, will vary depending on the individual and the diagnosis. Principal investigator Mark Zimmerman, MD, director of outpatient psychiatry at Rhode Island Hospital, conducted a study to test the accuracy of the MDQ.

The research team interviewed nearly 500 patients using the Structured Clinical Interview for Diagnostic Statistical Manual IV (DSM-IV) and the Structured Interview for DSM-IV for . The patients were also asked to complete the MDQ. The research team then scored the questionnaires and found that patients with a positive indication for bipolar disorder using the MDQ were as likely to be diagnosed with borderline personality disorder as bipolar disorder when using the structured clinical interview. Further, their findings indicate that borderline personality disorder was four times more frequently diagnosed in the group who screened positive on the MDQ.

Zimmerman says that these findings raise caution for using the MDQ in clinical practice because of how differently the disorders are treated. "An incorrect diagnosis of bipolar disorder will usually lead to a treatment involving medications. If a patient truly has , that treatment may work. However, at this time there are no approved medications to treat borderline personality disorder.

"Without an accurate diagnosis of borderline personality disorder, we may have many people in treatment who are taking medications that will not work to alleviate the characteristics of the condition from which they really suffer." Zimmerman, who is also an associate professor of psychiatry and human behavior at The Warren Alpert Medical School of Brown University, continues, "In addition, patients with unrecognized will not be treated with one of the effective psychotherapies for this condition. It is therefore vital that we develop or identify a more accurate method to distinguish between these two conditions, and adopt it into clinical practice."

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terrylwalker
not rated yet Mar 26, 2010
My sister Debbie now deceased was first told she had carpo tunnel, then fibro myalgia, then bi polar and lastly schizophrenia she was forced to take numerous psychotropic drugs and pain medications. One year of paxil left me with malignant neoplasms brain, hypothyroidism, syncope, dementia, severe pain... it was finally
decides that I had the personality disorder called multiple personality disorder (dissociative identity disorder). St. Michael's tried to get me to take Effexor, Toronto Western tried to get me to take Amitripoline, Baycrest tried to get me to take valpoic acid. Its been 7 years I drink wine with my meals and smoke pot once in a while when I can afford it, and I'm still alive having a fine time living in poverty singing in 5 choirs. My aunt Marion, John Doran (ex co-worker) both dead after to taking further psychotropic drugs after having the same toxic reaction to paxil. 3 sessions where I reported toxic reations to paxil to St. Mike doctors went missing; Why?

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