Overdiagnosis of Bipolar Disorder: A Critical Analysis of the Literature

Table 1

Studies addressing the overdiagnosis of bipolar disorder.

Author/year	Sample	Gold standard	Findings
Ghaemi et al. (2000) [9]	Outpatients	SCID	Clinician-based diagnosis of BD: PPV of 34% and NPV of 95%
Stewart and El-Mallakh (2007) [10]	Outpatients from a substance abuse treatment program	DSM-IV criteria	Only 42.9% of patients diagnosed with BD actually met diagnostic criteria
Goldberg et al. (2008) [11]	Dual diagnosis inpatients	SCID	Only 33% of patients diagnosed with BD actually met criteria for that condition.; Misdiagnosis associated with cocaine and polysubstance abuse
Zimmerman et al. (2008) [8]	Outpatients	SCID	Clinician-based diagnosis of BD: PPV of 37% and NPV of 95%
Ruggero et al. (2010) [12]	Outpatients	SCID	40% of patients with borderline personality disorder mistakenly diagnosed with BD
Zimmerman et al. (2010) [13]	Outpatients	SCID	Patients overdiagnosed with BD were significantly more likely to receive disability payments
Chilakamarri et al. (2011) [14]	Child outpatients	DSM-IV criteria	Minimum number of patients misdiagnosed with BD; underdiagnosis was common

BD: bipolar disorder, SCID: structured clinical interview for DSM-IV disorders; PPV: positive predictive value; NPV: negative predictive value.