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Depression Research and Treatment
Volume 2012, Article ID 435486, 6 pages
Research Article

Diagnostic Disagreements in Bipolar Disorder: The Role of Substance Abuse Comorbidities

Department of Psychology, University of Texas at Arlington, P.O. Box 19528, Arlington, TX 76019, USA

Received 1 July 2011; Revised 13 October 2011; Accepted 20 October 2011

Academic Editor: Colombo Cristina

Copyright © 2012 Rowena Shalini Theodore et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Substance abuse can produce symptoms similar to other psychiatric disorders, thus confusing the diagnostic picture. This paper attempts to elucidate how misdiagnosis in bipolar disorder might be explained by the presence of substance abuse comorbidities. The overlap of symptoms, limited information about symptom onset, and inexperienced clinicians can result in the misinterpretation of symptoms of substance abuse disorders for bipolar disorder. The present study found that the presence of a substance abuse comorbidity, the polarity of last episode (depressed, manic, mixed, not otherwise specified), and the total number of comorbidities affected the reliability of a bipolar disorder diagnosis.