Broadening the diagnosis of bipolar disorder: benefits vs. risks.

Content Provider	Europe PMC
Author	STRAKOWSKI, STEPHEN M. FLECK, DAVID E. MAJ, MARIO
Copyright Year	2011
Description	There is considerable debate over whether bipolar and related disorders that share common signs and symptoms, but are currently defined as distinct clinical entities in DSM-IV and ICD-10, may be better characterized as falling within a more broadly defined “bipolar spectrum”. With a spectrum view in mind, the possibility of broadening the diagnosis of bipolar disorder has been proposed. This paper discusses some of the rationale for an expanded diagnostic scheme from both clinical and research perspectives in light of potential drawbacks. The ultimate goal of broadening the diagnosis of bipolar disorder is to help identify a common etiopathogenesis for these conditions to better guide treatment. To help achieve this goal, bipolar researchers have increasingly expanded their patient populations to identify objective biological or endophenotypic markers that transcend phenomenological observation. Although this approach has and will likely continue to produce beneficial results, the upcoming DSM-IV and ICD-10 revisions will place increasing scrutiny on psychiatry’s diagnostic classification systems and pressure to re-evaluate our conceptions of bipolar disorder. However, until research findings can provide consistent and converging evidence as to the validity of a broader diagnostic conception, clinical expansion to a dimensional bipolar spectrum should be considered with caution.
Abstract	There is considerable debate over whether bipolar and related disordersthat share common signs and symptoms, but are currently defined as distinctclinical entities in DSM-IV and ICD-10, may be better characterized as fallingwithin a more broadly defined “bipolar spectrum”. With a spectrumview in mind, the possibility of broadening the diagnosis of bipolar disorderhas been proposed. This paper discusses some of the rationale for an expandeddiagnostic scheme from both clinical and research perspectives in light ofpotential drawbacks. The ultimate goal of broadening the diagnosis of bipolardisorder is to help identify a common etiopathogenesis for these conditionsto better guide treatment. To help achieve this goal, bipolar researchershave increasingly expanded their patient populations to identify objectivebiological or endophenotypic markers that transcend phenomenological observation.Although this approach has and will likely continue to produce beneficialresults, the upcoming DSM-IV and ICD-10 revisions will place increasing scrutinyon psychiatry’s diagnostic classification systems and pressure to re-evaluateour conceptions of bipolar disorder. However, until research findings canprovide consistent and converging evidence as to the validity of a broaderdiagnostic conception, clinical expansion to a dimensional bipolar spectrumshould be considered with caution.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC3188763&blobtype=pdf
ISSN	17238617
Volume Number	10
PubMed Central reference number	PMC3188763
Issue Number	3
PubMed reference number	21991268
Journal	World Psychiatry
DOI	10.1002/j.2051-5545.2011.tb00046.x
Language	English
Publisher	Elsevier Italy
Publisher Date	2011-10-01
Access Restriction	Open
Subject Keyword	Bipolar I disorder bipolar II disorder bipolar spectrum depression diagnosis hypomania mania
Content Type	Text
Resource Type	Article
Subject	Psychiatry and Mental Health