DIAGNOSTICS OF BIPOLAR II DISORDER AMONG PATIENTS WITH THE CURRENT DIAGNOSIS OF RECURRENT DEPRESSIVE DISORDER

Abstract

The objective of the study was detection of Bipolar II Disorder (BD II) among adult patients with the current diagnosis of Recurrent Depressive Disorder (RDD).
METHODS. A non-interventional diagnostic study conducted in the period from 2008 to 2012 included 409 in-and outpatients of the Moscow Research Institute of Psychiatry and the Moscow City Clinical Psychiatric Hospital № 4. The inclusion criteria were current diagnosis of RDD, age 18 to 65 years, an illness duration at least 3 years and history of two or more affective episodes. The diagnosis was confirmed or changed by an experienced psychiatrist and verified using a structured interview MINI. Another psychiatrist interviewed the patient using the HCL-32 scale, the Bipolarity Index (BI) and the Personal and Social Performance scale (PSP).
RESULTS. Patients with BD I were excluded from further analysis. The time lag between the first onset and establishing BD II diagnosis was 15 years. HCL-32 scale showed high diagnostic value, its sensitivity and specificity in detecting BD II were 83.7 and 71.9%, respectively. BI demonstrated significant differences between the groups, with the optimal ratio of sensitivity and specificity (73.5 and 72.3%, respectively) at the point of 22. However, the main BI item for differentiation of BD and UD was history of hypomanic episodes; other items had only secondary importance.
CONCLUSION: Diagnostic errors are the main reason of misdiagnosis of BD II in Russia. More than 40% of study participants had an inappropriate diagnosis of RDD for a mean period of 15 years Russian versions of the MINI, the HCL–32 and the BI as additional instrument could be recommended as useful instruments for differentiating between BD II and RDD.