Sociodemographic and clinical features of bipolar disorder patients misdiagnosed with major depressive disorder in China
Objectives Bipolar disorder (BD) is frequently misdiagnosed as major depressive disorder (MDD), which may lead to inappropriate treatment and poor outcomes. This study aimed to compare demographic and clinical features between patients with MDD and those with BD, but being misdiagnosed as MDD, in Ch...
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| Veröffentlicht in: | Bipolar disorders 2013-03, Vol.15 (2), p.199-205 |
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| creator | Xiang, Yu-Tao Zhang, Ling Wang, Gang Hu, Chen Ungvari, Gabor S Dickerson, Faith B Kilbourne, Amy M Si, Tian-Mei Fang, Yi-Ru Lu, Zheng Yang, Hai-Chen Lai, Kelly YC Lee, Edwin HM Hu, Jian Chen, Zhi-Yu Huang, Yi Sun, Jing Wang, Xiao-Ping Li, Hui-Chun Zhang, Jin-Bei Chiu, Helen FK |
| description | Objectives
Bipolar disorder (BD) is frequently misdiagnosed as major depressive disorder (MDD), which may lead to inappropriate treatment and poor outcomes. This study aimed to compare demographic and clinical features between patients with MDD and those with BD, but being misdiagnosed as MDD, in China.
Methods
A total of 1487 patients diagnosed with MDD were consecutively evaluated in 13 psychiatric hospitals or psychiatric units of general hospitals nationwide in China. The patients' sociodemographic and clinical characteristics were recorded using a standardized protocol and data collection procedure. The Mini‐International Neuropsychiatric Interview (MINI) was used to establish DSM‐IV diagnoses, and identify patients with MDD and those with BD, but being misdiagnosed with MDD.
Results
The proportions of BD (all types), bipolar I disorder (BD‐I), and bipolar II disorder (BD‐II) misdiagnosed as MDD in clinical practice were 20.8%, 7.9%, and 12.8%, respectively. Multiple logistic regression analyses revealed that compared to MDD patients, BD‐I was characterized by more atypical depressive features (increased appetite, increased sleep, and weight gain) [odds ratio (OR) = 2.0, 95% confidence interval (CI): 1.2–3.2], more psychotic symptoms (OR = 2.1, 95% CI: 1.3–3.5), more lifetime depressive episodes (OR = 1.1, 95% CI: 1.1–1.2), and earlier age of onset (OR = 0.97, 95% CI: 0.9–0.99); BD‐II was characterized by more psychotic symptoms (OR = 2.1, 95% CI: 1.4–3.1) and earlier age of onset (OR = 0.96, 95% CI: 0.9–0.97). In addition, compared to BD‐II patients, BD‐I patients were characterized by more frequent depressive episodes per year (OR = 3.1, 95% CI: 1.5–6.6).
Conclusions
Depressive episodes in the context of BD‐I and BD‐II, among those who were misclassified as MDD, present some different clinical features compared to MDD. This finding should be taken into account in guiding diagnostic practices in China. |
| doi_str_mv | 10.1111/bdi.12052 |
| format | Article |
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Bipolar disorder (BD) is frequently misdiagnosed as major depressive disorder (MDD), which may lead to inappropriate treatment and poor outcomes. This study aimed to compare demographic and clinical features between patients with MDD and those with BD, but being misdiagnosed as MDD, in China.
Methods
A total of 1487 patients diagnosed with MDD were consecutively evaluated in 13 psychiatric hospitals or psychiatric units of general hospitals nationwide in China. The patients' sociodemographic and clinical characteristics were recorded using a standardized protocol and data collection procedure. The Mini‐International Neuropsychiatric Interview (MINI) was used to establish DSM‐IV diagnoses, and identify patients with MDD and those with BD, but being misdiagnosed with MDD.
Results
The proportions of BD (all types), bipolar I disorder (BD‐I), and bipolar II disorder (BD‐II) misdiagnosed as MDD in clinical practice were 20.8%, 7.9%, and 12.8%, respectively. Multiple logistic regression analyses revealed that compared to MDD patients, BD‐I was characterized by more atypical depressive features (increased appetite, increased sleep, and weight gain) [odds ratio (OR) = 2.0, 95% confidence interval (CI): 1.2–3.2], more psychotic symptoms (OR = 2.1, 95% CI: 1.3–3.5), more lifetime depressive episodes (OR = 1.1, 95% CI: 1.1–1.2), and earlier age of onset (OR = 0.97, 95% CI: 0.9–0.99); BD‐II was characterized by more psychotic symptoms (OR = 2.1, 95% CI: 1.4–3.1) and earlier age of onset (OR = 0.96, 95% CI: 0.9–0.97). In addition, compared to BD‐II patients, BD‐I patients were characterized by more frequent depressive episodes per year (OR = 3.1, 95% CI: 1.5–6.6).
Conclusions
Depressive episodes in the context of BD‐I and BD‐II, among those who were misclassified as MDD, present some different clinical features compared to MDD. This finding should be taken into account in guiding diagnostic practices in China.</description><identifier>ISSN: 1398-5647</identifier><identifier>EISSN: 1399-5618</identifier><identifier>DOI: 10.1111/bdi.12052</identifier><identifier>PMID: 23437963</identifier><language>eng</language><publisher>Denmark: Blackwell Publishing Ltd</publisher><subject>Adult ; Age ; Analysis of Variance ; Appetite ; Bipolar disorder ; Bipolar Disorder - diagnosis ; Bipolar Disorder - epidemiology ; China - epidemiology ; Data collections ; Demography ; Depression ; Depressive Disorder, Major - diagnosis ; Depressive Disorder, Major - epidemiology ; diagnosis ; Diagnostic Errors ; Female ; Hospitals ; Humans ; Interview, Psychological ; major depressive disorder ; Male ; Middle Aged ; Odds Ratio ; Psychiatric Status Rating Scales ; Regression analysis ; Sleep</subject><ispartof>Bipolar disorders, 2013-03, Vol.15 (2), p.199-205</ispartof><rights>2013 John Wiley and Sons A/S. Published by Blackwell Publishing Ltd</rights><rights>2013 John Wiley and Sons A/S. Published by Blackwell Publishing Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fbdi.12052$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fbdi.12052$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23437963$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Xiang, Yu-Tao</creatorcontrib><creatorcontrib>Zhang, Ling</creatorcontrib><creatorcontrib>Wang, Gang</creatorcontrib><creatorcontrib>Hu, Chen</creatorcontrib><creatorcontrib>Ungvari, Gabor S</creatorcontrib><creatorcontrib>Dickerson, Faith B</creatorcontrib><creatorcontrib>Kilbourne, Amy M</creatorcontrib><creatorcontrib>Si, Tian-Mei</creatorcontrib><creatorcontrib>Fang, Yi-Ru</creatorcontrib><creatorcontrib>Lu, Zheng</creatorcontrib><creatorcontrib>Yang, Hai-Chen</creatorcontrib><creatorcontrib>Lai, Kelly YC</creatorcontrib><creatorcontrib>Lee, Edwin HM</creatorcontrib><creatorcontrib>Hu, Jian</creatorcontrib><creatorcontrib>Chen, Zhi-Yu</creatorcontrib><creatorcontrib>Huang, Yi</creatorcontrib><creatorcontrib>Sun, Jing</creatorcontrib><creatorcontrib>Wang, Xiao-Ping</creatorcontrib><creatorcontrib>Li, Hui-Chun</creatorcontrib><creatorcontrib>Zhang, Jin-Bei</creatorcontrib><creatorcontrib>Chiu, Helen FK</creatorcontrib><title>Sociodemographic and clinical features of bipolar disorder patients misdiagnosed with major depressive disorder in China</title><title>Bipolar disorders</title><addtitle>Bipolar Disord</addtitle><description>Objectives
Bipolar disorder (BD) is frequently misdiagnosed as major depressive disorder (MDD), which may lead to inappropriate treatment and poor outcomes. This study aimed to compare demographic and clinical features between patients with MDD and those with BD, but being misdiagnosed as MDD, in China.
Methods
A total of 1487 patients diagnosed with MDD were consecutively evaluated in 13 psychiatric hospitals or psychiatric units of general hospitals nationwide in China. The patients' sociodemographic and clinical characteristics were recorded using a standardized protocol and data collection procedure. The Mini‐International Neuropsychiatric Interview (MINI) was used to establish DSM‐IV diagnoses, and identify patients with MDD and those with BD, but being misdiagnosed with MDD.
Results
The proportions of BD (all types), bipolar I disorder (BD‐I), and bipolar II disorder (BD‐II) misdiagnosed as MDD in clinical practice were 20.8%, 7.9%, and 12.8%, respectively. Multiple logistic regression analyses revealed that compared to MDD patients, BD‐I was characterized by more atypical depressive features (increased appetite, increased sleep, and weight gain) [odds ratio (OR) = 2.0, 95% confidence interval (CI): 1.2–3.2], more psychotic symptoms (OR = 2.1, 95% CI: 1.3–3.5), more lifetime depressive episodes (OR = 1.1, 95% CI: 1.1–1.2), and earlier age of onset (OR = 0.97, 95% CI: 0.9–0.99); BD‐II was characterized by more psychotic symptoms (OR = 2.1, 95% CI: 1.4–3.1) and earlier age of onset (OR = 0.96, 95% CI: 0.9–0.97). In addition, compared to BD‐II patients, BD‐I patients were characterized by more frequent depressive episodes per year (OR = 3.1, 95% CI: 1.5–6.6).
Conclusions
Depressive episodes in the context of BD‐I and BD‐II, among those who were misclassified as MDD, present some different clinical features compared to MDD. This finding should be taken into account in guiding diagnostic practices in China.</description><subject>Adult</subject><subject>Age</subject><subject>Analysis of Variance</subject><subject>Appetite</subject><subject>Bipolar disorder</subject><subject>Bipolar Disorder - diagnosis</subject><subject>Bipolar Disorder - epidemiology</subject><subject>China - epidemiology</subject><subject>Data collections</subject><subject>Demography</subject><subject>Depression</subject><subject>Depressive Disorder, Major - diagnosis</subject><subject>Depressive Disorder, Major - epidemiology</subject><subject>diagnosis</subject><subject>Diagnostic Errors</subject><subject>Female</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Interview, Psychological</subject><subject>major depressive disorder</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Odds Ratio</subject><subject>Psychiatric Status Rating Scales</subject><subject>Regression analysis</subject><subject>Sleep</subject><issn>1398-5647</issn><issn>1399-5618</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkUtv3CAURlHVqnl10T8QsezGiQEb8DKdtHlo1FRqXjuEzXXmJrZxwdMk_z5kJo9t2fBJ9xyE7kfIV5bvsXT2a4d7jOcl_0A2maiqrJRMf1xlnXKhNshWjLd5zmSiPpMNLgqhKik2ycMf36B30PubYMcFNtQOjjYdDtjYjrZgp2WASH1Laxx9ZwN1GH1wEOhoJ4RhirTH6NDeDD6Co_c4LWhvb30iYUxuxH_wLuFAZwsc7A751NouwpeXe5tc_PxxPjvO5mdHJ7ODeYaiVDwrRau0VFpU1oFyIJWTbV1KKHhd5kWaMK1q1_JalTW3UkDD2qLQrGk4l5qJbfJt_e4Y_N8lxMmk3zbQdXYAv4yGCS50rgpd_QfKuH7eG0_o7gu6rHtwZgzY2_BoXhebgP01cI8dPL7NWW6eGzOpMbNqzHw_PFmFZGRrA-MED2-GDXdGKqFKc_XryJxy9fvq-vrSzMUTGleYrA</recordid><startdate>201303</startdate><enddate>201303</enddate><creator>Xiang, Yu-Tao</creator><creator>Zhang, Ling</creator><creator>Wang, Gang</creator><creator>Hu, Chen</creator><creator>Ungvari, Gabor S</creator><creator>Dickerson, Faith B</creator><creator>Kilbourne, Amy M</creator><creator>Si, Tian-Mei</creator><creator>Fang, Yi-Ru</creator><creator>Lu, Zheng</creator><creator>Yang, Hai-Chen</creator><creator>Lai, Kelly YC</creator><creator>Lee, Edwin HM</creator><creator>Hu, Jian</creator><creator>Chen, Zhi-Yu</creator><creator>Huang, Yi</creator><creator>Sun, Jing</creator><creator>Wang, Xiao-Ping</creator><creator>Li, Hui-Chun</creator><creator>Zhang, Jin-Bei</creator><creator>Chiu, Helen FK</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope><scope>7TK</scope></search><sort><creationdate>201303</creationdate><title>Sociodemographic and clinical features of bipolar disorder patients misdiagnosed with major depressive disorder in China</title><author>Xiang, Yu-Tao ; Zhang, Ling ; Wang, Gang ; Hu, Chen ; Ungvari, Gabor S ; Dickerson, Faith B ; Kilbourne, Amy M ; Si, Tian-Mei ; Fang, Yi-Ru ; Lu, Zheng ; Yang, Hai-Chen ; Lai, Kelly YC ; Lee, Edwin HM ; Hu, Jian ; Chen, Zhi-Yu ; Huang, Yi ; Sun, Jing ; Wang, Xiao-Ping ; Li, Hui-Chun ; Zhang, Jin-Bei ; Chiu, Helen FK</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-i3572-53f7867839ade7de67d6fb56e42b504678187bdf2b75b2a63ec1f4481cc226813</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Age</topic><topic>Analysis of Variance</topic><topic>Appetite</topic><topic>Bipolar disorder</topic><topic>Bipolar Disorder - diagnosis</topic><topic>Bipolar Disorder - epidemiology</topic><topic>China - epidemiology</topic><topic>Data collections</topic><topic>Demography</topic><topic>Depression</topic><topic>Depressive Disorder, Major - diagnosis</topic><topic>Depressive Disorder, Major - epidemiology</topic><topic>diagnosis</topic><topic>Diagnostic Errors</topic><topic>Female</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Interview, Psychological</topic><topic>major depressive disorder</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Odds Ratio</topic><topic>Psychiatric Status Rating Scales</topic><topic>Regression analysis</topic><topic>Sleep</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Xiang, Yu-Tao</creatorcontrib><creatorcontrib>Zhang, Ling</creatorcontrib><creatorcontrib>Wang, Gang</creatorcontrib><creatorcontrib>Hu, Chen</creatorcontrib><creatorcontrib>Ungvari, Gabor S</creatorcontrib><creatorcontrib>Dickerson, Faith B</creatorcontrib><creatorcontrib>Kilbourne, Amy M</creatorcontrib><creatorcontrib>Si, Tian-Mei</creatorcontrib><creatorcontrib>Fang, Yi-Ru</creatorcontrib><creatorcontrib>Lu, Zheng</creatorcontrib><creatorcontrib>Yang, Hai-Chen</creatorcontrib><creatorcontrib>Lai, Kelly YC</creatorcontrib><creatorcontrib>Lee, Edwin HM</creatorcontrib><creatorcontrib>Hu, Jian</creatorcontrib><creatorcontrib>Chen, Zhi-Yu</creatorcontrib><creatorcontrib>Huang, Yi</creatorcontrib><creatorcontrib>Sun, Jing</creatorcontrib><creatorcontrib>Wang, Xiao-Ping</creatorcontrib><creatorcontrib>Li, Hui-Chun</creatorcontrib><creatorcontrib>Zhang, Jin-Bei</creatorcontrib><creatorcontrib>Chiu, Helen FK</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><collection>Neurosciences Abstracts</collection><jtitle>Bipolar disorders</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Xiang, Yu-Tao</au><au>Zhang, Ling</au><au>Wang, Gang</au><au>Hu, Chen</au><au>Ungvari, Gabor S</au><au>Dickerson, Faith B</au><au>Kilbourne, Amy M</au><au>Si, Tian-Mei</au><au>Fang, Yi-Ru</au><au>Lu, Zheng</au><au>Yang, Hai-Chen</au><au>Lai, Kelly YC</au><au>Lee, Edwin HM</au><au>Hu, Jian</au><au>Chen, Zhi-Yu</au><au>Huang, Yi</au><au>Sun, Jing</au><au>Wang, Xiao-Ping</au><au>Li, Hui-Chun</au><au>Zhang, Jin-Bei</au><au>Chiu, Helen FK</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sociodemographic and clinical features of bipolar disorder patients misdiagnosed with major depressive disorder in China</atitle><jtitle>Bipolar disorders</jtitle><addtitle>Bipolar Disord</addtitle><date>2013-03</date><risdate>2013</risdate><volume>15</volume><issue>2</issue><spage>199</spage><epage>205</epage><pages>199-205</pages><issn>1398-5647</issn><eissn>1399-5618</eissn><abstract>Objectives
Bipolar disorder (BD) is frequently misdiagnosed as major depressive disorder (MDD), which may lead to inappropriate treatment and poor outcomes. This study aimed to compare demographic and clinical features between patients with MDD and those with BD, but being misdiagnosed as MDD, in China.
Methods
A total of 1487 patients diagnosed with MDD were consecutively evaluated in 13 psychiatric hospitals or psychiatric units of general hospitals nationwide in China. The patients' sociodemographic and clinical characteristics were recorded using a standardized protocol and data collection procedure. The Mini‐International Neuropsychiatric Interview (MINI) was used to establish DSM‐IV diagnoses, and identify patients with MDD and those with BD, but being misdiagnosed with MDD.
Results
The proportions of BD (all types), bipolar I disorder (BD‐I), and bipolar II disorder (BD‐II) misdiagnosed as MDD in clinical practice were 20.8%, 7.9%, and 12.8%, respectively. Multiple logistic regression analyses revealed that compared to MDD patients, BD‐I was characterized by more atypical depressive features (increased appetite, increased sleep, and weight gain) [odds ratio (OR) = 2.0, 95% confidence interval (CI): 1.2–3.2], more psychotic symptoms (OR = 2.1, 95% CI: 1.3–3.5), more lifetime depressive episodes (OR = 1.1, 95% CI: 1.1–1.2), and earlier age of onset (OR = 0.97, 95% CI: 0.9–0.99); BD‐II was characterized by more psychotic symptoms (OR = 2.1, 95% CI: 1.4–3.1) and earlier age of onset (OR = 0.96, 95% CI: 0.9–0.97). In addition, compared to BD‐II patients, BD‐I patients were characterized by more frequent depressive episodes per year (OR = 3.1, 95% CI: 1.5–6.6).
Conclusions
Depressive episodes in the context of BD‐I and BD‐II, among those who were misclassified as MDD, present some different clinical features compared to MDD. This finding should be taken into account in guiding diagnostic practices in China.</abstract><cop>Denmark</cop><pub>Blackwell Publishing Ltd</pub><pmid>23437963</pmid><doi>10.1111/bdi.12052</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Age Analysis of Variance Appetite Bipolar disorder Bipolar Disorder - diagnosis Bipolar Disorder - epidemiology China - epidemiology Data collections Demography Depression Depressive Disorder, Major - diagnosis Depressive Disorder, Major - epidemiology diagnosis Diagnostic Errors Female Hospitals Humans Interview, Psychological major depressive disorder Male Middle Aged Odds Ratio Psychiatric Status Rating Scales Regression analysis Sleep |
| title | Sociodemographic and clinical features of bipolar disorder patients misdiagnosed with major depressive disorder in China |
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