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Sociodemographic and clinical features of bipolar disorder patients misdiagnosed with major depressive disorder in China
Xiang Y.-T.4; Zhang L.4; Wang G.4; Hu C.4; Ungvari G.S.17; Dickerson F.B.2; Kilbourne A.M.8; Si T.-M.12; Fang Y.-R.10; Lu Z.16; Yang H.-C.3; Lai K.Y.9; Lee E.H.9; Hu J.6; Chen Z.-Y.5; Huang Y.14; Sun J.7; Wang X.-P.15; Li H.-C.11; Zhang J.-B.13; Chiu H.F.9
2013-03-01
Source PublicationBipolar Disorders
ISSN13985647 13995618
Volume15Issue:2Pages:199-205
AbstractObjectives: 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. © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.
KeywordBipolar disorder Diagnosis Major depressive disorder
DOI10.1111/bdi.12052
URLView the original
Language英語
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被引频次[WOS]:23   [WOS记录]     [WOS相关记录]
Document TypeJournal article
专题Faculty of Health Sciences
Affiliation1.Veterans Administration Ann Arbor Center for Clinical Management Research
2.The Stanley Research Program at Sheppard Pratt
3.Shenzhen Mental Health Centre
4.Beijing An Ding Hospital, Capital Medical University
5.Hangzhou Seventh People's Hospital
6.Harbin Medical University
7.Nanjing Medical University
8.University of Michigan Medical School
9.Chinese University of Hong Kong
10.Shanghai Jiao Tong University School of Medicine
11.Zhejiang University
12.Peking University
13.Sun Yat-Sen University
14.West China Hospital of Sichuan University
15.Second Xiangya Hospital of Central-South University
16.Tongji University
17.University of Notre Dame Australia
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GB/T 7714
Xiang Y.-T.,Zhang L.,Wang G.,et al. Sociodemographic and clinical features of bipolar disorder patients misdiagnosed with major depressive disorder in China[J]. Bipolar Disorders,2013,15(2):199-205.
APA Xiang Y.-T..,Zhang L..,Wang G..,Hu C..,Ungvari G.S..,...&Chiu H.F..(2013).Sociodemographic and clinical features of bipolar disorder patients misdiagnosed with major depressive disorder in China.Bipolar Disorders,15(2),199-205.
MLA Xiang Y.-T.,et al."Sociodemographic and clinical features of bipolar disorder patients misdiagnosed with major depressive disorder in China".Bipolar Disorders 15.2(2013):199-205.
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