Poster Session I Article Swipe
YOU?
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· 2020
· Open Access
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· DOI: https://doi.org/10.1111/bdi.12938
· OA: W3192490270
Introduction: Depressive episodes/symptoms of bipolar I disorder (BPD-I) are commonly misdiagnosed as major depressive disorder (MDD).We developed a brief, self-rated, pragmatic tool that screens for manic symptoms and identifies BPD-I risk factors (eg, age of onset) to reduce misdiagnosis of BPD-I as MDD.Method: Existing questionnaires and risk factors were identified through a targeted literature search to select concepts thought to differentiate BPD-I from MDD.Individuals with self-reported BPD-I or MDD (N = 12) participated in cognitive debriefing interviews to test and refine item wording.An observational study was conducted to evaluate the tool's predictive validity.Participants with clinical interview-confirmed diagnoses of BPD-I or MDD completed a 10item screening tool and other questionnaires.Data were analyzed to identify a smaller subset of items with optimized sensitivity and specificity.Results: Of 160 interviews conducted, 139 patients had confirmed BPD-I (n = 67) or MDD (n = 72).The screening tool was reduced from 10 to 6 items based on item-level analysis.When 4 items or more were endorsed ("yes"), the performance of this tool for identifying patients with BPD-I was 0.92 and specificity was 0.78; positive and negative predictive values, based on the analysis sample, were 0.78 and 0.92, respectively.These properties represent an improvement over the Mood Disorder Questionnaire, while using >50% fewer items. Conclusion:This brief and valid screening tool serves to identify patients with depressive symptoms who may have BPD-I instead of MDD, prompting more comprehensive clinical assessment, improved diagnostic accuracy and treatment selection, and enhanced health outcomes in busy clinical practices.
