Öz
Amaç: Bipolar bozukluğun yanlış tanısını inceleyen sınırlı sayıda çalışma olmasına rağmen, bipolar bozukluğun tanı oranını belirlemek için yeterli sistematik araştırma olduğunu söylemek çok zordur. Öte yandan Türkiye'de herhangi bir araştırmaya rastlamadık. Bu nedenle ülkemizde bipolar bozukluk yanlış tanısı açısından durum nedir diye merak ettik.
Metod: Bu çalışma xxx Üniversitesi Tıp Fakültesi Psikiyatri Anabilim Dalı'nda yapıldı. Hem ayaktan hem de yatan hasta kliniklerinden gelen hastalar çalışmaya dahil edildi. Bir seçim sürecinden sonra bipolar bozukluğu olan 171 hasta alındı. Bu hasta grubunda bipolar bozukluk yanlış tanısı araştırıldı.
Bulgular: Hastaların yüzde 56.14'ünde bipolar bozukluk yanlış tanısı vardı. En sık yanlış tanı majör depresif bozukluk olarak belirlendi (elli vakada %54.3). Bunu şizoaffektif bozukluk (on sekiz hastada %24,3), şizofreni (on üç hastada %24,3), sanrılı bozukluk (on üç hastada %24,3), distimik bozukluk (10 olguda %15,9), yaygın anksiyete bozukluğu (( on olguda %15,9), obsesif kompulsif bozukluk (yedi olguda %12.6), paranoid kişilik bozukluğu (iki olguda %4,1).
Sonuç: Çalışmanın sonuçları, bipolar bozukluğun sıklıkla yanlış teşhis edildiğini ve en sık yanlış tanıların majör depresif bozukluk ve ardından psikotik spektrum bozuklukları olduğunu göstermektedir. Klinisyenler bipolar bozukluğu olan hastalarda sık görülen yanlış tanıların farkında olmalıdır.
Anahtar Kelimeler
Kaynakça
- 1- Khouzam HR, Singh F. Bipolar disorder: historic perspective, current pharmacologic treatment options and a review of quetiapine. Expert Rev Neurother 2006;6:131-144. doi:10.1586/14737175.6.2.131.
- 2- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Third Edition, Washington DC 1980.
- 3- American Psychiatric Association .Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC 2000.
- 4- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Washington, DC 2013.
- 5- Hirschfeld RM, Lewis L, Vornik LA. Perceptions and impact of bipolar disorder: how far have we really come? Results of the national depressive and manic-depressive association 2000 survey of individuals with bipolar disorder. J Clin Psychiatry 2003;64:161-174.
- 6- Baldessarini RJ, Tondo L, Baethge CJ, Lepri B, Bratti IM. Effects of treatment latency on response to maintenance treatment in manic-depressive disorders. Bipolar Disord 2007;9:386-393. doi:10.1111/j.1399-5618.2007.00385.x.
- 7- Young AH. Bipolar disorder: diagnostic conundrums and associated comorbidities. J Clin Psychiatry 2009;70:e26. doi:10.4088/JCP.7067br6c.
- 8- Altamura, A. C., & Goikolea, J. M. Differential diagnoses and management strategies in patients with schizophrenia and bipolar disorder. Neuropsychiatric disease and treatment 2008. 4;1, 311–317. doi:10.2147/NDT.S2703.
- 9- Altamura AC, Buoli M, Albano A, Dell’Osso B. Age at onset and latency to treatment (duration of untreated illness) in patients with mood and anxiety disorders: a naturalistic study. Int Clin Psychopharmacol 2010. 25;3 : 172-179. doi:10.1097/YIC.0b013e3283384c74.
- 10- Riis P. Perspectives on the Fifth Revision of the Declaration of Helsinki. JAMA 2000;284:3045-3046. doi:10.1001/jama.284.23.3045.
- 11- Shen H, Zhang L, Xu C, Zhu J, Chen M, Fang Y. Analysis of Misdiagnosis of Bipolar Disorder in An Outpatient Setting. Shanghai Arch Psychiatry 2018;30:93-101. doi:10.11919/j.issn.1002-0829.217080.
Öz
Background: As much there have been limited number of studies which have examined misdiagnosis of bipolar disorder, it is so difficult to say that there are enough systematic research to identify the diagnostic rate of bipolar disorder. On the other hand, we did not find any research in Turkey. For this reason, we wondered what is situation in our country in terms of misdiagnosis of bipolar disorder.
Methods: The present study was done at xxx University, School of Medicine, Department of Psychiatry. Patients who were from both out-patient and in-patient clinics were included in the study. After a selection process, 171 patients with bipolar disorder were enrolled. In this group of patients, misdiagnosis of bipolar disorder were investigated.
Results: 56.14 percent of patients had misdiagnosis of bipolar disorder. The most frequent misdiagnosis was fetermined to be major depressive disorder (in fifty cases, 54.3%). Followings were schizoaffective disorder (in eighteen cases, 24.3%), schizophrenia (in thirteen patients, 24.3%), delusional disorder (in thirteen patients, 24.3%), dysthymic disorder (in ten cases, 15.9%), generalized anxiety disorder ((in ten cases, 15.9%), obsessive compulsive disorder (in seven cases, 12.6%), paranoid personality disorder (in two cases, 4.1%).
Conclusions: The results of the study suggest that bipolar disorder is frequently misdiagnosed one and that the most frequent misdagnoses were majör depressive disorder and following psychotic spectrum disorders. Clinicians should be aware of frequent misdiagnosis in patients with bipolar disorder.
Anahtar Kelimeler
Kaynakça
- 1- Khouzam HR, Singh F. Bipolar disorder: historic perspective, current pharmacologic treatment options and a review of quetiapine. Expert Rev Neurother 2006;6:131-144. doi:10.1586/14737175.6.2.131.
- 2- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Third Edition, Washington DC 1980.
- 3- American Psychiatric Association .Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC 2000.
- 4- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Washington, DC 2013.
- 5- Hirschfeld RM, Lewis L, Vornik LA. Perceptions and impact of bipolar disorder: how far have we really come? Results of the national depressive and manic-depressive association 2000 survey of individuals with bipolar disorder. J Clin Psychiatry 2003;64:161-174.
- 6- Baldessarini RJ, Tondo L, Baethge CJ, Lepri B, Bratti IM. Effects of treatment latency on response to maintenance treatment in manic-depressive disorders. Bipolar Disord 2007;9:386-393. doi:10.1111/j.1399-5618.2007.00385.x.
- 7- Young AH. Bipolar disorder: diagnostic conundrums and associated comorbidities. J Clin Psychiatry 2009;70:e26. doi:10.4088/JCP.7067br6c.
- 8- Altamura, A. C., & Goikolea, J. M. Differential diagnoses and management strategies in patients with schizophrenia and bipolar disorder. Neuropsychiatric disease and treatment 2008. 4;1, 311–317. doi:10.2147/NDT.S2703.
- 9- Altamura AC, Buoli M, Albano A, Dell’Osso B. Age at onset and latency to treatment (duration of untreated illness) in patients with mood and anxiety disorders: a naturalistic study. Int Clin Psychopharmacol 2010. 25;3 : 172-179. doi:10.1097/YIC.0b013e3283384c74.
- 10- Riis P. Perspectives on the Fifth Revision of the Declaration of Helsinki. JAMA 2000;284:3045-3046. doi:10.1001/jama.284.23.3045.
- 11- Shen H, Zhang L, Xu C, Zhu J, Chen M, Fang Y. Analysis of Misdiagnosis of Bipolar Disorder in An Outpatient Setting. Shanghai Arch Psychiatry 2018;30:93-101. doi:10.11919/j.issn.1002-0829.217080.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Original Article |
| Yazarlar | |
| Erken Görünüm Tarihi | 29 Ağustos 2023 |
| Yayımlanma Tarihi | 31 Ağustos 2023 |
| Gönderilme Tarihi | 22 Eylül 2022 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 33 Sayı: 4 |
Genel Tıp Dergisi Creative Commons Atıf-GayriTicari 4.0 Uluslararası Lisansı (CC BY NC) ile lisanslanmıştır.