A Debate Amongst Experts To Expand the Bipolar Spectrum

 Is it a Problematic Concept?

Mason, Ohio – June 15, 2011 – At the Annual American Psychiatric Association (APA) meeting held May 14-18, Dr. Susan L. McElroy, Chief Research Officer at Lindner Center of HOPE presented research evidence supporting the broadening of the concept of Bipolar Disorder. Colleagues Dr. Mari Maj, from Italy and Dr. Stephen Strakowski, Professor and Chair at University of Cincinnati Department of Psychiatry & Behavioral Health argued that the diagnostic criteria should not be broadened.

Susan L. McElroy, MDDr. McElroy argued that Bipolar Disorder diagnostic criteria needs to be broadened to account for the broad range of mixed states- for instance when manic and depressive symptoms co-occur and for subthreshold hypomania- hypomanic symptoms that are shorter than 4 days.

Over the last decade a number of experts in the field have encouraged expanding the diagnosis to include mood changes that are much different than the traditional classic definition-which includes episodes of major depression that last at least two weeks and periods of mania or hypomania that last at least seven or four days respectively. At the APA Conference, Ellen Frank, PhD from Pittsburgh, Pa reviewed the risks and benefits of expanding the diagnostic criteria including misdiagnosis, exposure to inappropriate medications and their side effects. On the plus side, expanding the spectrum could mean an increase in diagnosis which could potentially mean that more people who need help will receive it.

On the other side of the debate are questions concerning emergency rooms and clinics seeing many patients who say they have bipolar disorder and who are then being prescribed a large number of psychiatric drugs for vague and unclear indications.
In our next issue of The Source, Dr. McElroy will provide a definition of bipolar spectrum and will explain one of the major differences of opinion around the diagnosis. Her perspective is that widening the Bipolar Spectrum will offer more accurate diagnosis and more appropriate treatment of those with true bipolar disease.

What do you think? Join us on LinkedIn to share your thoughts and hear from your colleagues and patient advocates on this APA topic. Will the broadening of Bipolar Spectrum lead to the over diagnosis of bipolar disorder or to more accurate diagnosis and more effective treatments? How will this affect individuals with milder symptoms and those without the illness to ineffective medications with harmful side effects? Has research helped delineate the importance of DSM IV expansion? We hope to hear from you.