Sociodemographic and clinical features of bipolar disorder patients misdiagnosed with major depressive disorder in China

Yu Tao Xiang; Ling Zhang; Gang Wang; Chen Hu; Gabor S. Ungvari; Faith B. Dickerson; Amy M. Kilbourne; Tian Mei Si; Yi Ru Fang; Zheng Lu; Hai Chen Yang; Kelly Yc Lai; Edwin Hm Lee; Jian Hu; Zhi Yu Chen; Yi Huang; Jing Sun; Xiao Ping Wang; Hui Chun Li; Jin Bei Zhang; Helen Fk Chiu

doi:10.1111/bdi.12052

Sociodemographic and clinical features of bipolar disorder patients misdiagnosed with major depressive disorder in China

Yu Tao Xiang, Ling Zhang, Gang Wang, Chen Hu, Gabor S. Ungvari, Faith B. Dickerson, Amy M. Kilbourne, Tian Mei Si, Yi Ru Fang, Zheng Lu, Hai Chen Yang, Kelly Yc Lai, Edwin Hm Lee, Jian Hu, Zhi Yu Chen, Yi Huang, Jing Sun, Xiao Ping Wang, Hui Chun Li, Jin Bei ZhangHelen Fk Chiu

School of Medicine

Research output: Contribution to journal › Article › peer-review

33 Scopus citations

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.

Original language	English (US)
Pages (from-to)	199-205
Number of pages	7
Journal	Bipolar Disorders
Volume	15
Issue number	2
DOIs	https://doi.org/10.1111/bdi.12052
State	Published - Mar 2013

Keywords

Bipolar disorder
Diagnosis
Major depressive disorder

ASJC Scopus subject areas

Psychiatry and Mental health
Biological Psychiatry

Access to Document

10.1111/bdi.12052

Cite this

Xiang, Y. T., Zhang, L., Wang, G., Hu, C., Ungvari, G. S., Dickerson, F. B., Kilbourne, A. M., Si, T. M., Fang, Y. R., Lu, Z., Yang, H. C., Lai, K. Y., Lee, E. H., Hu, J., Chen, Z. Y., Huang, Y., Sun, J., Wang, X. P., Li, H. C., ... 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. https://doi.org/10.1111/bdi.12052

Xiang, YT, Zhang, L, Wang, G, Hu, C, Ungvari, GS, Dickerson, FB, Kilbourne, AM, Si, TM, Fang, YR, Lu, Z, Yang, HC, Lai, KY, Lee, EH, Hu, J, Chen, ZY, Huang, Y, Sun, J, Wang, XP, Li, HC, Zhang, JB & Chiu, HF 2013, 'Sociodemographic and clinical features of bipolar disorder patients misdiagnosed with major depressive disorder in China', Bipolar Disorders, vol. 15, no. 2, pp. 199-205. https://doi.org/10.1111/bdi.12052

@article{ec296c313aa341af8a8ec1924008e129,

title = "Sociodemographic and clinical features of bipolar disorder patients misdiagnosed with major depressive disorder in China",

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.",

keywords = "Bipolar disorder, Diagnosis, Major depressive disorder",

author = "Xiang, {Yu Tao} and Ling Zhang and Gang Wang and Chen Hu and Ungvari, {Gabor S.} and Dickerson, {Faith B.} and Kilbourne, {Amy M.} and Si, {Tian Mei} and Fang, {Yi Ru} and Zheng Lu and Yang, {Hai Chen} and Lai, {Kelly Yc} and Lee, {Edwin Hm} and Jian Hu and Chen, {Zhi Yu} and Yi Huang and Jing Sun and Wang, {Xiao Ping} and Li, {Hui Chun} and Zhang, {Jin Bei} and Chiu, {Helen Fk}",

year = "2013",

month = mar,

doi = "10.1111/bdi.12052",

language = "English (US)",

volume = "15",

pages = "199--205",

journal = "Bipolar Disorders",

issn = "1398-5647",

publisher = "Blackwell Munksgaard",

number = "2",

}

TY - JOUR

T1 - Sociodemographic and clinical features of bipolar disorder patients misdiagnosed with major depressive disorder in China

AU - Xiang, Yu Tao

AU - Zhang, Ling

AU - Wang, Gang

AU - Hu, Chen

AU - Ungvari, Gabor S.

AU - Dickerson, Faith B.

AU - Kilbourne, Amy M.

AU - Si, Tian Mei

AU - Fang, Yi Ru

AU - Lu, Zheng

AU - Yang, Hai Chen

AU - Lai, Kelly Yc

AU - Lee, Edwin Hm

AU - Hu, Jian

AU - Chen, Zhi Yu

AU - Huang, Yi

AU - Sun, Jing

AU - Wang, Xiao Ping

AU - Li, Hui Chun

AU - Zhang, Jin Bei

AU - Chiu, Helen Fk

PY - 2013/3

Y1 - 2013/3

N2 - 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.

AB - 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.

KW - Bipolar disorder

KW - Diagnosis

KW - Major depressive disorder

UR - http://www.scopus.com/inward/record.url?scp=84874266825&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84874266825&partnerID=8YFLogxK

U2 - 10.1111/bdi.12052

DO - 10.1111/bdi.12052

M3 - Article

C2 - 23437963

AN - SCOPUS:84874266825

SN - 1398-5647

VL - 15

SP - 199

EP - 205

JO - Bipolar Disorders

JF - Bipolar Disorders

IS - 2

ER -

Sociodemographic and clinical features of bipolar disorder patients misdiagnosed with major depressive disorder in China

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this