Two indicators: Research and practice. Well a new study seems to indicate that overdiagnosis is the order of the day. Furious Seasons has two stories on this topic, April 6 and 7, both quotes are straight from Furious Seasons.
Clinical Psychology and Psychiatry, advocating a Bipolar Overawareness Week, has an extensive treatment of the topic, with some great quotes from David Healy, an Abilify video, and some wise words about the significance of getting a diagnosis, from The Last Psychiatrist.
To top it off, John Grohol at Word of Psychology covers the study and links to a first-person account of being diagnosed. It’s called To Hell and Back published in the Daily Kansan. Here’s a quote from the initial study’s author, Mark Zimmerman:
Clinicians are inclined to diagnose disorders that they feel more comfortable treating. We hypothesize that the increased availability of medications that have been approved for the treatment of bipolar disorder might be influencing clinicians who are unsure whether or not a patient has bipolar disorder or borderline personality disorder to err on the side of diagnosing the disorder that is medication responsive.’ He continues, ‘This bias is reinforced by the marketing message of pharmaceutical companies to physicians, which has emphasized the literature on the delayed and underrecognition of bipolar disorder, and may be sensitizing clinicians to avoid missing the diagnosis of bipolar disorder.
Zimmerman concludes, ‘The results of this study suggest that bipolar disorder is being overdiagnosed and we recommend that clinicians use a standardized, validated method in diagnosing bipolar disorder.
Thanks to Furious Seasons again for this quote, from a clinician:
In my private practice as a psychologist, I frequently find people misdiagnosed with Bipolar disorder. If someone has an anger problem, they often end up diagnosed as Bipolar. This happens frequently by family doctors and also psychiatrists. In my opinion, it’s really often a matter of justifying the meds they want to prescribe (most often an antipsychotic). I’d say, anecdotally, that the level of overdiagnosis I see is pretty consistent with the studies results (50-60%). I do evaluations for people seeking disability based on mental illness diagnoses, so I frequently see people labeled as Bipolar. More often than not, the diagnosis is more consistent with a cluster B personality disorder (erratic, unstable, and hyperemotional personality traits). But once you diagnose someone as being Bipolar, you can pretty well throw any class of psychotropic medication at them that you want to.”