Мания диагностирования биполярного расстройства

ПРОВИДЕНС, РОД-АЙЛЕНД – Последние несколько лет многие эксперты утверждали, что биполярное расстройство – тяжелое заболевание, ведущее к ярко выраженным психосоциальным расстройствам и избыточной смертности – не достаточно часто распознается, особенно у пациентов с сильной депрессией. А те пациенты, которым все-таки ставится диагноз биполярное расстройство, зачастую  ждут правильного диагноза более 10 лет с момента первоначального обращения за медицинской помощью.

Клинические аспекты не выявления у пациентов с депрессией биполярного расстройства, включают в себя предписание недостаточно сильных нормотимиков, а также увеличенный риск резкой «цикличности» – скачков между маниакальной и депрессивной фазой. Но, возможно, как следствие совместных усилий по улучшению установления диагноза биполярного расстройства, последние несколько лет мы наблюдали появление противоположного явления – его излишне частое диагностирование.

В своей практике мои коллеги и я сталкивались с пациентами, которые говорили, что ранее им был поставлен диагноз биполярное расстройство, несмотря на то, что у них не наблюдались маниакальные или гипоманиакальные приступы. И, несомненно, мы также наблюдали пациентов, которые обращались за лечением депрессии, в то время как у них в действительности наблюдалось биполярное расстройство. Тем не менее, похоже, что излишнее диагностирование встречается гораздо чаще недостаточного.

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