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A diagnostic profile of those who return a false positive assignment on bipolar screening measures

Gordon Parker1, Rebecca Graham, Anne-Marie Rees

  • 1School of Psychiatry, University of New South Wales, Australia. g.parker@unsw.edu.au

Journal of Affective Disorders
|May 29, 2012
PubMed
Abstract

Insights

Anxiety conditions are frequently misidentified as bipolar disorder on screening tests like the Mood Swings Questionnaire (MSQ) and Mood Disorders Questionnaire (MDQ). This highlights the need for careful clinical assessment to avoid false positive bipolar diagnoses.

Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Mental Health Screening

Background:

  • Accurate bipolar disorder diagnosis is crucial for effective treatment.
  • Screening questionnaires, such as the Mood Swings Questionnaire (MSQ) and Mood Disorders Questionnaire (MDQ), are widely used but can yield false positive results.
  • Understanding the profile of false positive cases is essential for improving diagnostic accuracy.

Purpose of the Study:

  • To identify the diagnostic characteristics of patients incorrectly flagged as 'false positives' by the MSQ and MDQ.
  • To analyze the clinical diagnoses associated with false positive screening results for bipolar disorder.

Main Methods:

  • 1534 patients at a depression clinic completed the MSQ-46; 852 also completed the MDQ.
  • All participants underwent psychiatric assessment by Institute psychiatrists.
  • Clinical diagnoses were used as the criterion to evaluate the accuracy of the screening measures.

Main Results:

  • The MSQ-46 showed 84% agreement with clinical diagnosis, while the MDQ had 74% agreement.
  • False positives were most commonly diagnosed with unipolar non-melancholic depression or primary anxiety with secondary depression.
  • A significant proportion of these false positives also had co-occurring anxiety conditions.

Conclusions:

  • Anxiety disorders are a major contributor to false positive results on bipolar screening tools.
  • These findings necessitate refinement of bipolar screening measures.
  • Clinical evaluation must consider the high prevalence of anxiety in patients with false positive screening results.

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