Diagnostic stability in bipolar disorder: a systematic review.

INTRODUCTION: Stability of a diagnosis over time represents the best evidence to validate psychiatric diagnoses and helps to predict the course of a disorder. The diagnosis of bipolar disorder shows large variability over time and only a few numbers of investigations have evaluated the impact of the diagnostic stability vs the change. MATERIAL AND METHODS: A systematic review was made through a literature search in Pubmed, Medline and Web of Science of the articles published in the last 10 years (2008- 2018). We used the following key words; "stability diagnosis", AND "bipolar disorders", AND "mood disorders". We selected those studies conducted in patients who presented affective and/or psychotic clinic where the stability of the diagnosis was studied over time. RESULTS: The initial search showed a total of 140 articles, 13 of which met inclusion criteria. In this review we have found that, compared to other mental disorders, Bipolar Disorder has in its favor a greater construct validity and longterm stability. CONCLUSIONS: Initial phases of Bipolar Disorder constitute a real diagnostic and therapeutic challenge. Despite this, it is considered, added to schizophrenia as one of the most stable diagnostic categories (60% of patients who receive this initial diagnosis remain it during time). The absence of reliable and valid instruments for diagnosis is considered as a limitation so it would be convenient that in the next classifications of mental disorders they continue striving so that the nosological entities have greater construct validity possible.

Estabilidad diagnóstica en el trastorno bipolar: una revisión sistemática / Diagnostic stability in bipolar disorder: a systematic review

INTRODUCCIÓN: La estabilidad de un diagnóstico psiquiátrico en el tiempo representa la mejor prueba para validarlo y es útil para predecir el curso de un trastorno. El diagnóstico de Trastorno Bipolar presenta gran variabilidad a lo largo del tiempo y son pocas las investigaciones que han evaluado el impacto de la estabilidad diagnóstica vs su cambio. MATERIAL Y MÉTODOS: Se realizó una revisión sistemática mediante búsqueda bibliográfica en Pubmed, Medline y Web of Science de artículos publicados en los últimos diez años (2008-2018), utilizando las siguientes palabras clave: stability diagnosis, bipolar disorders y mood disorders. Se seleccionaron aquellos estudios realizados en pacientes que presentaban un cuadro afectivo y/o psicótico y en los que se estudiaba la estabilidad temporal del diagnóstico. RESULTADOS: La búsqueda inicial mostró un total de 140 artículos, de los cuales 13 cumplieron los CRITERIOS DE INCLUSIÓN: Hemos encontrado que, en comparación con otros trastornos mentales, en el Trastorno Bipolar se observa una mayor validez de constructo y estabilidad a largo plazo. CONCLUSIONES: El Trastorno Bipolar en su fase inicial constituye un desafío diagnóstico y terapéutico. Pese a ello, se considera junto con la esquizofrenia una de las categorías diagnósticas más estables (el 60% de los pacientes que reciben este diagnóstico inicial se mantiene en el tiempo). La ausencia de instrumentos fiables y válidos para el diagnóstico es considerada una limitación, por lo que sería conveniente que en sucesivas clasificaciones de los trastornos mentales sigan esforzándose en que las entidades nosológicas tengan la mayor validez de constructo posible

INTRODUCTION: Stability of a diagnosis over time rep-resents the best evidence to validate psychiatric diagnoses and helps to predict the course of a disorder. The diagnosis of bipolar disorder shows large variability over time and only a few numbers of investigations have evaluated the impact of the diagnostic stability vs the change. MATERIAL AND METHODS: A systematic review was made through a literature search in Pubmed, Medline and Web of Science of the articles published in the last 10 years (2008-2018). We used the following key words; "stability diagno-sis", AND "bipolar disorders", AND "mood disorders". We selected those studies conducted in patients who presented affective and/or psychotic clinic where the stability of the diagnosis was studied over time. RESULTS: The initial search showed a total of 140 articles, 13 of which met inclusion criteria. In this review we have found that, compared to other mental disorders, Bipolar Disorder has in its favor a greater construct validity and long-term stability. CONCLUSIONS: Initial phases of Bipolar Disorder consti-tute a real diagnostic and therapeutic challenge. Despite this, it is considered, added to schizophrenia as one of the most stable diagnostic categories (60% of patients who receive this initial diagnosis remain it during time). The absence of reliable and valid instruments for diagnosis is considered as a limitation so it would be convenient that in the next classifications of mental disorders they continue striv-ing so that the nosological entities have greater construct validity posible

Perfusión intravenosa de tiaprida en un caso de delirium resistente a tratamiento / Intravenous perfusion of tiapride in a case of treatment-resistant delirium

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