Can the MiniSCID improve the detection of bipolarity in private practice?
BACKGROUND
Several recent studies have re-examined the prevalence of Bipolar Disorder, raising the suspicion that it is being underdiagnosed, particularly early in the course of the disease. The MiniSCID is a screening instrument for Axis-I diagnoses.


METHODS
A chart review was performed on all 1161 active patients seen in an outpatient setting. Data collected included demographic information, initial clinical diagnosis, current clinical diagnosis, MiniSCID diagnoses, and SCL-90 results.


RESULTS
Of the 796 patients who had taken the MiniSCID at their initial visit, 256 have a current clinical diagnosis of Bipolar Disorder, and 540 have a nonbipolar diagnosis. They were seen over an average period of 5.3 years. The MiniSCID had a sensitivity of 0.58 and a specificity of 0.63 in predicting a current diagnosis of bipolar disorder. There are 201 patients who endorsed current or past mania/hypomania on the MiniSCID, yet have a current clinical diagnosis of a nonbipolar illness. These patients had a SCL-90 profile that was much closer to those of bipolar patients than those of unipolar patients.


CONCLUSIONS
The major limitation is the reliability and validity of the MiniSCID.


CONCLUSIONS
There is a large group of patients who are potentially bipolar, but are not yet clinically diagnosed as such. Several factors relating to this finding are discussed. The use of MiniSCID and SCL-90 as an in-office-screening tool can improve recognition of Bipolar illness.
Nasr
Suhayl
S
sjnasr@msn.com
Popli
Anand
A
Wendt
Burdette
B
D000328:Adult; D000553:Ambulatory Care / Q000379:methods*; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006801:Humans; D008297:Male; D011331:Private Practice / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D011570:Psychiatry / Q000379:methods* / Q000706:statistics & numerical data; D011594:Psychometrics; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity