Misdiagnosis of bipolar disorder as borderline personality disorder: clinical and economic consequences.
We report the case of a 26-year-old patient with bipolar spectrum disorder who was misdiagnosed with borderline personality disorder. In spite of trials of various psychotropic drugs and frequent, prolonged hospitalizations, the patient had remained chronically symptomatic. Following a detailed examination of the longitudinal illness course and confirmation of the diagnosis of bipolar spectrum disorder, antidepressants were discontinued and the patient was treated with lamotrigine and quetiapine. This treatment resulted in sustained euthymia and cessation of deliberate self-harm in addition to a significant reduction in utilization of health resources.
John
Hyacinth
H
Department of Psychiatry, University of Western Ontario, London, Ontario, Canada.
Sharma
Verinder
V
D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000191:economics / Q000523:psychology; D001883:Borderline Personality Disorder / Q000175:diagnosis* / Q000191:economics / Q000523:psychology; D003365:Costs and Cost Analysis; D003951:Diagnostic Errors; D016527:Drug Costs / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000191:economics; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D010343:Patient Admission / Q000191:economics / Q000706:statistics & numerical data; D011619:Psychotropic Drugs / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D017211:Treatment Failure
D011619:Psychotropic Drugs