title: Frequency of bipolar affective disorder in patients with major depressive episode with or without psychiatric co-morbid disorders.
abstract: BACKGROUND
  Epidemiological studies indicate that only 20% of patients with Bipolar Affective Disorder are diagnosed on time while in 35% of patients diagnosis is 10 years late. Unipolar depression represents the most frequent misdiagnosis.
  
  
  OBJECTIVE
  The aim of this study was to determine the frequency of BAD in subjects diagnosed with Major Depressive Episode with or without co-morbid disorders.
  
  
  METHODS
  The study was a part of a large international, multi-center, non-interventional study that was conducted in 14 countries between May and November 2008. Sample in Bosnia and Herzegovina included 200 adult subjects with MDE according to the DSM IV diagnostic criteria who consented to take part in the study, who did not exhibit symptoms of acute somatic condition at the time, and who were capable of filling the HCL-32 checklist.
  
  
  METHODS
  The following assessment instruments were used: CRF (Case Report Form) that includes general psychiatric assessment, GAF (Global Assessment of Functioning) and HCL-32 (Hypomania Symptom Checklist).
  
  
  RESULTS
  Bipolar Affective Disorder was diagnosed in 67.84% of the study subjects, and MDE in 32.16%. At least one co-morbid psychiatric disorder was present in 77.78% of subjects with BAD and in 22.22% of subjects with MDE. Anxiety disorders co-morbidity was present in 61.9% of subjects with BAD and in 38.10% of subjects with MDE.
  
  
  CONCLUSIONS
  Our results confirm previous research about underdiagnosing of BAD. This has unforeseen consequences on the course and prognosis of the disorder significantly affecting quality of life of the patients.
authors.affiliation: Department of Psychiatry, University of Sarajevo Clinical Center, Bolnička 25, 71 000 Sarajevo, Bosnia and Herzegovina. adokucukalic@hotmail.com
authors.forename: Abdulah
authors.initials: A
authors.lastname: Kučukalić
authors.forename: Alma
authors.initials: A
authors.lastname: Bravo-Mehmedbašić
authors.forename: Alma Džubur
authors.initials: AD
authors.lastname: Kulenović
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000453:epidemiology*; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D011569:Psychiatric Status Rating Scales; D013997:Time Factors