Bipolar Diagnosis Rules Have Been Changed

Well, that might be a bit of an overstatement. But that's journalism, right?

Here's what really happened. The International Society for Bipolar Disorders (ISBD) is a group of researchers and clinicians interested in bipolar disorder, with members from all around the world. The leadership of this organization decided several years ago that we needed an update on the DSM (Diagnostic and Statistical Manual), because the next edition of that official rulebook won't come out for another three or four years.

The current DSM was written about 15 years ago. You would hope that by now we might have some additional insight into the nature of bipolar disorder and how it should be diagnosed.

So the ISBD commissioned 25 mood specialists to look at the existing literature on bipolar disorder and make recommendations in a different areas of controversy: mixed states, Bipolar II, bipolar depression (how is it different, if at all, from unipolar depression?), rapid cycling, children and adolescents, and the "bipolar spectrum" perspective.

For intrepid interested readers, I have posted a summary of these guidelines, with the relevant links, on my PsychEducation website. The bottom line, from my point of view: virtually all of the papers prepared by this committee of bipolar specialists acknowledge that the DSM system of discrete categories -- in which one either has unipolar depression, for example, or bipolar depression, but nothing in between -- is causing some trouble. While switching over to a "spectrum" perspective, as reflected on my website, is not a solution either (all sorts of logistic problems would follow), the validity of that way of thinking is supported by the work of these experts.

Dr. Phelps

So although the official rules for bipolar diagnosis have not literally changed, an important update on those rules has been issued. Anyone who depends on the rule system -- which hopefully includes a broad array of patients and practitioners -- should be interested in further details on the work of the ISBD Committee on Diagnosis. Here is the summary link again.