School of Psychiatry, University of New South Wales, Sydney, Australia.
Acta Psychiatr Scand. 2013 May;127(5):381-93. doi: 10.1111/acps.12005. Epub 2012 Aug 20.
The World Mental Health Version of the Composite International Diagnostic Interview (WMH-CIDI) DSM-IV bipolar disorder diagnostic algorithms were recalibrated in about 2006 following evidence of over-diagnosis of bipolar I disorder. There have been no reports of the impact of this recalibration on epidemiological findings.
Data were taken from the 2007 Australian National Survey of Mental Health and Wellbeing. Findings for cases identified by the recalibrated bipolar disorder definition were contrasted against those identified by the un-recalibrated definition.
The 12-month prevalence of recalibrated bipolar disorder and un-recalibrated bipolar disorder were 0.9% and 1.7% respectively. The un-recalibrated bipolar disorder group was younger and more likely to have never married than the recalibrated bipolar disorder group. They were also more likely to have a comorbid alcohol use disorder, substance use disorder and asthma or arthritis. While they were more likely to have at least severe interference in at least one of the Sheehan Scale domains of functioning, they were less likely to have made a suicide attempt. Similarly, they were less likely to have consulted a psychiatrist.
It is not possible to be certain about the nature of these differences. Some may be artifactual (reflecting greater statistical power to detect differences with the larger un-recalibrated bipolar disorder defined sample), while others may be indicative of the inclusion of a clinically distinct subpopulation with the un-recalibrated bipolar disorder definition, thereby producing a more heterogeneous sample. These findings indicate the need for clarity in the diagnostic algorithm used in epidemiological reports on bipolar disorder using the World Mental Health Version of the Composite International Diagnostic Interview.
世界心理健康版复合国际诊断访谈（WMH-CIDI）DSM-IV 双相障碍诊断算法在大约 2006 年进行了重新校准，原因是双相 I 型障碍的诊断过度。目前还没有关于这种重新校准对流行病学发现的影响的报告。
数据来自 2007 年澳大利亚国家心理健康和幸福感调查。对比了根据重新校准的双相障碍定义和未经重新校准的定义确定的病例的发现。
重新校准的双相障碍和未经重新校准的双相障碍的 12 个月患病率分别为 0.9%和 1.7%。未经重新校准的双相障碍组比重新校准的双相障碍组年龄更小，未婚的可能性更大。他们也更有可能同时患有酒精使用障碍、物质使用障碍、哮喘或关节炎。虽然他们在至少一个 Sheehan 量表功能领域至少有严重的障碍，但他们自杀未遂的可能性较小。同样，他们咨询精神科医生的可能性较小。
目前尚无法确定这些差异的性质。有些可能是人为的（反映出使用未经重新校准的较大双相障碍定义样本更有统计学能力来检测差异），而另一些则可能表明包括未经重新校准的双相障碍定义中具有临床特征的亚人群，从而产生更具异质性的样本。这些发现表明，在使用世界心理健康版复合国际诊断访谈报告双相障碍的流行病学报告中，需要明确诊断算法。
