Quote:
Originally Posted by bluebicycle
That's one thing I disagree with -- the "med-induced BP". I don't think it should be considered criteria for BP... DSM-IV specifically says that med-induced BP should not count toward a diagnosis of BP, but then the DSM-V says the exact opposite.
There are some people who never get hypo/mania, but they do get it when they try an antidepressant for the first time. Then when they get off the medication and their depression goes away, they never get depressed again. Should that count toward a diagnosis of BP? I think not
IDK. I've always had qualms about that clause in DSM-V
|
The DSM has (and had in previous editions) a diagnostic hierarchy made explicit by exclusion rules in the "normative" descriptions of all mental disorders. The DSM-IV states that if a mental disorder is due to the use of substance, it should be diagnosed as such. Between parentheses it says in could be a drug of abuse, medication or something else (elsewhere it mentions toxins as another example).
The DSM-V uses a similar hierarchy and similarly explicit, but it also adds "medication" to the name of the substance induced disorders (so it becomes "substance/medication". That's a win.
The new DSM also, and this is critical, describes a med-induced BP, not just a med-induced mood disorder (which can be anything). The specificity, therefore, is greater than the BP diagnosis (arguably), while that didn't use to be the case. That's a huge win.
That the DSM-IV mentions, in a note, not the actual criteria, that a diagnosis of BP can be made is just a reminder (that's how I read it), but it doesn't really matter since it's just a note in the margin, that a history of substance use doesn't disqualify someone, that one might have BP regardless of antidepressant use.