How Do We Actually Make a Diagnosis? Lessons Learned From the Bipolar Action Network

Abstract

The Bipolar Action Network seeks to address the challenges in diagnosing bipolar disorder by bridging the gap between research and clinical practice through a systematic approach. The diagnostic method variability contributes to errors of omission, such as failing to identify hypomanic episodes in patients presenting with depression, and errors of commission, such as misinterpreting mood instability as bipolar symptoms. To improve diagnostic accuracy, the use of validated tools is encouraged, including the Composite International Diagnostic Interview (CIDI), Mood Disorder Questionnaire (MDQ), or Rapid Mood Screener (RMS), and the Bipolarity Index by Gary Sachs. These tools provide structured frameworks to cap ture the full spectrum of bipolar disorder. However, integration of these instruments into routine practice faces obstacles, such as lack of accessibility within electronic medical records and additional workload for clinicians. The Bipolar Action Network adopts a collaborative learning health network model, engaging patients, families, and clinicians to co-develop solutions. The network also prioritizes simplicity in its early phases, beginning with a user-friendly tool such as the Clinical Global Impression Scale-Severity for Bipolar Disorder. Practical concerns, including diagnosing comorbid conditions, minimizing patient burden, and streamlining workflows, remain central to ongoing efforts.