Diagnostic disagreements in bipolar disorder: the role of substance abuse comorbidities.

Substance abuse can produce symptoms similar to other psychiatric disorders, thus confusing the diagnostic picture. This paper attempts to elucidate how misdiagnosis in bipolar disorder might be explained by the presence of substance abuse comorbidities. The overlap of symptoms, limited information about symptom onset, and inexperienced clinicians can result in the misinterpretation of symptoms of substance abuse disorders for bipolar disorder. The present study found that the presence of a substance abuse comorbidity, the polarity of last episode (depressed, manic, mixed, not otherwise specified), and the total number of comorbidities affected the reliability of a bipolar disorder diagnosis.