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Schizophrenia Bulletin Advance Access originally published online on June 11, 2007
Schizophrenia Bulletin 2007 33(4):886-892; doi:10.1093/schbul/sbm057
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© 2007 The Authors
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.0/uk/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Deconstructing Bipolar Disorder: A Critical Review of its Diagnostic Validity and a Proposal for DSM-V and ICD-11

Eduard Vieta1,2 and Mary L. Phillips3
2 Bipolar Disorders Program, Institute of Neuroscience, University of Barcelona Hospital Clinic, IDIBAPS, ISCIII-RETIC RD06/0011 (REM-TAP Network), Rossello 140, Barcelona 08036, Catalonia, Spain
3 Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, PA

1 To whom correspondence should be addressed; tel: +34932275401, fax: + 34932279876, e-mail: evieta{at}clinic.ub.es.

The development of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and International Classification of Diseases, Eleventh Edition, deserves a significant conceptual step forward. There is a clear need to improve and refine the current diagnostic criteria, but also to introduce dimensions, perhaps not as an alternative but rather as a useful complement to categorical diagnosis. Laboratory, family, and treatment response data should also be systematically included in the diagnostic assessment when available. We have critically reviewed the content, concurrent, discriminant, and predictive validity of bipolar disorder, and to overcome the validity problems of the current classifications of mental disorders, we propose a modular system which may integrate categorical and dimensional issues, laboratory data, associated nonpsychiatric medical conditions, psychological assessment, and social issues in a comprehensive and nevertheless practical approach.

Keywords: bipolar disorder / classification / diagnosis / DSM-V / ICD-11


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