While bipolar disorder is something we all encounter in practice, views are mixed as to how best to diagnose and treat it. In this issue of TCPR,Drs Amos and James argue that bipolar disorder is over-diagnosed and the introduction of “soft” criteria may contribute to a worsening of this trend. On the other hand, Dr Baldassano argues that expanded criteria are necessary to treat certain populations more effectively, such as those with bipolar depression.
As with much in psychiatry, there are no easy answers—and, unlike the rest of medicine, no objective diagnostic tests—and even experts may interpret the same phenomena differently. What matters most is that we offer our patients the care they need, in a fashion that is motivated neither by ideology nor by a blind adherence to “evidence.” We trust the reader to synthesize the views expressed here into a treatment approach that works best for his or her patients.