Estabilidad diagnóstica del Trastorno Bipolar. Una revisión sistemática.
Palabras clave:
Bipolar disorder, stability, review, mood disorders, diagnosisResumen
Introducción.
El Trastorno Bipolar (BD) es una enfermedad mental grave y recurrente. Por tanto, una vez establecido el diagnóstico, éste debe ser estable en el tiempo. Las dificultades diagnósticas complican el estudio epidemiológico de este trastorno, pero en general se acepta una prevalencia entre el 1-2%. Son pocas las investigaciones que han evaluado el impacto de la estabilidad diagnóstica vs su cambio.
Material y Métodos.
Se realizó una revisión sistemática mediante búsqueda bibliográfica en Pubmed, Medline y Web of Science de artículos publicados hasta la fecha, utilizando las siguientes palabras clave: stability diagnosis, bipolar disorders y mood disorders. Se seleccionaron aquellos estudios que se centraban en el estudio de la estabilidad diagnóstica del trastorno bipolar tanto en adultos como en niños o adolescentes.
Resultados.
La búsqueda inicial mostró un total de 323 artículos, de los cuales 8 cumplieron los criterios de inclusión. Hemos encontrado que, en comparación con otros trastornos mentales, en el BD se observa una mayor validez de constructo y estabilidad a largo plazo. los estudios coinciden en la estabilidad de alrededor del 90% o más en el diagnóstico del BD tanto en población infantil como adulta.
Conclusiones
El Trastorno Bipolar en su fase inicial constituye un desafío diagnóstico y terapéutico. Pese a ello, se considera junto una de las categorías diagnósticas más estables. La ausencia de instrumentos fiables y válidos para el diagnóstico es considerada una limitación, que condiciona el curso y evolución de la enfermedad. Para investigaciones futuras es importante conseguir la mayor validez posible como constructo del BD.
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