Multi-Modal Investigation of Reward-Related Brain Function and Bipolar Disorder Symptoms

Bipolar disorder is associated with significant work impairment, high rates of divorce and substance abuse, a 10-year earlier mortality rate, and leads to suicide in nearly one out of every five diagnosed individuals.1,2 Despite the severity of this illness, bipolar disorder is either frequently misdiagnosed, or there is a lengthy time period from the point of illness onset to correct diagnosis. Delays ranging from 6 to 10 years or longer have been reported before individuals with bipolar disorder receive an accurate diagnosis and appropriate treatment.3 Data from the National Depressive and Manic Depressive Association4 survey indicate that close to 70% of individuals with bipolar disorder are initially misdiagnosed, with the most frequent misdiagnosis being major depressive disorder (MDD) (60%). The misdiagnosis of bipolar disorder not only delays administration of appropriate treatment but may have a deleterious effect on the course of bipolar disorder given research suggesting that antidepressant medications typically used for treating MDD may be a risk factor for ‘switching’ into hypomanic/manic episodes among individuals at risk for bipolar disorder.3