{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:13:18Z","timestamp":1786119198027,"version":"build-2736575974"},"reference-count":21,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Bipolar I Disorder (BP\u2010I) is frequently misdiagnosed as Major Depressive Disorder (MDD), delaying appropriate treatment. This study aimed to examine treatment patterns among BP\u2010I patients misdiagnosed with MDD and assess the impact of these regimens on the time until BP\u2010I diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted using the MarketScan Commercial Claims and Encounters database, analyzing 21,771 BP\u2010I patients initially misdiagnosed with MDD and 50,667 correctly diagnosed BP\u2010I patients. Treatment patterns and their influence on time to BP\u2010I diagnosis were assessed using multinomial logistic regression and Cox proportional hazards models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the misdiagnosed cohort, 25.1% were initially started on antidepressant monotherapy, with 8.7% continuing this regimen after BP\u2010I diagnosis. In contrast, 7.6% of the initially BP\u2010I diagnosed cohort received antidepressant monotherapy. The time to BP\u2010I conversion was shortest for those on mood stabilizer monotherapy (HR: 1.26, 95% CI: 1.19\u20131.34,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), compared to those on antidepressant monotherapy. After BP\u2010I diagnosis, patients originally misdiagnosed with MDD had different prescribing patterns, exhibiting lower rates of guideline\u2010consistent treatments. Specifically, patients initially diagnosed with BP\u2010I were more likely to receive mood stabilizing therapy, either as monotherapy (OR\u2009=\u20092.63,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) or in combination with an antidepressant (OR\u2009=\u20091.84,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Misdiagnosis of BP\u2010I as MDD leads to significant delays in accurate diagnosis and inappropriate treatment regimens, highlighting the critical need for improved diagnostic accuracy at initial presentation. Prompt and accurate BP\u2010I diagnosis can optimize treatment approaches and improve patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bdi.70137","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T06:53:12Z","timestamp":1782888792000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Psychotropic Prescribing Patterns Among Bipolar\u2010I Patients Prior to Established Bipolar\u2010I Disorder Diagnosis"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-9890-7827","authenticated-orcid":false,"given":"Filmon","family":"Haile","sequence":"first","affiliation":[{"name":"Department of Pharmacy CHOICE Institute University of Washington, School of Pharmacy  Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7999-5191","authenticated-orcid":false,"given":"Clayton","family":"English","sequence":"additional","affiliation":[{"name":"Department of Pharmacy CHOICE Institute University of Washington, School of Pharmacy  Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyueun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pharmacy CHOICE Institute University of Washington, School of Pharmacy  Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2012.06.010"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.18.4.233"},{"issue":"10","key":"e_1_2_8_4_1","first-page":"57","article-title":"Misdiagnosis of Bipolar Disorder","volume":"3","author":"Singh T.","year":"2006","journal-title":"Psychiatry (Edgmont)"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/acps.13490"},{"issue":"10","key":"e_1_2_8_6_1","first-page":"57","article-title":"Misdiagnosis of Bipolar Disorder","volume":"3","author":"Singh T.","year":"2006","journal-title":"Psychiatry (Edgmont (Pa.: Township))"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.4088\/PCC.10r01097"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2022.07.069"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2017.09.011"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.62.6.617"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.4088\/PCC.13r01609"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.4088\/PCC.9064su1c.01"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.09r05385gre"},{"key":"e_1_2_8_14_1","unstructured":"CAMH \u201cMood Stabilizing Medications \u201d(2012) https:\/\/www.camh.ca\/en\/health\u2010info\/mental\u2010illness\u2010and\u2010addiction\u2010index\/mood\u2010stabilizing\u2010medication."},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102015\u2010008341"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.20230477"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.4103\/0019\u20105545.196974"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2011.15"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.13135"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399\u20105618.2007.00559.x"},{"issue":"2","key":"e_1_2_8_22_1","article-title":"Screening for Bipolar I Disorder and the Rapid Mood Screener: Results of a Nationwide Health Care Provider Survey","volume":"25","author":"Thase M. 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