False Positive Diagnosis of Mood Disorders in an Objective Structured Clinical Examination Setting

Objective: Given that the topic of bipolar disorder overdiagnosis has been relatively neglected in the literature and considering its significance in psychiatric training. The present study was conducted through an Objective Structured Clinical Examination (OSCE) on psychiatric residents to assess the validity of their clinical diagnosis.

Methods: Twenty forth residents participated in the examination. The first station (the mood disorder station) was designed to explore clinical skill of psychiatric residents in diagnosing major depressive disorder through a clinical interview with a simulated patient. The rating checklist to evaluate the residents included 11 items. Each item was scored on a Likert scale. Two raters completed the checklists independently

Results: Out of 24 residents, 15 individuals (62.5%) diagnosed major depressive disorder accurately and 9 individuals (37.5%) diagnosed bipolar disorder instead of major depressive disorder. The score of the last psychiatric written exam (p<0.05), the mean score of OSCE on the mood disorder station (p<0.001), and the total score of the OSCE (six stations) (p=0.09) were significantly higher in the group who correctly diagnosed major depressive disorder than the group who did not.

Conclusion: Current study provides evidence for bipolar disorder overdiagnosis and opens up new scopes for improvement in psychiatric training