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DOI: 10.1111/j.1600-0447.2006.00908.x

Invited comment

The case report by Xu and colleagues nicelyillustrates critical issues relevant to the correctdiagnosis and management of bipolar disorder.Firstly, it highlights the �imprecision of currentdiagnostic criteria� and adds to the growingevidence suggesting that misdiagnosis of bipolardisorder II is perhaps more common than realizedand, if so, possibly leads to ineffective therapeuticinterventions which in some cases may retard oreven worsen the outcome. Secondly, it emphasizesthe need for �greater awareness of potential organicetiology� in psychiatric symptoms and argues forthe use of modern imaging techniques in minim-izing misdiagnosis of psychiatric disorders in clin-ical settings.At present, the role of neuroimaging is limited to

that of a research tool helping to understand the

development and course of bipolar disorder (1, 2).It is hoped that, supported and guided by suchempirical data, it would make its way into clinicalpractice and help to establish or rule out certainpsychiatric diagnoses, as well as to formulate andmonitor appropriate treatment strategies, over thecoming years.

Veena KumariKing’s College London

Institute of Psychiatry, Department of Psychology,PO78

London SE5 8AF, UK

References

1. Bruno SD. Neuroimaging of bipolar disorder: emphasis onnovel MRI techniques. Epilepsia 2005;46(Suppl. 4):14–18.

2. Hajek T, Carrey N, Alda M. Neuroanatomical abnormalitiesas risk factors for bipolar disorder. Bipolar Disord2005;7:393–403.

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