LATE DIAGNOSIS IN BIPOLAR AFFECTIVE DISORDER: ASSOCIATED FACTORS AND CLINICAL IMPACT

Abstract

Introduction: Bipolar Affective Disorder (BAD) refers to a chronic, recurrent, and severe psychiatric condition characterized by intense mood swings, varying between episodes of mania, hypomania, and depression. Even though it is widely recognized by the scientific community, BAD still faces challenges regarding its correct diagnosis, which can be confused with other psychiatric conditions such as depression, schizophrenia, and personality disorders, potentially compromising the effectiveness of treatment and improving the quality of life of patients (Bosaipo et al., 2017). Objective: To analyze the associated factors and clinical impact of late diagnosis in Bipolar Affective Disorder. Methodology: This is a narrative literature review; the search for relevant studies was conducted in the following electronic databases: MEDLINE/PubMed (Medical Literature Analysis and Retrieval System Online); LILACS (Latin American and Caribbean Literature in Health Sciences); SCIELO (Scientific Electronic Library Online); Cochrane Library; PsycINFO; EMBASE (Excerpta Medica Database); Web of Science. Results and Discussion: The studies found show that worldwide, the maximum age of onset of severe psychotic symptoms, such as bipolar disorder and psychosis, occurs in late adolescence and early adulthood. Bipolar disorder generally presents with a fluctuating nature and associated morbidity, such that outpatients and inpatients remain symptomatic for up to 2/3 of the follow-up period. If this symptom appears in childhood, its development is generally more severe. This has serious financial and social consequences for affected individuals, who are frequently dismissed from their jobs. Furthermore, late diagnosis is associated with more pronounced cognitive impairment, particularly in patients with recurrent manic episodes. Final Considerations: It is concluded that the prognosis and quality of life are better for patients diagnosed with bipolar disorder when detected in the early stages of development compared to patients diagnosed with the disease in advanced stages.