Over-diagnosing Bipolar Disorder; History, Causes and Forensic Consequences
Roberto Flores de Apodaca

Abstract
What was once classified some 60 years ago as a “Manic-Depressive Psychosis” and considered a rare disorder affecting only adults has come to represent one point along a broad spectrum of presumptively kindred conditions ranging from the mild to the severe, afflicting infants to adults. The formal definitions have expanded over the various editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM). Along with a number of earlier authors, we maintain that there has been an overexpansion of this diagnosis on the basis of theory rather than scientific findings. The reasons for this overexpansion have included; the advent of managed care (with its economic incentives to certain remunerable conditions, and pressure to treat conditions with medications whenever possible), the development of effective medications for use with genuine Bipolar Disorders, and an unconscious collusion between therapists and patients for the over-diagnosing of Bipolar Disorder, which ostensibly (but actually does not) serve the needs of both groups. This phenomenon of over-diagnosing can have adverse consequences in the forensic arena when individuals are given a Bipolar Disorder diagnosis they do not warrant. Two case examples from the criminal arena are provided; both confounded the legal process with one “favoring” Defense and the other the Prosecution.

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