Cegla-Schvartzman F, Ovejero S, López-Castroman J, et al. - Via this longitudinal study, researchers described common diagnostic practices in outpatient settings in community mental health centers over a 30-year period (130,000 patient-years).

• Data on all outpatient visits performed at Madrid’s Community Mental Healthcare Centers between 1980–2009 were retrieved from the Cumulative Register of Cases of the Community of Madrid.

• ICD-9/ICD-10 criteria were used to make diagnoses.

• BD was diagnosed in 14,557 patients for at least 1 evaluation and these patients had at least 10 visits and 1 year of follow-up.

• Findings revealed delay of > 10 years in achieving diagnostic stability.

• There were frequent diagnostic shifts in relation to BD, the most common being with other affective disorders.

• Also, a common misdiagnosis was anxiety.

• Having been diagnosed after hospitalization, having an age at onset > 25 years, and having an age at diagnosis < 24 years were noted to be linked with greater stability.