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The Differential Diagnosis of Multiple Sclerosis and Bipolar Disorder

J Clin Psychiatry 1997;58(3):123 [letter]

Letter to the Editor

Sir: Pine et al. described a series of patients hospitalized for mania who were also found to have multiple sclerosis, thus reminding us of the importance of considering multiple sclerosis in patients presenting with psychiatric symptoms plus neurologic abnormalities. We present a case illustrative of this point, yet raise the issue that magnetic resonance imaging (MRI) findings, commonly used to differentiate bipolar disorder from multiple sclerosis, are similar for both disorders. This complicates diagnosis and points to a similar etiology for symptoms that overlap both bipolar illness and multiple sclerosis.