Reliability, Not Overdiagnosis

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Letter to the Editor

Sir: The recent Journal article by Zimmerman et al. does not show that bipolar disorder is overdiagnosed, because it mistakes reliability and validity. All the authors showed was that, about half the time, researchers reached different diagnoses than clinicians who had diagnosed bipolar disorder. This merely reflects interrater diagnostic reliability, a long-established issue in epidemiology.

J Clin Psychiatry 2009;70(4):603