Perceptions and impact of bipolar disorder: how far have we really come? Results of the national depressive and manic-depressive association 2000 survey of individuals with bipolar disorder.

By R. Hirschfeld, L. Lewis, L. Vornik. Journal of Clinical Psychiatry, 2003

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The HCL-32: towards a self-assessment tool for hypomanic symptoms in outpatients. (2005, methodology): “TheMDQwas tested first in a tertiary care clinical sample and showed a sensitivity of 73% and a specificity of 90% (two thirds of the sample had BP-I); in a population sample (Hirschfeld et al., 2003a) the sensitivity was 28% and the specificity was 97% for BP.”
Long-term implications of early onset in bipolar disorder: data from the first 1000 participants in the systematic treatment enhancement program for bipolar disorder (STEP-BD). (2004, result): “Indeed, in our cohort, the mean age of onset is somewhat earlier than in other reports (Bellivier et al 2003), though more similar to patient self-report (Hirschfeld et al 2003).”
Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder (2018, background): “Indeed, many individuals are not accurately diagnosed until up to 10 years after onset of symptoms with on to four alternate diagnoses typically being given prior to correct recognition and treatment (34) (35).”