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91. Heuristic bias in diagnosing bipolar disorder: Evidence from Korea in favor of weighting model
The DSM adopts a polythetic model of diagnostic decision making. However, previous research indicated that clinicians might rather follow a weighting model (presence of prototypical symptoms) in diagnosing bipolar disorder (BD). This may contribute to underdiagnosis of BD. The present study investigated if Korean clinical psychologists (N=202) were also susceptible to such diagnostic bias. Participants were instructed to make a diagnostic decision after reading a case vignette. All four vignettes described a case with BD according to the DSM-5 criteria; however, they varied in terms of presence/absence of decreased sleep need and life event (causal explanation). There were two major findings. First, contrary to previous research in which only a minority diagnosed BD, most Korean clinical psychologists (88%) diagnosed BD. Second, the case vignettes with the ‘decreased need for sleep’ had a higher likelihood of BD diagnosis, replicating previous research. Meanwhile, presence/absence of life event did not systematically affect the diagnostic decision. In summary, these results add support for the notion that presence of a prototypical symptom affects likelihood of BD diagnosis, nevertheless the total number of symptoms was equal. In addition, increased overall rate of BD diagnosis may suggest better recognition of BD lately.