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CPA Bulletin: Psychiatric Diagnosis and the Bipolar Spectrum Over the years, psychiatry has been susceptible to diagnostic fads. Some of these have been based on theory (overdiagnosis of schizophrenia) or on etiological concepts (overdiagnosis of posttraumatic stress disorder), while others have been based on treatment considerations. Since the introduction of lithium several decades ago, psychiatrists have tended to diagnose bipolar disorder much more frequently. Even after standard diagnostic criteria for schizophrenia were introduced (1), there was a tendency to change the diagnosis of patients with schizophrenia to bipolar disorder. Patients with borderline personality disorder who suffer from frequent mood swings have also been seen as falling within the spectrum of bipolar illness (2). Over the years, psychiatry has been susceptible to diagnostic fads. Some of these have been based on theory (overdiagnosis of schizophrenia) or on etiological concepts (overdiagnosis of posttraumatic stress disorder), while others have been based on treatment considerations. Since the introduction of lithium several decades ago, psychiatrists have tended to diagnose bipolar disorde with diagnosticfadsoverdiagnosispsychiatryschizophreniasusceptibletheoryyears