How reliable do you find it to make the diagnosis of bipolar disorder based on a patient report of prior symptoms or questionnaire and not the actual observation of hypo/mania on the exam?

I agree that direct observation is always nice, but we certainly don't want to wait for a manic episode to determine the correct diagnosis. I find that by asking lots of detailed questions, most people who have experienced and manic episode can report enough history to correctly. Identify the episod...

Of course, direct observation is the most reliable way to diagnose a patient with bipolar disorder. Self-report can be less reliable especially if the described symptom of hypomania/mania is in the distant past. I find that patients are least likely to describe past periods of paranoia, intense irri...