The limits of bipolar disorder can be difficult to trace and they merge with other syndromic groups, and this is a diagnostic and therapeutic challenge. Indeed, an early diagnosis can reduce the duration and severity of the episodes as well as the risk of suicide.

The objective of our study was to determine the different clinical diagnoses made before the bipolarity and the main therapeutic errors and their consequences.

This is a retrospective descriptive study based on the records of bipolar patients hospitalized . Data were collected using a medical form assessing sociodemographic and clinical data, the diagnoses obtained before the bipolarity, corollaries therapeutic conducts and the time required to adjust the diagnosis.

Seventy cases of bipolar patients hospitalized in our department were reviewed.

• In 28.5% of cases, the first retained diagnosis was other than bipolar disorder: the most frequent initial diagnosis was major depressive disorder (35%), followed by a not specified psychotic disorder (25%), schizophrenia (12.1%) of personality disorder (10%) and substance abuse (6.3%).

• An average of eight years was necessary for the diagnosis of bipolar disorder, starting from the first hospitalization.

• In over 60% of the cases, treatment with incisive antipsychotic was introduced and lasted more than six months. An antidepressant was prescribed in 35% of the cases. The prescription of mood stabilizers was absent in the majority of cases (> 70%).

In one third of the cases, the diagnosis of bipolar disorder is delayed causing an inadequate therapy management.