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Unrecognized bipolar disorder in primary care patients with depression

According to a study published in the British Journal of Psychiatry, As many as 1 in 5 people being treated for depression in primary care could have undiagnosed bipolar disorder.

Individuals who were being treated for depression (n=3,117) by their general practitioners in the UK were asked to take part in the study. In total, 576 completed a questionnaire to determine if they had symptoms of bipolar disorder. 370 were then invited for an in-person clinical assessment, and 154 agreed. The researchers found that 29 of the 154 people assessed (18.8%) met the diagnostic criteria for bipolar disorder.

The authors concluded that a more realistic estimate of between 3.3 and 21.6% of primary care patients with unipolar depression may have an undiagnosed bipolar disorder and believe that screening questionnaires may be useful for detecting a broader definition of bipolar disorder especially in primary care. The implications of these finding are important for the way depression is diagnosed and treated in primary care.  Lead author DJ Smith pointed out that “we know that many patients with bipolar disorder are not correctly diagnosed for many years. It’s therefore important that the possibility of undiagnosed bipolar disorder is given greater recognition in primary care, and that GPs are supported in developing strategies to ensure that their patients with depression receive the correct diagnosis.”

Smith DJ, Griffiths E, Kelly M, Hood K, Craddock N and Simpson SA. Unrecognised bipolar disorder in primary care patients with depression. Br J Psychiatry. 2011 Feb
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