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- Title
Screening for Bipolar Disorder in a Primary Care Practice.
- Authors
Das, Amar K.; Olfson, Mark; Gameroff, Marc J.; Pilowsky, Daniel J.; Blanco, Carlos; Feder, Adriana; Gross, Raz; Neria, Yuval; Lantigua, Rafael; Shea, Steven; Weissman, Myrna M.
- Abstract
Context Bipolar disorder consists of episodes of manic and depressive symptoms. Efforts to screen for depression in a primary care setting without assessment of past manic symptoms can lead to incorrect diagnosis and treatment of bipolar disorder. Objectives To screen for bipolar disorder in adult primary care patients and to examine its clinical presentation and effect on functioning. Design, Setting, and Participants A systematic sample of 1157 patients between 18 and 70 years of age who were seeking primary care at an urban general medicine clinic serving a low-income population. The study was conducted between December 2001 and January 2003. Main Outcome Measures Prevalence of bipolar disorder, its treatment and patient functioning. Study measures included the Mood Disorder Questionnaire, the PRIME-MD Patient Health Questionnaire, the Medical Outcomes Study 12-Item Short Form health survey, the Sheehan Disability Scale, data on past mental health treatments, and a review of medical records and International Classification of Diseases, Ninth Revision codes for each visit dating from 6 months prior to the screening day. Results The prevalence of receiving positive screening results for lifetime bipolar disorder was 9.8% (n = 112; 95% confidence interval, 8.0%-11.5%) and did not differ significantly by age, sex, or race/ethnicity. Eighty-one patients (72.3%) who screened positive for bipolar disorder sought professional help for their symptoms, but only 9 (8.4%) reported receiving a diagnosis of bipolar disorder. Seventy-five patients (68.2%) who screened positive for bipolar disorder had a current major depressive episode or an anxiety or substance use disorder. Of 112 patients, only 7 (6.5%) reported taking a mood-stabilizing agent in the past month. Primary care physicians recorded evidence of current depression in 47 patients (49.0%) who screened positive for bipolar disorder, but did not record a bipolar disorder diagnosis either in administrative billing o...
- Subjects
BIPOLAR disorder; DIAGNOSIS; PEOPLE with bipolar disorder; PRIMARY care; MEDICAL screening; MEDICAL informatics; MEDICAL history taking; QUESTIONNAIRES; HEALTH surveys; HEALTH outcome assessment
- Publication
JAMA: Journal of the American Medical Association, 2005, Vol 293, Issue 8, p956
- ISSN
0098-7484
- Publication type
Article
- DOI
10.1001/jama.293.8.956