Bipolar Disorder in Primary Care

bipolar disorder in primary care

We know from conversations with many of the primary care practices we serve that the Bipolar Disorders (BP) are among the psychiatric conditions for which primary care clinicians often seek psychiatric support. The table to the right presents data from the National Institutes of Health regarding prevalence of BP in the general population. 

Drilling down a bit, research also indicates that prevalence of BP in a primary care patient panel may be somewhat higher than in the general population (somewhere between .5 - 4.3% across studies), suggesting that in a patient panel of about 2,200 unique patients, as many as 108 of them might benefit from treatment for BP (Cerimele, et al. 2014).

Also, and probably of particular note, is the finding that many patients with BP report symptoms to their primary care providers that might well lead to a different diagnosis and to (probably ineffective) treatment of a different psychiatric condition. For example, Chiu, et al., (2011) found that among patients in primary care settings who reported past or current symptoms of depression, anxiety, substance abuse or attention deficit disorder, 27.9% screened positive for BP on a standardized and validated screening measure.

Data like those suggest the considerable importance - in terms of accurate diagnosis and guideline-concordant treatment - of screening, decision support, and psychiatric involvement for patients with known or suspected BP in the primary care setting, or for patients who report symptoms of other psychiatric conditions which don't seem to quite fit your sense of the patient. For a look at a validated and widely used screen for Bipolar Disorder, click this link to the Mood Disorders Questionnaire (MDQ)

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