8th Mar 2011
AT LEAST one in 30 patients who are currently being treated for unipolar depression may have unrecognised bipolar disorder, a UK-based study of primary care patients suggests.
Australian experts said the results were likely to be relevant here, and highlighted the importance of screening all patients who present with depressive symptoms.
Professor Gordon Parker, director of the Black Dog Institute, Sydney, and Dr Paul Morgan (PhD), deputy director of Sane Australia, said the majority of missed cases were likely bipolar II.
“The interval from the onset of symptoms to diagnosis is 10 to 20 years,” Professor Parker said.
“People tend to enjoy their highs and they only come along when they’re depressed. They don’t talk about the highs, and often they’re not asked about them.”
Dr Morgan said more than one-half of patients who have bipolar disorder were originally misdiagnosed with something else and were often prescribed antidepressants rather than a mood stabiliser.
Antidepressants “may be unhelpful by causing suicidal behaviour, treatment resistance and more frequent cycling of mood episodes”, the study authors wrote.
The Australian experts said tools such as the self-test on the Black Dog website or the Mood Disorder questionnaire could assist in screening, but patient history and asking “pointed questions” was vital.
Br J Psychiatry 2011, in press
