Andi
03-04-05, 08:40 PM
About 5 percent of people are thought to experience the cycles of mania and depression that characterize bipolar disorder. But it's not clear that primary-care doctors know how to catch the disorder during routine checkups. Researchers at a clinic for low-income patients in New York City looked at how likely primary-care doctors were to diagnose the disorder.
What the researchers wanted to know: Do primary-care doctors catch bipolar disorder in routine screenings?
What they did: The researchers approached patients in the waiting room of a low-income clinic (only 20 percent of the participants had jobs) in New York City. While the patients were waiting for their doctors, the researchers pulled them aside and asked them questions about their mental health history, mood, substance use, and thoughts about suicide. Then they looked at these patients' medical records for signs that a primary-care physician had recognized either depression or bipolar disorder in the patients. Overall, 1,146 patients participated in the study.
What they found: Though researchers thought nearly 10 percent of the participants had bipolar disorder, primary-care physicians had not diagnosed the disorder in a single patient. The prevalence of bipolar disorder (9.8 percent) was very high given that most studies estimate the prevalence in the general population at somewhere below 5 percent. The researchers attribute their high number to the low income of the participants—an average of $18,000 a year—since bipolar disorder is more common among those with low incomes. Nearly three fourths of the patients who tested positive for bipolar disorder had sought help for a mental health disorder, but fewer than 9 percent had received a diagnosis of bipolar disorder (not from a primary-care physician).
What it means to you: Primary-care doctors, who are quite adept at asking patients about depression, might be much less apt to ask follow-up questions to determine if there is a manic side to their patients, indicating bipolar disorder. Common depression medications, such as serotonin reuptake inhibitors, could be dangerous for bipolar patients because these medications can exacerbate manic periods. People who have symptoms of bipolar disorder, such as cycles of depression followed by hyper or anxious times (links are given below for more information) should talk to their doctors directly rather than waiting to be asked.
Caveats: This study was done in a low-income, inner-city clinic, where bipolar disorder would be expected to be more common than in the general population. It's very unlikely that 10 percent of the general population has bipolar disorder. Second, the patient's self-reported symptoms of mania and depression can sometimes be caused by other conditions or medications, which might also lead the researchers to overstate the prevalence of bipolar disorder.
Find out more: The National Institute of Mental Health has a website that answers general questions about bipolar disorder.
The Depression and Bipolar Support Alliance has information on mood disorders, including a questionnaire to help people recognize signs of bipolar disorder.
http://www.usnews.com/usnews/health/briefs/mentalhealth/hb050223a.htm
What the researchers wanted to know: Do primary-care doctors catch bipolar disorder in routine screenings?
What they did: The researchers approached patients in the waiting room of a low-income clinic (only 20 percent of the participants had jobs) in New York City. While the patients were waiting for their doctors, the researchers pulled them aside and asked them questions about their mental health history, mood, substance use, and thoughts about suicide. Then they looked at these patients' medical records for signs that a primary-care physician had recognized either depression or bipolar disorder in the patients. Overall, 1,146 patients participated in the study.
What they found: Though researchers thought nearly 10 percent of the participants had bipolar disorder, primary-care physicians had not diagnosed the disorder in a single patient. The prevalence of bipolar disorder (9.8 percent) was very high given that most studies estimate the prevalence in the general population at somewhere below 5 percent. The researchers attribute their high number to the low income of the participants—an average of $18,000 a year—since bipolar disorder is more common among those with low incomes. Nearly three fourths of the patients who tested positive for bipolar disorder had sought help for a mental health disorder, but fewer than 9 percent had received a diagnosis of bipolar disorder (not from a primary-care physician).
What it means to you: Primary-care doctors, who are quite adept at asking patients about depression, might be much less apt to ask follow-up questions to determine if there is a manic side to their patients, indicating bipolar disorder. Common depression medications, such as serotonin reuptake inhibitors, could be dangerous for bipolar patients because these medications can exacerbate manic periods. People who have symptoms of bipolar disorder, such as cycles of depression followed by hyper or anxious times (links are given below for more information) should talk to their doctors directly rather than waiting to be asked.
Caveats: This study was done in a low-income, inner-city clinic, where bipolar disorder would be expected to be more common than in the general population. It's very unlikely that 10 percent of the general population has bipolar disorder. Second, the patient's self-reported symptoms of mania and depression can sometimes be caused by other conditions or medications, which might also lead the researchers to overstate the prevalence of bipolar disorder.
Find out more: The National Institute of Mental Health has a website that answers general questions about bipolar disorder.
The Depression and Bipolar Support Alliance has information on mood disorders, including a questionnaire to help people recognize signs of bipolar disorder.
http://www.usnews.com/usnews/health/briefs/mentalhealth/hb050223a.htm