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Rapid Screening Tool Can Flag Bipolar Depression in Primary Care

September 21, 2020

Although a quarter of patients presenting with depressive symptoms in primary care have bipolar disorder, a misdiagnosis of major depressive disorder is common, according to a poster presented at Psych Congress 2020.

“Primary care clinicians are often the first and only healthcare providers for patients with mental health issues, so knowledge to facilitate earlier recognition, more accurate diagnosis, and management of bipolar disorder is essential,” researchers wrote.

Information in the poster stemmed from a literature review on the current state of diagnosis and management of bipolar disorder in patients.

According to the findings, just 1 in 5 patients with a bipolar disorder episode is correctly diagnosed in 1 year. The average delay in diagnosis is between 5 years and 10 years. Some 60% of patients receive an inaccurate diagnosis of major depressive disorder. Inaccurate or missed diagnoses in people with bipolar disorder can hurt outcomes, raise suicide risk, and lead to improper and potentially harmful treatment with antidepressant monotherapy, which can cause manic/hypomanic symptoms and rapid mood cycling.

While most patient-reported screening tools for bipolar disorder are lengthy and do not include depressive aspects of bipolar disorder, the 6-item Rapid Mood Screener can be completed in less than 2 minutes, addresses depression, and can help primary care providers identify bipolar disorder, researchers advised.

To date, the US Food & Drug Administration has approved 4 agents for treatment of bipolar depression: cariprazine, quetiapine, fluoxetine-olanzapine combination, and lurasidone. Only cariprazine and quetiapine, however, are approved for both bipolar mania and bipolar depression. Cariprazine is also approved for mixed episodes, according to the poster.

AbbVie sponsored the study.

—Jolynn Tumolo 

Reference 

Montano CB, Rolin D, Wilson A, Patel M. Depressive symptoms – could it be bipolar depression? An overview for primary care. Poster presented at Psych Congress 2020; September 10-13, 2020; Virtual.

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