Eugene Gorski1, K C Willis. 1. Dr. Gorski and Mr. Willis are in private practice in Sugarloaf, Pa.
Abstract
INTRODUCTION: The incidence of bipolar disorder in the general population has been estimated at approximately 5%. The purpose of this study was to establish a relationship between patients' complaints on arrival to a primary care clinic and their subsequent scores on the Hirschfeld Mood Disorder Questionnaire (MDQ). METHOD: After reviewing data obtained from 178 consecutive patients, 171 were found adequate for study inclusion. The inclusion criteria for this study were presentation to a family practice office for care regardless of complaint and age of 18 years or older. Study participants were asked to complete a historical/demographic questionnaire, which gathered data on primary and secondary complaints and medication history, and the MDQ. RESULTS: Thirty patients (17.5%) tested positive on the MDQ for bipolar symptoms; all were aged 65 years or under. Of those who tested positive, 20% (N = 6) presented with a primary complaint of anxiety or depression. Somatic primary complaints of pain and headache carried a high likelihood of secondary complaints of anxiety or depression. CONCLUSION: Patients with complicated or multiple somatic complaints in primary care may also have concomitant undiagnosed bipolar disorder. Clinicians should use a high index of suspicion for the diagnosis of bipolar disorder when treating patients with these assessment characteristics. Further research is necessary to determine if these trends are applicable in a larger population.
INTRODUCTION: The incidence of bipolar disorder in the general population has been estimated at approximately 5%. The purpose of this study was to establish a relationship between patients' complaints on arrival to a primary care clinic and their subsequent scores on the Hirschfeld Mood Disorder Questionnaire (MDQ). METHOD: After reviewing data obtained from 178 consecutive patients, 171 were found adequate for study inclusion. The inclusion criteria for this study were presentation to a family practice office for care regardless of complaint and age of 18 years or older. Study participants were asked to complete a historical/demographic questionnaire, which gathered data on primary and secondary complaints and medication history, and the MDQ. RESULTS: Thirty patients (17.5%) tested positive on the MDQ for bipolar symptoms; all were aged 65 years or under. Of those who tested positive, 20% (N = 6) presented with a primary complaint of anxiety or depression. Somatic primary complaints of pain and headache carried a high likelihood of secondary complaints of anxiety or depression. CONCLUSION:Patients with complicated or multiple somatic complaints in primary care may also have concomitant undiagnosed bipolar disorder. Clinicians should use a high index of suspicion for the diagnosis of bipolar disorder when treating patients with these assessment characteristics. Further research is necessary to determine if these trends are applicable in a larger population.
Authors: R M Hirschfeld; J B Williams; R L Spitzer; J R Calabrese; L Flynn; P E Keck; L Lewis; S L McElroy; R M Post; D J Rapport; J M Russell; G S Sachs; J Zajecka Journal: Am J Psychiatry Date: 2000-11 Impact factor: 18.112
Authors: T Suppes; G S Leverich; P E Keck; W A Nolen; K D Denicoff; L L Altshuler; S L McElroy; A J Rush; R Kupka; M A Frye; M Bickel; R M Post Journal: J Affect Disord Date: 2001-12 Impact factor: 4.839