Literature DB >> 16912817

Bipolar disorder detection, ascertainment, and treatment: primary care physician knowledge, attitudes, and awareness.

Paul Stang1, Cathy Frank, Marianne Ulcickas Yood, Karen Wells, Steven Burch, Bruce Muma.   

Abstract

OBJECTIVE: To describe knowledge, attitudes, and awareness of bipolar disorder detection, ascertainment, and treatment among primary care physicians in a managed care setting.
METHOD: Quota sampling was used to obtain 102 completed surveys assessing knowledge, attitudes, and awareness of bipolar disorder from a pool of 350 primary care physicians in a large, vertically integrated Midwestern health system from June 2004 through August 2004. Descriptive statistics were used to characterize the distribution of the study results at the physician level.
RESULTS: Primary care physicians are experiencing challenges in diagnosing and treating bipolar patients, who can be difficult and time-consuming. In answering questions about major depressive episode and manic episode symptoms, at least 15% of respondents assessed most symptoms incorrectly. In analyzing 3 case studies, 9%, 11%, and 28% of respondents, respectively, answered all of the questions correctly. When asked which drugs are U.S. Food and Drug Administration-approved for the maintenance treatment of adults with bipolar I disorder, no survey respondent replied correctly for all drugs listed. Importantly, our survey also indicates that these physicians are very willing to refer bipolar patients to psychiatrists for evaluation and treatment, which may help to ensure optimal care.
CONCLUSIONS: Opportunities for improvement exist in diagnosing and treating patients with bipolar disorder in the primary care setting, perhaps aided by guidelines, education, and a collaborative care model with psychiatry.

Entities:  

Year:  2006        PMID: 16912817      PMCID: PMC1540393          DOI: 10.4088/pcc.v08n0304

Source DB:  PubMed          Journal:  Prim Care Companion J Clin Psychiatry        ISSN: 1523-5998


  19 in total

1.  Screening for bipolar disorder in a primary care practice.

Authors:  Amar K Das; Mark Olfson; Marc J Gameroff; Daniel J Pilowsky; Carlos Blanco; Adriana Feder; Raz Gross; Yuval Neria; Rafael Lantigua; Steven Shea; Myrna M Weissman
Journal:  JAMA       Date:  2005-02-23       Impact factor: 56.272

2.  Course of the manic-depressive cycle and changes caused by treatment.

Authors:  A Kukopulos; D Reginaldi; P Laddomada; G Floris; G Serra; L Tondo
Journal:  Pharmakopsychiatr Neuropsychopharmakol       Date:  1980-07

Review 3.  Can antidepressants cause mania and worsen the course of affective illness?

Authors:  T A Wehr; F K Goodwin
Journal:  Am J Psychiatry       Date:  1987-11       Impact factor: 18.112

4.  The clinical history and costs associated with delayed diagnosis of bipolar disorder.

Authors:  Paul E Stang; Cathy Frank; Anupama Kalsekar; Marianne Ulcickas Yood; Karen Wells; Steven Burch
Journal:  MedGenMed       Date:  2006-04-19

5.  The emerging epidemiology of hypomania and bipolar II disorder.

Authors:  J Angst
Journal:  J Affect Disord       Date:  1998-09       Impact factor: 4.839

6.  Prevalence, nature, and comorbidity of depressive disorders in primary care.

Authors:  J C Coyne; S Fechner-Bates; T L Schwenk
Journal:  Gen Hosp Psychiatry       Date:  1994-07       Impact factor: 3.238

7.  The de facto US mental and addictive disorders service system. Epidemiologic catchment area prospective 1-year prevalence rates of disorders and services.

Authors:  D A Regier; W E Narrow; D S Rae; R W Manderscheid; B Z Locke; F K Goodwin
Journal:  Arch Gen Psychiatry       Date:  1993-02

8.  Perceptions and impact of bipolar disorder: how far have we really come? Results of the national depressive and manic-depressive association 2000 survey of individuals with bipolar disorder.

Authors:  Robert M A Hirschfeld; Lydia Lewis; Lana A Vornik
Journal:  J Clin Psychiatry       Date:  2003-02       Impact factor: 4.384

9.  Antidepressant-induced mania and cycle acceleration: a controversy revisited.

Authors:  L L Altshuler; R M Post; G S Leverich; K Mikalauskas; A Rosoff; L Ackerman
Journal:  Am J Psychiatry       Date:  1995-08       Impact factor: 18.112

10.  The prevalence and disability of bipolar spectrum disorders in the US population: re-analysis of the ECA database taking into account subthreshold cases.

Authors:  Lewis L Judd; Hagop S Akiskal
Journal:  J Affect Disord       Date:  2003-01       Impact factor: 4.839

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  2 in total

1.  Managing bipolar disorder in the primary care setting: a perspective for mental health professionals.

Authors:  Randy A Sansone; Lori A Sansone
Journal:  Innov Clin Neurosci       Date:  2011-10

2.  Primary care perspectives on treating bipolar disorder: a cross-sectional survey.

Authors:  Randy A Sansone; Jeremy S Forbis; Tres Sosa
Journal:  Prim Care Companion CNS Disord       Date:  2011
  2 in total

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