INTRODUCTION: While most of the management of mental health in the UK is conducted in primary care, the diagnosis by GPs has been shown to deficient in some areas. Bipolar disorder in particular is known to under-diagnosed but there is confusion as to whether this is due to poor recognition or conversion from unipolar depression SUBJECTS AND METHODS: In April and May 2012 an audit was conducted in secondary psychiatric services in Bedford, UK among 146 representative patients and 112 bipolar patients, examining the course of their illness and diagnosis RESULTS: Bipolar disorder is under-diagnosed in the community and in secondary care. First manic or hypomanic symptoms usually follow first depressive symptoms by several years (μ=7.3, σ=7.9). A diagnosis of bipolar also commonly follows manic or hypomanic symptoms by years (μ=7.6, σ=8.3). DISCUSSION: Both psychiatrists and GPs under-diagnose bipolar, but this study shows it may be due to two factors: poor recognition by doctors and conversion from major depressive disorder. CONCLUSION: GPs and psychiatrists must be more aware of the under-diagnosis of bipolar and its tendency to convert from pure depressive symptoms.
INTRODUCTION: While most of the management of mental health in the UK is conducted in primary care, the diagnosis by GPs has been shown to deficient in some areas. Bipolar disorder in particular is known to under-diagnosed but there is confusion as to whether this is due to poor recognition or conversion from unipolar depression SUBJECTS AND METHODS: In April and May 2012 an audit was conducted in secondary psychiatric services in Bedford, UK among 146 representative patients and 112 bipolarpatients, examining the course of their illness and diagnosis RESULTS:Bipolar disorder is under-diagnosed in the community and in secondary care. First manic or hypomanic symptoms usually follow first depressive symptoms by several years (μ=7.3, σ=7.9). A diagnosis of bipolar also commonly follows manic or hypomanic symptoms by years (μ=7.6, σ=8.3). DISCUSSION: Both psychiatrists and GPs under-diagnose bipolar, but this study shows it may be due to two factors: poor recognition by doctors and conversion from major depressive disorder. CONCLUSION: GPs and psychiatrists must be more aware of the under-diagnosis of bipolar and its tendency to convert from pure depressive symptoms.