TY - JOUR
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Antidepressive Agents/therapeutic use
KW - Bipolar Disorder/diagnosis/drug therapy/epidemiology
KW - Depression/drug therapy/epidemiology
KW - Humans
KW - Interview, Psychological
KW - Male
KW - Middle Aged
KW - New York/epidemiology
KW - Prevalence
KW - Primary Health Care/statistics & numerical data
KW - Psychiatric Status Rating Scales
KW - Young Adult
AU - S. L. Dubovsky
AU - K. Leonard
AU - K. Griswold
AU - E. Daurignac
AU - B. Hewitt
AU - C. Fox
AU - D. Seymour
AU - A. N. Dubovsky
AU - F. DeGruy
A1 - 
AB - OBJECTIVE: To examine the prevalence and treatment of typical and subsyndromal bipolar disorder (BD) in depressed primary care patients. METHODS: Patients with a diagnosis of a mood disorder being treated with antidepressants in 2 academic family practice clinics underwent a structured diagnostic interview (Mini International Neuropsychiatric Inventory) for manic and hypomanic symptoms. RESULTS: Of 58 patients evaluated, 19% met full criteria for bipolar I disorder and 8.6% for bipolar II disorder; 31% had subsyndromal BD (ie, persistent elation or irritability accompanied by additional symptoms of hypomania but not enough symptoms to meet full criteria for bipolar I or II disorder). Only 5 patients with BD were receiving mood stabilizers, which had not been instituted in any patient by the primary care physician. CONCLUSIONS: The high prevalence of patients meeting full criteria for BD and the low rate of identification of BD in primary care patients are consistent with estimates using self-administered questionnaires, but the interview revealed a substantial additional population that could be considered to have subsyndromal BD. Because subsyndromal forms of BD are associated with significant impairment and comorbidity as well as progression to frank BD, recognition of both full and subthreshold BD in primary care practice should be improved.
BT - Postgraduate medicine
C5 - General Literature
CP - 5
CY - United States
DO - 10.3810/pgm.2011.09.2468
IS - 5
JF - Postgraduate medicine
N2 - OBJECTIVE: To examine the prevalence and treatment of typical and subsyndromal bipolar disorder (BD) in depressed primary care patients. METHODS: Patients with a diagnosis of a mood disorder being treated with antidepressants in 2 academic family practice clinics underwent a structured diagnostic interview (Mini International Neuropsychiatric Inventory) for manic and hypomanic symptoms. RESULTS: Of 58 patients evaluated, 19% met full criteria for bipolar I disorder and 8.6% for bipolar II disorder; 31% had subsyndromal BD (ie, persistent elation or irritability accompanied by additional symptoms of hypomania but not enough symptoms to meet full criteria for bipolar I or II disorder). Only 5 patients with BD were receiving mood stabilizers, which had not been instituted in any patient by the primary care physician. CONCLUSIONS: The high prevalence of patients meeting full criteria for BD and the low rate of identification of BD in primary care patients are consistent with estimates using self-administered questionnaires, but the interview revealed a substantial additional population that could be considered to have subsyndromal BD. Because subsyndromal forms of BD are associated with significant impairment and comorbidity as well as progression to frank BD, recognition of both full and subthreshold BD in primary care practice should be improved.
PP - United States
PY - 2011
SN - 1941-9260; 0032-5481
SP - 129
EP - 133
EP - 
T1 - Bipolar disorder is common in depressed primary care patients
T2 - Postgraduate medicine
TI - Bipolar disorder is common in depressed primary care patients
U1 - General Literature
U2 - 21904095
U3 - 10.3810/pgm.2011.09.2468
VL - 123
VO - 1941-9260; 0032-5481
Y1 - 2011
ER -