Screening for bipolar disorder in Primary Care patients with psychological symptoms

Objective: To estimate the proportion of positive results in the screening of bipolar disorder (BD) among primary care patients presenting with psychological symptoms, and to analyze their characteristics. Design: Multicenter cross-sectional study. Settings: Nineteen Primary Care clinics in different Spanish regions. Patients: A total of 360 consecutive primary care patients aged 18 to 70, presenting with psychological symptoms. Measurements: Screening for BP was performed by means of the Mood Disorders Questionnaire. Data on quality of life (EuroQol-5D) and functional impairment (Sheehan Disability Inventory) were obtained. Data on psychiatric comorbidity and data on the use of psychotropic medication were acquired by review of medical records. Results: Of the patients screened, 11.9% were positive (95% CI: 8.8%-15.7%). Only two patients had a diagnosis of BP in their clinical records and, although more than half received treatment with antidepressants, only two received treatment with mood stabilizers. Positive screening is associated with work, social and family dysfunction, greater perceived stress and poor quality of life. Conclusions: BD screening in primary care patients with psychologial problems leads to a striking proportion of positive results, indicating that there may be a significant prevalence of BP patients, most of them undiagnosed and untreated. Further research is needed to determine the role that Primary Care can or should assume in the screening, diagnosis and management of this disorder. (C) 2014 Elsevier Espana, S.L.U. All rights reserved.