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By Traci Pedersen
Around 10 percent of primary care patients who are prescribed antidepressants for depression or anxiety have undiagnosed bipolar disorder, according to a new UK study published in the British Journal of General Practice (BJGP).

Bipolar disorder is a mental illness characterized by strong fluctuations in a patient’s mood, energy, activity levels, and the ability to carry out everyday tasks. Approximately eight percent of the population suffers from recurring depression, and about one percent suffers from bipolar disorder.

Bipolar disorder can be difficult to diagnose initially as many patients tend to seek help for the troubling symptom of depression first. Patients who have experienced symptoms of mania (such as increased energy and activity, increased confidence, over-talkativeness, or being easily distracted) often don’t recognize these symptoms as significant or problematic and therefore don’t mention them to their doctor.

This often leads to inappropriate treatment, such as the prescription of antidepressants without mood-stabilizing medication. Many bipolar patients respond very poorly to antidepressants alone as they can intensify mania and worsen the disorder. When bipolar disorder is diagnosed, drug treatment should include a mood-stabilizing drug such as lithium, with or without an antidepressant.

The study, conducted by researchers from Leeds and York Partnership NHS Foundation Trust and the School of Medicine at the University of Leeds, involved young adult patients from general practices.

The researchers discovered that among patients aged 16-40 years who had been prescribed antidepressants for depression or anxiety, around 10 percent had unrecognized bipolar disorder. This was more common among younger patients and in those who reported more severe episodes of depression.

These findings suggest that health care professionals should review the life histories of patients with anxiety or depression, particularly younger patients and those who are not responding well to medication or treatment, for evidence of bipolar disorder.

“Bipolar disorder is a serious problem, with high levels of disability and the risk of suicide. When it is present in depressed patients it can easily be overlooked. Under-diagnosis and over-diagnosis of illnesses bring problems,” said Dr. Tom Hughes, consultant psychiatrist at Leeds and York Partnership NHS Foundation Trust and the University of Leeds.

Hughes added that he hopes these new findings will help doctors and patients better recognize bipolar disorder, which he calls an “important and disabling condition.”

Source: University of Leeds

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