Many at Risk for Undiagnosed Bipolar Disorder

About one out of seven of patients who are diagnosed with unipolar depression have experienced manic symptoms within the last year and are likely to actually have bipolar disorder, according to Kevin Nanry of GlaxoSmithKline and coauthors in a poster presented at the Seventh International Conference on Bipolar Disorder in Pittsburg, Pennsylvania.

The painful lows of depression are what often lead patients to seek help, the authors noted; but, if previous manic episodes are overlooked, it can lead to incorrect diagnosis and treatment. This is important to realize because treatment with antidepressants alone, which is how unipolar depression is commonly treated, can sometimes trigger mania in those with bipolar disorder.

The authors conducted their study using subjects who had participated in the National Health and Wellness Survey. Out of the 40,000 people who had participated in the survey, 6,000 were identified who had been diagnosed with unipolar depression. Out of these, 1,602 responded to a request to participate in the study and met the three study inclusion criteria: a diagnosis of depression by a health care provider, depression within the past year, and no previous diagnosis of bipolar disorder or schizophrenia.

Out of those 1,602, 219 (14 percent) were identified as being at risk for undiagnosed bipolar disorder. More than 70 percent of the respondents identified at risk for bipolar disorder reported discussing their manic symptoms with a medical professional, and eight percent had visited an emergency room specifically for manic symptoms.

Current treatments among the patients included antidepressants in 70 percent of those at risk for undiagnosed bipolar disorder vs. 67 percent of those not at risk, anti-anxiety medications in 31 percent of those at risk vs. 14 percent of those not at risk, mood stabilizers for six percent of those at risk vs. three percent for those not at risk, and antipsychotics in six percent of those at risk vs. two percent of those not at risk.

“The early and accurate diagnosis of bipolar disorder presenting with depressive symptoms should be of utmost concern to mental and public health officials", said the authors. “Failure to diagnose bipolar disorder accurately and early is a significant problem, contributing to significant morbidity, increasing the already high risk for suicide, and possibly decreasing the effectiveness of treatment once a correct diagnosis is made."

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