Latest research identifies prior signals of bipolar disorder

‘Strong indicators’ of bipolar

Latest research from the Universities of Keele and Manchester has found that psychiatric diagnoses, psychotropic prescriptions, and health service use patterns are strong indicators of bipolar disorder.

The findings – published within the British Journal of General Practice – will allow doctors to perform quicker referral, assessment, and treatment of the devastating condition which was often known as manic depression.

The early warning signs, identifiable for over 10 years before diagnosis, include previous depressive episodes, sleep disturbance, substance misuse, receipt of three or more various kinds of psychotropic medications in a 12 months, escalating self-harm, frequent consultations and missing scheduled appointments.

The findings could help improve delays between the early manifestations of bipolar disease and its diagnosis and treatment, currently estimated to be around six years.

Major reforms required

The National Institute for Health and Care Research (NIHR) and the NIHR Greater Manchester Patient Safety Translational Research Centre funded research team analysed routinely collected electronic primary healthcare data from between January 2010 and July 2017

They identified 2,366 individuals with a bipolar disorder diagnosis and 47,138 people without bipolar disorder in England.

The work supports the remit of the recent Bipolar Commission Report ‘Bipolar Minds Matter’ which is asking for major reform of healthcare practice to develop a dedicated care pathway for specialist treatments and lifelong support for individuals with bipolar disorder.

As much as 3% of the UK population experience bipolar disorder in some unspecified time in the future during their lives.

Many people who find themselves undiagnosed experience hostile health outcomes including poor social adjustment, multiple hospital admissions, poor physical health, interpersonal violence and increased risk of self-harm and suicide.

Higher referrals for patients

Professor Carolyn Chew-Graham OBE, Professor of General Practice Research at Keele University and member of the Bipolar UK Advisory group, said: “Higher referral pathways from primary to specialist care are desperately needed each for patients and GPs, when a diagnosis of bipolar is suspected, if patient are to receive the timely help they need. ‘Think bipolar’ is a powerful message to send out to GPs. The findings from our study support the recent call from the Bipolar Commission Report for dedicated take care of individuals with bipolar disorder https://www.bipolaruk.org/bipolarcommission.

“There’s evidence that a delay in diagnosis of bipolar may be as much as 9 years, with a 3rd of people who find themselves eventually diagnosed with bipolar could have made an attempt on their lives due to the distress they feel and the delay in getting appropriate care.”

Bipolar disorders are serious mental illnesses characterised by instability in mood. They will have devastating impacts on the lives of patients and their families.

Early treatment, nevertheless, may be crucial in averting years of hardship for patients; our study provides crucial information that would help GPs to contemplate a diagnosis of bipolar much earlier and refer on for specialist assessment.”

Dr Catharine Morgan, Research Fellow, The University of Manchester