Earlier Diagnosis of Bipolar Disorder is Needed, Say Researchers

the Psychiatry Advisor take:

Improvements need to be made to eliminate delays that prevent many people from bipolar disorder from getting treatment, particularly those with substance use disorders.

Rashmi Patel, PhD, of the Institute of Psychiatry, Psychology & Neuroscience at King's College London, and colleagues examined anonymous mental health records from a database of more than 1,300 adults who were diagnosed with bipolar disorder. They looked at the amount of time it took between when they presented for mental health services and when they were actually diagnosed and received treatment.

It took an average of two months between the first presentation and when they were actually diagnosed, the researchers reported in the journal PLOS ONE. But the amount of time was far longer for those who presented and had alcohol and substance use disorders. For this group, the average delay was two years, though some had a delay of more than five years.

The authors say that the delays in bipolar diagnosis among those with alcohol and substance abuse problems could be due to some clinicians’ mistaken belief that the symptoms are a result of the drug issues, rather than the bipolar disorder. Instead, those clinicians should consider a bipolar disorder or dual diagnosis of both disorders.

They add that failure to recognize and treat both disorders simultaneously could worsen both conditions. In addition, other research has indicated those with mania, hypomania, or depression have an increased risk of alcohol and substance abuse.

“We need to develop better strategies to identify bipolar disorder, perhaps through specialized early intervention services, in order to offer appropriate treatment sooner,” Patel said in a statement. “There is a clear need for further research to better understand how to treat people with a dual diagnosis of both disorders.”