What is it about?
Depression is common in primary care, but detecting bipolar depression is difficult. We show that screening all patients with depression for the entire mood spectrum (from plain depression to clearly bipolar) is feasible. It's also appropriate, given the spectrum of results on screening tests. And it does not lead to "overdiagnosis", as judged by patient outcomes.
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Why is it important?
Primary care provides more mental health services than psychiatry and psychotherapists *combined*. So if you want to help address depression in your entire service population, you have to work with your primary care colleagues. We've shown that this is do-able (and fun, by the way), targeting one of the depression variations they have the most trouble with (next on the list will be PTSD...).
Perspectives
I've spent 20 years exploring bipolar variations that don't look overtly "bipolar". Figure 1 in this paper, which shows a smooth distribution of scores on the CIDI 3.0 (standard bipolar screening tool), is a nice validation of the "mood spectrum" concept that is finally becoming routine amongst mood specialists. Also nice to show here that using this diagnostic perspective does not lead to worse outcomes!
James Phelps
Samaritan Mental Health
Read the Original
This page is a summary of: Bipolarity in a Collaborative Care Model Variation: Detection, Prevalence, and Outcomes, Psychiatric Services, November 2020, American Psychiatric Association,
DOI: 10.1176/appi.ps.202000024.
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