Practical Clues to Early Recognition of Bipolar Disorder: A Primary Care Approach
Alan C. Swann, MD; Barbara Geller, MD; Robert M. Post, MD; Lori Altshuler, MD; Kiki D. Chang, MD; Melissa P. DelBello, MD; Christopher Reist, MD; Iver A. Juster, MD
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Early treatment can favorably impact the course of bipolar
disorder, a lifelong illness. Because bipolar disorder can
masquerade as various mental and physical illnesses--primarily
major depressive disorder--patients with this condition
frequently go unrecognized for years. During this recognition
lag, such patients may present to their primary care physician on
multiple occasions. Accordingly, primary care physicians would
benefit from knowing the "clues" to early recognition
of the disorder, because early recognition and management can
reduce disability, improve social and employment stability, and
result in improved functional outcomes. This review describes 3
pathways to the diagnosis of bipolar disorder relevant to the
primary care setting: detection of mania or hypomania,
differential diagnosis of recurrent depressive episodes, and
identification of interepisode disorder and its comorbidities. We
summarize these pathways in terms of a practical tool that a
primary care physician can use to trigger further evaluation or
referral.
Prim Care Companion J Clin Psychiatry 2005;7(1):15-21
https://doi.org/10.4088/PCC.v07n0103
© Copyright 2005 Physicians Postgraduate Press, Inc.