Predicting lifetime mood elevation in primary care patients and psychiatric patients

Abstract

Unipolar depression is undoubtedly the most common affective disorder, but recently the role of bipolar disorders has become more and more significant. The aim of the study was to improve the detection of mood elevations by careful anamnestic assessment, especially family history and psychosocial functional skills. A sample, screened for depression, of 430 primary care patients and 423 psychiatric patients aged 18-64 were interviewed in 1991-1992 using the Present State Examination. Anamnestic information was obtained by questionnaire and interview. Participants were re-contacted in 1998-1999. Experienced lifetime mood elevation was assessed in the follow-up study using the main criteria of the ICD-10 in a telephone interview by three research psychiatrists. Patient's smoking, suicidality in the Hamilton Depression Scale (HAM-D), problems in making contact with the opposite sex when a teenager, and mental problems in either of the parents when the patient was < or = 15 years were associated with experienced lifetime mood elevation. Quick and easy questions about smoking and difficulties in making contact with the opposite sex may improve the detection of mood elevation.

Instruments that prospectively predict bipolar disorder – A systematic review

“…These studies (Akiskal et al, 1995;Bechdolf et al, 2014;Biederman et al, 2009;Gan et al, 2011;Manning et al, 1997;Poutanen et al, 2008;Solomon et al, 2006;Tillman and Geller, 2006) were excluded for the above reasons. Studies or sub-samples were excluded when BD I or II were included in the baseline sample and it was not possible to exclude data for these participants (Alloy et al, 2012;Arrasate et al, 2013).…”

The Prevalence of Bipolar Disorder in Primary Care Patients With Depression or Other Psychiatric Complaints: A Systematic Review

“…We found seven studies 19-25 meeting our inclusion criteria. Bipolar disorder prevalence was measured in primary care patients with depression 20-22,24 (n=4 studies), any psychiatric complaint 23 (n=1 study), trauma exposure 25 (n=1 study), and medically unexplained symptoms 19 (n=1study).…”

“…Two studies 19,20 used structured interviews to diagnose bipolar disorder, three studies used screening measures 21-23 , and two studies 24,25 used both a structured interview and a screening measure. Five studies 21-25 used the Mood Disorder Questionnaire (MDQ) 26 screening measure and one study used Hypomania Checklist-32 (HCL-32) 27 and the MDQ.…”

“…Poutanen, et al 20 measured the prevalence of bipolar disorder in a sample of 319 primary care patients with depression in community health centers in Finland. This group used two standardized questions from the Composite International Diagnostic Interview (CIDI) 30 structured interview and a follow-up phone interview in those with positive responses to one of the CIDI questions in order to diagnose bipolar disorder, and found that 4.8% of the sample met criteria for bipolar disorder.…”

“…Poutanen, et al 20 used two standardized questions from the CIDI and then performed a full structured interview on patients with a positive response to at least one of the two questions. Accurate use of the CIDI involves administering the entire CIDI to patients with a positive response from one of the two screening questions.…”