P0109 - Under diagnosis of bipolar affective disorder in an English community mental health team

Abstract

Background and Aims:

Bipolar disorder is frequently misdiagnosed or diagnosed late.

We aimed to improve the diagnosis of bipolar disorder in our team.

Methods:

Using an excel database, an audit of the diagnoses of all patients in a CMHT in Bedford was carried out.

It was noted that few patients were diagnosed as having bipolar II disorder, while there was a large number of Bipolar I patients, and a larger number of patients with recurrent depressive disorder, mixed anxiety and depression, unipolar depression, and psychotic depression.

All patients with recurrent depressive disorder, anxiety and depression, unipolar depression and psychotic depression are being reassessed in the outpatient clinic, using a longitudinal history, a family history, and, when these tests are positive, the ‘mood disorder questionnaire’.

The new diagnoses are recorded in the Database.

Results:

This poster represents work in progress. Increased awareness of bipolar disorder is leading to a more frequent diagnosis or re-diagnosis of Bipolar II disorder, as well as a consequent change in the proportions of each diagnosis in the sample.

Conclusions:

The frequent misdiagnosis of Bipolar II disorder frequently leads to the treatment of these patients with anti-depressants only.

This leads to the possibility of patients becoming elated, or going into mixed states, with increased suicidality.

Appropriate diagnosis of bipolar II disorder requires skills at present found in secondary care. Such patients should therefore be referred to secondary care. Both Primary and Secondary care should be more aware of this diagnosis and its consequences.