Bipolar illness is commonly seen in primary care settings, generally as a result of a poor response to depression medication. Although bipolar I disease has a 1% lifetime incidence, bipolar spectrum disorders have a substantially greater frequency, particularly among patients with depression. Misdiagnosis can have disastrous effects. Screening for bipolar spectrum illnesses is one strategy to enhance detection. The mood disorder questionnaire is a self-reported screening tool that may be used to determine which people are most likely to have bipolar disorder. Bipolar illness sufferers’ lives can be significantly improved once they are discovered and adequately diagnosed.
Many people with depression are treated by primary care professionals in the United States. Although 60 to 70% of depressed people improve, approximately one-third do not, and many do not achieve full remission. Undiagnosed bipolar spectrum illness might be one explanation for a poor or partial response. The term “bipolar spectrum disorder” has been used to describe a wide range of conditions. However, bipolar I, bipolar II, cyclothymia, and bipolar illness not otherwise described are the most common. Impulsive conduct, alcohol or substance misuse, energy changes, and legal issues are just a few of the signs and symptoms. Furthermore, the gloomy mood that is typical of these diseases’ depressive phases is sometimes mistaken for depression. As a result, mood disorder icd 10, in other words, a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes, may linger undiagnosed for seven to ten years. Furthermore, many bipolar illness patients go through three or more expert exams before obtaining a proper diagnosis and therapy. Because the medical care of bipolar illness differs significantly from that of depression, the consequences of a delayed or wrong diagnosis can be disastrous.
Bipolar illness is estimated to cost $7 billion in direct expenditures for inpatient and outpatient care. Indirect costs account for about $38 billion of total spending. According to recent research, the lifetime cost of people diagnosed with bipolar illness in 1998 was $24 billion, with the average lifetime cost per patient ranging from under $11,000 for single manic episodes to over $600,000 for chronic or non-responsive conditions. Indeed, bipolar illness ranks sixth among all health diseases on the globe in terms of generating impairment. Greater detection of bipolar illness warning indicators in primary care settings might certainly enhance treatment results, resulting in fewer visits to costly treatment institutions.
According to the results of a survey conducted by the National Depressive and Manic-Depressive Association, 73% of people with bipolar disorder were misdiagnosed when they first presented to a healthcare practitioner. Depression was the most common misdiagnosis. Anxiety disorder, schizophrenia, personality problems, and alcohol misuse were among the other misdiagnoses.
Several clinical trials conducted in doctors’ offices back up the survey results. In order to give an example of how a clinical psychologist might treat someone diagnosed with a mood disorder, we can observe a family practice environment. For example, more than a quarter of patients with depression or anxiety had bipolar spectrum illness. Our colleagues found a 10-year lag between the onset of bipolar disorder symptoms and the initiation of therapy in a sample of 261 outpatients with bipolar illness. Many individuals were given antidepressants without mood stabilizers at this time. The problem isn’t getting any better. In 2000, the NDMDA survey was conducted again. Unfortunately, just like in 1994, nearly a third of the new bipolar patients waited at least ten years for the right diagnosis.
A clinical evaluation, which includes a mental state test and a psychiatric history, is required to diagnose bipolar disorder. Past instances of mania, hypomania, and mood swings must be discussed with the doctor. Identifying high-risk patients can save time for busy clinicians. Screening for bipolar illness, especially among patients with depression, is one way to identify high-risk people.
The Mood Disorder Questionnaire (MDQ) is a simple bipolar disorder screening tool that may be used in primary care settings. The MDQ has high sensitivity as well as high specificity. The MDQ can properly identify 7 out of 10 people who have bipolar disorder, whereas 9 out of 10 patients who do not have bipolar disorder can be screened out. The MDQ consists of 13 questions as well as elements that assess symptom clustering and functional impairment. The MDQ can help primary care doctors quickly and easily identify people who are most likely to develop bipolar illness. If the patient’s MDQ results are positive, the doctor should do a comprehensive clinical assessment for bipolar disorder. Probing based on MDQ replies might be useful for directing queries. Thyroid function tests and liver function tests are examples of appropriate laboratory testing.
Psychiatrists are frequently the first to recommend therapy for bipolar illness. The psychiatrist or the primary care physician can undertake the follow-up. Patient and family education can greatly improve compliance and attentiveness for early detection of recurrence. We are the ones who can help people in need of psychological help at an early age.