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The Impact of Detecting Bipolar Disorder in Previously Diagnosed Unipolar Patients at a Specialist Depression Clinic

Parker, Gordon MBBS, MD, PhD, DSc, FRANZCP*†; Fletcher, Kathryn BSc (Psych Hons)*†; Barrett, Melissa MBBS, FRANZCP*; Synnott, Howe MBBS, D ObstRCOG, FRANZCP*; Breakspear, Michael BSc (Med Hons), BA (Hons), MBBS, PhD, FRANZCP*†‡§; Rees, Anne-Marie MBBS, DRANZCOG, FRANZCP*†; Blanch, Bianca B LibStu(Hons)*†

The Journal of Nervous and Mental Disease: June 2011 - Volume 199 - Issue 6 - p 419-422
doi: 10.1097/NMD.0b013e31821ccb1d
Brief Reports

This study aimed to examine the short-term clinical impact of identifying bipolar disorder in patients previously managed as having a unipolar disorder. The study was incorporated within a consecutive sample of 1000 patients attending a specialist depression clinic for diagnostic and management considerations. Of those assessed, 34% were evaluated as having a bipolar disorder, with this condition having been diagnosed for the first time in three-quarters of those patients. We reviewed sample members 12 weeks later and compared the courses of the "newly diagnosed" and "established" bipolar subsets. Some four-fifths of the bipolar patients reported a degree of improvement, whereas there were no clear differences between the two bipolar subsets. The nondifferential outcome of the bipolar (previously and newly diagnosed) subsets could suggest that there were nonspecific benefits of assessment or that the management was optimized for both groups. Future studies examining the impact of diagnosing a bipolar disorder would therefore benefit from the close consideration of the optimal control group or control strategy.

*Black Dog Institute, Sydney; †School of Psychiatry, University of New South Wales, Sydney; ‡Queensland Institute of Medical Research, Herston; and §Royal Brisbane and Women's Hospital, Herston, Australia.

This study was supported by a National Health and Medical Research Council Program Grant (510135) and an Infrastructure Grant from New South Wales Department of Health.

Send reprint requests to Prof Gordon Parker, MBBS, MD, PhD, DSc, FRANZCP, Black Dog Institute, Prince of Wales Hospital, Randwick NSW 2031, Australia. E-mail:

© 2011 Lippincott Williams & Wilkins, Inc.