Today I link to and excerpt from The Curbsiders‘ “#415 Bipolar Disorder With Dr. Kevin Johns”. November 13, 2023 | By Deb Gorth.
All that follows isfrom the above resource.
Show Segments
- Intro
- Case
- Screening for mania
- History for diagnosing bipolar disorder
- Definition
- Mimickers
- Treatment
- Outro
Bipolar Pearls
- SIG-E-CAPS are the diagnosis criteria for a major depressive episode, not major depressive disorder, so consider other causes of depressive episodes before making a diagnosis.
- Depressive episodes are the most common and impairing symptoms of bipolar disorder (Judd et al 2002). It is important to have on your differential for major depressive episodes.
- Bipolar disorder has a strong genetic component with a monozygotic concordance rate of nearly 50% (Kieseppa et al 2014).
- The Mood Disorder Questionnaire (MDQ) is the “d-dimer” of psychiatry; if it is negative, you can be fairly certain that the patient doesn’t have bipolar disorder, but a positive value does not give you a definitive diagnosis (Hirschfeld et al 2005).
- If a patient presents to your clinic with a prior diagnosis of bipolar disorder, it is important to learn the circumstances leading to their diagnosis and who made it to confirm validity.
- Screen for suicidality* at every visit; patients with bipolar disorder are 20-30 times more likely to die from suicide than the general population (Plans et al 2019).
*Here are links to some tools for suicidality screening:
- Youth ASQ Toolkit
- Brief Suicide Safety Assessment Guide (PDF | HTML)
- Brief Suicide Safety Assessment Worksheet (PDF | HTML)
- ASQ Suicide Risk Screening Tool (PDF | HTML)
- Outpatient Suicide Risk Clinical Pathway (PDF | HTML)
- Mental Health Resources (PDF | HTML)
- Script for Nursing Staff (PDF | HTML)
- Parent/Guardian Flyer (PDF | HTML)
- Links to Videos (PDF | HTML)
- Information Sheet (PDF | HTML)
- Adults ASQ Toolkit
