Hughes Tom, Cardno Alastair, West Robert, Marino-Francis Federica, Featherstone Imogen, Rolling Keeley, Locker Alice, McLintock Kate, House Allan
Leeds and York Partnership NHS Foundation Trust, Leeds.
Leeds Institute of Health Sciences, University of Leeds, Leeds.
Br J Gen Pract. 2016 Feb;66(643):e71-7. doi: 10.3399/bjgp16X683437. Epub 2016 Jan 6.
Bipolar disorder is not uncommon, is associated with high disability and risk of suicide, often presents with depression, and can go unrecognised.
To determine the prevalence of unrecognised bipolar disorder among those prescribed antidepressants for depressive or anxiety disorder in UK primary care; whether those with unrecognised bipolar disorder have more severe depression than those who do not; and the accuracy of a screening questionnaire for bipolar disorder, the Mood Disorder Questionnaire (MDQ), in this setting.
Observational primary care study of patients on the lists of 21 general practices in West Yorkshire aged 16-40 years and prescribed antidepressant medication.
Participants were recruited using primary care databases, interviewed using a diagnostic interview, and completed the screening questionnaire and rating scales of symptoms and quality of life.
The prevalence of unrecognised bipolar disorder was 7.3%. Adjusting for differences between the sample and a national database gives a prevalence of 10.0%. Those with unrecognised bipolar disorder were younger and had greater lifetime depression. The predictive value of the MDQ was poor.
Among people aged 16-40 years prescribed antidepressants in primary care for depression or anxiety, there is a substantial proportion with unrecognised bipolar disorder. When seeing patients with depression or anxiety disorder, particularly when they are young or not doing well, clinicians should review the life history for evidence of unrecognised bipolar disorder. Some clinicians might find the MDQ to be a useful supplement to non-standardised questioning.
双相情感障碍并不罕见，与高致残率和自杀风险相关，常表现为抑郁，且可能未被识别。
确定在英国初级保健机构中，因抑郁或焦虑障碍而开具抗抑郁药的人群中未被识别的双相情感障碍的患病率；未被识别的双相情感障碍患者是否比未患该障碍的患者有更严重的抑郁；以及在这种情况下，双相情感障碍筛查问卷——心境障碍问卷（MDQ）的准确性。
对西约克郡21家全科诊所中年龄在16 - 40岁且开具了抗抑郁药物的患者进行观察性初级保健研究。
通过初级保健数据库招募参与者，采用诊断性访谈进行询问，并让他们完成筛查问卷以及症状和生活质量评定量表。
未被识别的双相情感障碍患病率为7.3%。对样本与全国数据库之间的差异进行调整后，患病率为10.0%。未被识别的双相情感障碍患者更年轻，且终生抑郁程度更高。MDQ的预测价值较差。
在初级保健机构中因抑郁或焦虑而开具抗抑郁药的16 - 40岁人群中，有相当一部分患有未被识别的双相情感障碍。在诊治抑郁或焦虑障碍患者时，尤其是年轻患者或病情不佳的患者，临床医生应回顾其生活史，以寻找未被识别的双相情感障碍的证据。一些临床医生可能会发现MDQ是对非标准化询问的有用补充。
