Fidan Yagmur Sever, Arman Ikbal Humay, Calli Sumeyye Yasemin, Domac Fusun Mayda, Yeniceri Emine Nese, Tasdelen Bahar, Ozge Aynur
Erenkoy Mental and Nervous Diseases Training and Research Hospital, Istanbul, Turkiye.
Faculty of Medicine, Department of Family Medicine, Istanbul Medipol University, Istanbul, Turkiye.
Brain Behav. 2025 Jun;15(6):e70611. doi: 10.1002/brb3.70611.
This study explores the diagnostic, treatment, and follow-up approaches of neurologists, psychiatrists, and family physicians in managing late-onset bipolar disorder (BD) in elderly patients, emphasizing the role of interdisciplinary collaboration.
A cross-sectional survey involved 300 specialists (100 from each discipline). The survey assessed diagnostic accuracy, treatment preferences, follow-up adherence, and barriers to interdisciplinary collaboration. A pairwise z-test with Bonferroni correction was applied for comparative analysis across specialties to evaluate differences in response proportions.
Neurologists demonstrated high proficiency in imaging and treatment initiation (91% correct imaging responses) but faced challenges in holistic management and follow-up adherence (2%). Psychiatrists excelled in diagnosing organic causes of mood disorders (92%) and therapeutic decisions but struggled with non-priority diagnostic tests (44%) and long-term follow-up strategies (14%). Family physicians showed strong skills in pharmacological management (96%) and follow-up adherence (89%) but encountered barriers like stigma and referral timing for high-risk cases. Common interdisciplinary challenges included diagnostic communication, treatment coordination, and follow-up collaboration.
Late-onset BD management requires a multidisciplinary approach to address specialty-specific gaps and foster effective interdisciplinary collaboration. Enhanced training, integrated care models, and shared guidelines are recommended to optimize outcomes for elderly patients with mood disorders. Future research should focus on developing standardized protocols and evaluating the long-term impact of interdisciplinary interventions.
本研究探讨神经科医生、精神科医生和家庭医生在管理老年患者迟发性双相情感障碍（BD）时的诊断、治疗和随访方法，强调跨学科协作的作用。
一项横断面调查涉及300名专家（每个学科100名）。该调查评估了诊断准确性、治疗偏好、随访依从性以及跨学科协作的障碍。采用经Bonferroni校正的成对z检验对各专业进行比较分析，以评估反应比例的差异。
神经科医生在影像学检查和开始治疗方面表现出较高的熟练度（影像学检查回答正确率为91%），但在整体管理和随访依从性方面面临挑战（2%）。精神科医生在诊断情绪障碍的器质性病因（92%）和治疗决策方面表现出色，但在非重点诊断检查（44%）和长期随访策略（14%）方面存在困难。家庭医生在药物管理（96%）和随访依从性（89%）方面表现出较强的能力，但遇到了诸如耻辱感和高危病例转诊时机等障碍。常见的跨学科挑战包括诊断沟通、治疗协调和随访协作。
迟发性BD的管理需要多学科方法来弥补各专业的差距并促进有效的跨学科协作。建议加强培训、采用综合护理模式并共享指南，以优化老年情绪障碍患者的治疗效果。未来的研究应侧重于制定标准化方案并评估跨学科干预的长期影响。
