Watson S, Ahuja N, Azim L, Cipriani A, Clark E, Evans J, Gergel T, Gibson J, Hall J, Kabir T, Mathias A, Nixon N, Wall L, Chew-Graham C
School of Medicine, Keele University, Keele, UK.
Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
Health Expect. 2025 Aug;28(4):e70398. doi: 10.1111/hex.70398.
Patients living with bipolar disorder in the UK face, on average, a delay of 9.5 years from initial presentation of symptoms to confirmation of diagnosis. The aim of this qualitative study was to understand the challenges and facilitators involved in diagnosing individuals with BD from the perspectives of GPs and psychiatrists and how the delay in diagnosis of BD from the first presentation might be reduced.
Semi-structured interviews with clinicians (GPs and psychiatrists) were used to explore attitudes and perspectives towards diagnosing, managing, and accessing or delivering specialist opinion for BD within the current NHS systems and pathways. Thematic analysis was conducted.
GPs report a lack of confidence in identifying BD due to limited understanding of the condition, resources, and lack of continuity of care. Both primary and secondary care clinicians expressed frustrations with the referral pathway in relation to high thresholds for secondary care acceptance and long waiting times for assessments. Clinicians suggest that further education and training in primary care supported by psychometric tools and mood diaries to improve identification of BD. Clinicians also advocated for enhanced communication and collaboration between primary and secondary care to streamline and reduce delays in the diagnostic process.
We suggest a number of strategies which could reduce the harmful delay in diagnosis of bipolar.
A Lived Experience Advisory Panel (LEAP) was convened with the support of the McPin Foundation. LEAP members have contributed towards the development of public-facing documents, including the topic guides, qualitative data analysis and dissemination of findings.
在英国，双相情感障碍患者从首次出现症状到确诊，平均会有9.5年的延迟。这项定性研究的目的是从全科医生和精神科医生的角度，了解诊断双相情感障碍患者所涉及的挑战和促进因素，以及如何减少从首次出现症状到双相情感障碍确诊的延迟。
通过对临床医生（全科医生和精神科医生）进行半结构化访谈，探讨他们对当前国民保健服务体系和途径中双相情感障碍的诊断、管理以及获取或提供专家意见的态度和观点。进行了主题分析。
全科医生表示，由于对病情的了解有限、资源不足以及缺乏连续护理，他们对识别双相情感障碍缺乏信心。初级和二级护理临床医生都对转诊途径感到沮丧，因为二级护理接受的门槛高，评估等待时间长。临床医生建议在初级护理中通过心理测量工具和情绪日记提供进一步的教育和培训，以改善双相情感障碍的识别。临床医生还主张加强初级和二级护理之间的沟通与协作，以简化和减少诊断过程中的延迟。
我们提出了一些可以减少双相情感障碍诊断中有害延迟的策略。
在麦克平基金会的支持下，召集了一个生活经验咨询小组（LEAP）。LEAP成员为面向公众的文件的制定做出了贡献，包括主题指南、定性数据分析和研究结果的传播。
