PT  - JOURNAL ARTICLE
AU  - Tom Hughes
AU  - Alastair Cardno
AU  - Robert West
AU  - Federica Marino-Francis
AU  - Imogen Featherstone
AU  - Keeley Rolling
AU  - Alice Locker
AU  - Kate McLintock
AU  - Allan House
TI  - Unrecognised bipolar disorder among UK primary care patients prescribed antidepressants: an observational study
AID  - 10.3399/bjgp16X683437
DP  - 2016 Feb 01
TA  - British Journal of General Practice
PG  - e71--e77
VI  - 66
IP  - 643
4099  - http://bjgp.org/content/66/643/e71.short
4100  - http://bjgp.org/content/66/643/e71.full
SO  - Br J Gen Pract2016 Feb 01; 66
AB  - Background Bipolar disorder is not uncommon, is associated with high disability and risk of suicide, often presents with depression, and can go unrecognised.Aim 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.Design and 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.Method 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.Results 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.Conclusion 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.