Episode 152: Signals before a diagnosis of bipolar disorder and opportunities for earlier diagnosis by GPs

In this episode, we talk to Dr Cathy Morgan, a Research Fellow within the NIHR Greater Manchester Patient Safety Research Collaboration at the University of Manchester, and Professor Carolyn Chew-Graham, GP and Professor of General Practice Research at Keele University.

Title of paper: Identifying prior signals of bipolar disorder using primary care electronic health records

Available at:

Delayed diagnosis and treatment of BD of between 6-10 years leads to adverse patient outcomes.  No published studies examine the timings of early signals of BD in a primary care setting and/or use electronic health records.  Routinely collected data identified early signals of undiagnosed BD: previous depressive episodes, sleep disturbance, substance misuse, those receiving 3 or more different psychotropic medication classes in a year, escalating self-harm, twice as many face-to face consultations and missing scheduled appointments.  Awareness of collective early signals can be used to prompt consideration of BD and offer timelier referral for specialist assessment of a BD diagnosis and initiation of appropriate treatment.

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