Doctors Failing to Identify Bipolar Disorder

Doctors are failing to recognise manic depression, otherwise known as bipolar disorder, despite it being the most common mental illness, the government’s drug watchdog warned yesterday. Patients are waiting an average of eight years to be accurately diagnosed. If untreated, they suffer 20 years of ill health, 14 years when they cannot work, and nine years off their life expectancy.

The legacy of the disorder was outlined by the National Institute for Health and Clinical Excellence (Nice) as it published its first guidelines on how to identify, treat and manage the condition in adults and children. Half a million people in England and Wales – 1% of the population – have the condition, and they are 28 times more likely to commit suicide than the rest of the public. A total of 2,000 people – 0.4% of those diagnosed – kill themselves every year. But the disorder is far less well-known than conditions such as schizophrenia.

Richard Morris, professor of psychiatry at Nottingham University and chair of the guideline committee, said: “This is quite a technical disorder and it hasn’t been given the emphasis other conditions have in terms of training of all doctors and health professionals, including psychiatrists. The treatment is quite complicated because bipolar goes in phases and which drug you take depends on which phase you’re in. Psychiatrists and health professionals do need help and guidance on which drugs to use in the right conditions. This aims to sharpen their practice. The treatment being provided [at present] is suboptimal.”

Bipolar disorder is characterised by the presence of episodes of mania and depression. During a manic episode, a person feel elation and/or irritability. When they have depression, they may experience feelings of worthlessness and contemplate suicide or self-harm.

The guidelines also demand annual physical health reviews, and the need for all healthcare professionals to monitor medication. Psychological therapy such as cognitive behavioural therapy should also be considered for patients with mid to moderate symptoms.

Andrea Sutcliffe, deputy chief executive of Nice, said: “Bipolar disorder often goes unrecognised or misdiagnosed and more needs to be done to raise awareness of the condition and the fact there are effective treatments.”