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Title: The diagnostic process in bipolar disorder : a service user perspective
Author: Swift, Naomi
ISNI:       0000 0004 2733 9848
Awarding Body: Cardiff University
Current Institution: Cardiff University
Date of Award: 2012
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Bipolar disorder is a severe and enduring mental health condition. Although early identification is associated with better outcomes, research has shown that many people wait over a decade after first experiencing affective symptoms before a correct diagnosis is made. A misdiagnosis of unipolar depression often leads to the inappropriate prescription of potentially mood-destabilising antidepressant medications. The aim of this study was to consider service user and carer experiences and their often overlooked views on diagnostic issues. Participants were recruited via the charity Bipolar UK. Initially a focus group discussed the diagnostic process and relevant issues, then the transcript was analysed thematically and used to develop a detailed survey questionnaire. The survey was piloted before being launched online and completed by 262 service users and 65 carers. Survey respondents reported an average delay of over eleven years between first seeking help for bipolar symptoms and being correctly diagnosed. Almost 70% reported a previous misdiagnosis of depression, and over half had experienced mania/hypomania whilst taking antidepressant medication. Nearly a third consulted a doctor over 20 times with bipolar symptoms before receiving help for bipolar disorder. Participants considered that improvements are needed in primary care mental health assessment and that GPs need more training. Many reported that their condition had led them to be discriminated against and agreed that society’s lack of understanding was a major problem. Carers indicated similar opinions and emphasised the potential benefits of including carers in the assessment process. This study suggests that the identification of bipolar disorder is often poor and that assessment of the condition in primary care needs to be improved. Service users offered suggestions for improvements, including recognition of early indicators, appropriate assessment questions and better training which could be adopted by service providers. Limitations of the study and implications for future research were discussed.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: BF Psychology ; RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry ; RM Therapeutics. Pharmacology