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Research ArticleOriginal Article

Screening for Bipolar Disorder in Patients Treated for Depression in a Family Medicine Clinic

Robert M. A. Hirschfeld, Alvah R. Cass, Devin C. L. Holt and Carol A. Carlson
The Journal of the American Board of Family Practice July 2005, 18 (4) 233-239; DOI: https://doi.org/10.3122/jabfm.18.4.233
Robert M. A. Hirschfeld
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Alvah R. Cass
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Devin C. L. Holt
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Carol A. Carlson
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Article Figures & Data

Tables

    • View popup
    Table 1.

    Sociodemographic Characteristics versus MDQ Results

    Characteristics%MDQ Positive N = 138%MDQ Negative N = 511%Total Sample N = 649P
    Age
        Mean (years)47.71 ± 11.4851.84 ± 13.4950.0.005
    Gender
        Male15.219.218.3.268
        Female84.880.881.7
    Racial/ethnic background
        White76.170.671.8
        Black or African American15.216.416.2.017
        Hispanic or Mexican American2.910.28.6
        Other5.82.73.4
    Education level
        Not a high school graduate13.215.915.3.448
        High school graduate or higher86.884.184.7
    Family
        Alone2925.926.6
        Spouse20.329.727.7.018
        Simple30.432.832.3
        Extended20.311.613.4
    Martial Status
        Married29.745.442.1
        Divorced/separated45.628.635.3.001
        Widowed812.711.7
        Single/never married16.713.313.3
    Employment status
        Employed55.146.848.5
        Not employed33.331.131.6.021
        Retired11.622.119.9
    Previous history of bipolar
        Yes34.811.216.2.000
        No65.288.883.8
    • MDQ, Mood Disorder Questionnaire.

    • View popup
    Table 2.

    Endorsement of Symptoms in the Entire Sample (N = 649)

    SymptomFrequency of Positive ResponsePercentage of Positive Response
    Felt so good or so hyper...19830.6
    Were so irritable...40862.9
    Felt much more self confident...29145.3
    Got much less sleep... didn’t miss it23035.5
    Were much more talkative...26941.6
    Thoughts raced...39761.5
    Were easily distracted...44368.4
    Had much more energy...21533.1
    Were much more active...26541.1
    Were much more social...12819.8
    Were much more interested in sex...16024.8
    Did things that were unusual...20632.0
    Spending money...20030.8
    Co-occurrence of symptoms38462.0
    Symptom severity—moderate/serious29045.7
    • View popup
    Table 3.

    Comparison of Subjects Who Completed SCID versus Those Who Did Not

    VariableMDQ Positive N = 138MDQ Negative N = 511
    SCID N = 83No SCID N = 54StatisticPSCID N = 97No SCID N = 415StatisticP
    MDQ Score9.92 ± 2.129.02 ± 1.90t = 2.503P =.7513.77 ± 2.304.15 ± 2.76t = −1.232P =.169
    Age47.5 ± 11.348.1 ± 11.9t = −0.318P =.75151.0 ± 12.452.2 ± 13.7t = −0.637P =.524
    Gender
        Female (%)87.480.4χ2 = 1.209P =.27286.079.7χ2 = 1.983P =.159
    Ethnicity
        NHW (%)77.074.580.668.4
        AA (%)13.817.6χ2 = 1.123P =.77111.817.5χ2 = 6.978P =.073
        HIS (%)2.33.97.510.8
    Education
        High school graduate (%)87.286.0χ2 = 0.040P =.84189.183.0χ2 = 2.110P =.146
    H/O BPD (%)35.630.8χ2 = 0.320P =.57212.011.1χ2 = 0.057P =.811
    • NHW, non-Hispanic white; AA, African American; HIS, Hispanic; H/O BPD, history of bipolar disorder; MDQ, Mood Disorder Questionnaire; SCID, Structured Clinical Interview based on the DSM-IV.

    • View popup
    Table 4.

    Structured Clinical Interview Results versus MDQ Results

    SCIDTotal
    PositiveNegative
    MDQ
        Positive454186
        Negative148094
        Total59121180
    • View popup
    Table 5.

    Operating Characteristics of the MDQ Compared with Previous Reports

    Current Study*Psychiatric Outpatient†General Population‡
    Sensitivity0.5800.730.281
    Specificity0.9300.900.972
    • * Primary care outpatients treated for depression (adjusted for sampling).

    • † Psychiatric outpatient clinics focused on mood disorders.7

    • ‡ Adult general population randomly selected from a group of respondents in a nationwide epidemiological general population sample.9

    • View popup
    Table 6.

    Previous History of Bipolar Disorder by SCID Diagnosis

    SCID Diagnosis of Bipolar Disorder
    PositiveNegativeTotal
    Previous history of291443
    Bipolar disorder by30107137
    Self-report59121180
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The Journal of the American Board of Family Practice: 18 (4)
The Journal of the American Board of Family Practice
Vol. 18, Issue 4
July-August 2005
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Screening for Bipolar Disorder in Patients Treated for Depression in a Family Medicine Clinic
Robert M. A. Hirschfeld, Alvah R. Cass, Devin C. L. Holt, Carol A. Carlson
The Journal of the American Board of Family Practice Jul 2005, 18 (4) 233-239; DOI: 10.3122/jabfm.18.4.233

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Screening for Bipolar Disorder in Patients Treated for Depression in a Family Medicine Clinic
Robert M. A. Hirschfeld, Alvah R. Cass, Devin C. L. Holt, Carol A. Carlson
The Journal of the American Board of Family Practice Jul 2005, 18 (4) 233-239; DOI: 10.3122/jabfm.18.4.233
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