Bipolar disorder : Initial assessment guide

Bipolar Disorder is a complex mental health condition characterized by significant mood swings, including episodes of mania or hypomania and depression. These mood swings go beyond the normal ups and downs of daily life, often causing substantial impairment in personal, social, and occupational functioning. For primary care clinicians, early identification of bipolar disorder is crucial, as it can often be misdiagnosed or overlooked, particularly when presenting as depression.

The manic phase is marked by feelings of euphoria, high energy, reduced need for sleep, rapid speech, impulsivity, and sometimes severe irritability or aggressive behaviour. Conversely, the depressive phase involves persistent sadness, loss of interest in pleasurable activities, fatigue, and changes in sleep and appetite. Hypomania, a milder form of mania, presents similar but less intense symptoms and does not include psychotic features.

Our specially developed questionnaire aims to assist primary care clinicians in screening for potential bipolar disorder. It focuses on key symptoms and behaviours indicative of the disorder, including mood fluctuations, changes in energy and activity levels, sleep patterns, speech, thought processes, and impulsivity. The questionnaire also considers family history and the presence of any comorbid substance use, which are important factors in bipolar disorder.