Delay in Diagnosis of Bipolar Disorder Linked With Sex, Suicide Attempts, Age at Onset

therapy G 1214458835 — Emotional Well-being, Mental Health, Psychiatrists, Psychologists

Age at onset and age when looking for specialist assist have been identified to be linked with delays in diagnosis of bipolar disorder, Canadian researchers found in a study published in the Journal of Affective Disorders. The investigators also identified a longer period till diagnosis of bipolar I disorder compared with bipolar II disorder.

Delays in diagnosis of bipolar disorder can lead to social, psychiatric, and other well being challenges, and early interventions can lead to psychosocial improvements.  Therefore, the investigators sought to recognize elements involved in delays making use of information from the Health Outcomes and Patient Evaluations in Bipolar Disorder (HOPE-BD) multicentre study of The Canadian Network for Bipolar Disorder (CAN-BD).

The researchers chosen a sample of patients who participated in the HOPE-BD study, which integrated patients in Ontario, Quebec, and British Columbia who had been at least 15 years of age. Patients integrated in the sample (n=319, imply age 42 years, 60.2% female) had been diagnosed with bipolar I disorder I (n=192) or bipolar II disorder (n=127) according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and knew the duration of their undiagnosed bipolar disorder.

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The median age at onset of bipolar disorder was 23 years, and the median age at diagnosis of bipolar disorder was 35 years. The median duration of undiagnosed bipolar disorder was 8 years. In their 1st episode, the majority of patients skilled depression (53.6%), which was linked with longer duration in which bipolar disorder went undiagnosed (P &lt.0001).

Onset of bipolar disorder ahead of the age of 18 years was linked with longer duration of undiagnosed bipolar disorder  (P &lt.0001), and females had been more most likely to have longer duration of undiagnosed bipolar disorder compared with males (P =.0013).

Delays in diagnosis tended to be longer for bipolar II disorder and when there was an absence of lifetime psychotic symptoms (P &lt.0001). Lifetime suicide attempts (P =.0045) and comorbid anxiousness issues (P =.0324) had been connected with longer duration of undiagnosed bipolar disorder.

“Clinical factors such as lifetime suicide attempts and comorbid anxiety disorders were associated with a longer diagnostic delay, whereas the presence of lifetime psychotic symptoms and psychiatric hospitalizations were associated with a shorter delay,” the researchers mentioned. “These findings highlight the need for implementation of strategies for early identification and interventions in BD.”

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device corporations. This investigation was supported by Janssen-Ortho, Canada. Please see the original reference for a complete list of disclosures.


Keramatian K, Pinto JV, Schaffer A, et al. Clinical and demographic factors associated with delayed diagnosis of bipolar disorder: data from Health Outcomes and Patient Evaluations in Bipolar Disorder (HOPE-BD) study. J Affect Disord. Published on-line October 1, 2021. doi:10.1016/j.jad.2021.09.094

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