The Curbsiders Internal Medicine Podcast #415 Bipolar Disorder With Dr. Kevin Johns
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Nov 13, 2023 Dr. Kevin Johns, an expert in diagnosing and treating bipolar disorder, discusses the challenges of diagnosing and treating this condition. Topics covered include screening for mania, the importance of family history, understanding the diagnosis and criteria for bipolar disorder, and the challenges of accurate diagnosis and effective treatment. The hosts emphasize the need for regular assessment, monitoring, and a healthy lifestyle for individuals with bipolar disorder.
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Screen For Past Manic Periods
- Ask patients with depression about past periods of elevated energy, decreased need for sleep, grandiosity, or risky behavior to screen for bipolar disorder.
- When positive, get collateral history from family or partners to confirm duration and functional impairment.
Depression Dominates Bipolar Course
- Most symptomatic time in bipolar disorder is spent depressed, not manic.
- You often cannot confidently diagnose bipolar disorder until you actually observe a manic episode.
Choose Screening Tools Wisely
- Use screening tools with known properties: MDQ to rule out bipolar when negative, CIDI 3.0 interview when you strongly suspect bipolar disorder.
- Reserve MDQ positives for further evaluation because of poor positive predictive value.