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23-05-2013 | Mental health | Article

Bipolar internet screening shows ‘real world’ promise

Abstract

Free abstract

medwireNews: The web-based Mood Swings Questionnaire (MSQ) has been confirmed as a clinically useful tool for patients to screen for bipolar disorder in a replication study.

The simple screening strategy was able to accurately detect a bipolar condition in over one-third of people not previously diagnosed, who then sought diagnostic clarification from a clinician.

"The MSQ would appear to distinctly assist a percentage of individuals with a previously undiagnosed bipolar disorder to receive disorder-specific management," note Gordon Parker and Kathryn Fletcher, from the University of New South Wales in Sydney, Australia.

They add that this makes "a strong case for the MSQ as a screening measure with high clinical utility, especially when it is readily accessible, provided without cost, and available for anonymous completion."

The MSQ, accessed online, includes standardized self-report measures such as the Quick Inventory of Depressive Symptomatology and the Altman Self-Rating Mania Scale. On completion, individuals receive an MSQ score, and are informed that if they score 22 or more they have a "possible" bipolar condition that warrants detailed clinical assessment.

The researchers assessed 670 participants who scored 22 or above and had not previously been diagnosed with bipolar disorder.

Of these, 141 took no action, 394 took action but did not receive a confirmed clinical diagnosis of bipolar disorder, and 135 took action and had their diagnosis clinically confirmed.

The main reasons given for not taking action included: being too busy, reluctant to consult a health practitioner, averse to taking medication, and not feeling treatment was necessary.

Among the individuals who took action but did not receive a confirmed diagnosis, 141 did not consult a clinician but made lifestyle changes, while for the 388 who did consult a clinician, the health professional disagreed with the diagnosis in 71 cases and was unsure in 182 cases.

"Thus, we can conclude that the 'positive' screening result had a quite distinctive impact on the majority of participants," say the researchers.

They highlight in the Journal of Affective Disorders that, while all patients who took action showed clinical improvement over 3 months of follow up, the greatest improvement was seen in those who had their diagnosis confirmed after seeking diagnostic clarification.

Indeed, this group showed the greatest improvement in depression severity, quality of life, and overall functioning.

They conclude: "[O]verall, results were strikingly similar to those obtained in the initial study. Participants receiving a 'positive' screen generally appeared to accept the result, commonly responding by seeking help and in applying bipolar disorder management components."

medwireNews (www.medwirenews.com) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

By Lucy Piper, Senior medwireNews Reporter

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