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Implementing a Community Bipolar Screening Questionnaire in VT
Cooper, Suven
Cooper, Suven
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The National Institute of Mental Health estimates the number of adults with a diagnosed mental disorder is nearly 1 in 5, this equates to about 43 million Americans. The national shortage of psychiatrists has hit Vermont particularly hard. There has been both a lack of funding and a lack of psychiatrists. For example there is often a waiting line for acute level 1 beds at the Vermont Psychiatric Care Hospital since it opened after the flooding of the state hospital in 2011. In light of the shortage of resources and psychiatrists in Vermont it is important to maximize the limited time that family practitioners have with patients with mental illness. With regards to diagnosing bipolar spectrum disorder the best method is using the Mood Disorder Questionnaire (MDQ) which is a 17 question survey and practical for an outpatient setting. A study examining the validity of the MDQ found that it provided good sensitivity (0.73, 95% [CI]=0.65–0.81) without sacrificing specificity (0.90, 95% CI=0.84–0.96). Another study was conducted in a community setting and it was found that the MDQ had a sensitivity of 0.28 and a specificity of 0.97. The MDQ has been proven to be effective in a psychiatric outpatient setting and been proven to be less effective or limited in the outpatient setting. However we must weigh the risks and benefits. In a setting like Vermont, with restricted resources, limited inpatient beds, lack of psychiatrists and a population of individuals with undiagnosed bipolar spectrum disorder the MDQ can prove to be more useful than harmful and can aid in identifying patients who potentially have bipolar spectrum disorder.
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2017-01-01
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