Volume 198 - Issue 3
Treatment of bipolar depression
Authors: Andrew R Robertson, Greg M de Moore and Philip M Boyce
Med J Aust 2013; 198 (3): 138-139. || doi: 10.5694/mja12.11658
Published online: 18 February 2013
Published online: 18 February 2013
To the Editor: The most common cause of difficult-to-treat depression may be a failure to diagnose bipolar II depression.
To the Editor: We were interested to read the MJA Open supplement Difficult-to-treat depression: a guide to management in primary care, and in particular the article on treatment of bipolar depression.1 However, we were surprised that nowhere in the supplement was there any mention of the importance of diagnosing bipolar II disorder, and that there was no emphasis on the need to recognise that bipolar depression requires different treatment to non-bipolar depression to be effective.
In a recent study of patients in a rural setting referred largely by general practitioners for psychiatric assessment, we found that 113 of 559 newly referred patients (20%) were diagnosed with bipolar II disorder and, of these, the diagnosis was made for the first time in 69 patients (61%).2 Our findings suggest that the most common cause of difficult-to-treat depression is a failure to diagnose bipolar II depression — or, when it is diagnosed, a failure to know that bipolar depression requires different treatment to be effective.
Competing interests
No relevant disclosures.
References
- Berk M, Berk L, Davey CG, et al. Treatment of bipolar depression. MJA Open 2012; 1 Suppl 4: 32-35. doi: 10.5694/mjao12.10611. 0_CHDHGFEI
- Robertson A, de Moore G, Boyce P. Bipolar II disorder in rural New South Wales. Australas Psychiatry 2012; 20: 203-207. 0_i1142858