Bipolar Research Today is a free monthly online journal that collates and summarizes the latest research about Bipolar, including details on bipolar disorder, symptoms, treatment, depression, medication.

Diagnosing bipolar disorder in trauma exposed primary care patients.

Graves RE, Alim TN, Aigbogun N, Chrishon K, Mellman TA, Charney DS, Lawson WB

Howard University School of Medicine, Washington, DC, USA.

Objectives: Bipolar disorder (BD) is often under-recognized in non-psychiatric settings, especially in African Americans. The Mood Disorder Questionnaire (MDQ) is a screening instrument proposed to show adequate sensitivity and specificity for bipolar spectrum disorders. The current study is an examination of the usefulness of this instrument in a trauma exposed subgroup of mainly African American patients attending primary care clinics. Methods: The sample is a part of a larger study exploring traumatic stress exposure and psychopathology. Consenting patients in 3 academically affiliated primary care clinics were asked to complete the MDQ. Ninety percent of the participants were African American. Diagnostic performance was determined in a trauma exposed subgroup by employing the Structured Clinical Interview for DSM-IV (SCID) as a gold standard. Results: Of the total group of 579 participants, 178 (30.7%) screened positive for BD along with 77 (33.7%) of the 228 trauma exposed subjects who were SCID interviewed. Only 13 (27%) of the MDQ positives met SCID criteria for BD and were true positives. The sensitivity was 61.9% and the specificity was 69%, with a positive predictive value of 16.8% and a negative predictive value of 94.7%. Conclusions: The MDQ was found to have low specificity in a predominately African American group of trauma exposed patients attending primary care.

Published 5 June 2007 in Bipolar Disord, 9(4): 318-23.
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