Bipolar disorder usually manifests during late adolescence. With the success of treatment dependent on early detection, accurate screening tools are vitally important. Yet current tools have been validated using older populations who have had symptoms for many years. With this in mind, a new study investigated the success of these tools on younger subjects.
The Success Of Bipolar Screening Tools On Younger Patients
A team including Thomas Meyer of Newcastle University took a look at 11 previous studies to find out how well tools established with older subjects identified symptoms in younger patients. The findings highlight a serious breach between the expressed desire to treat bipolar as early as possible and the attention given to validated, age-appropriate screenings.
Meyer and his colleagues took a look at seven scales used to screen for bipolar disorder: the Bipolar Spectrum Diagnostic Scale, the Hypomania Checklist, the Center for Epidemiological Studies Depression Scale, the General Behavior Inventory (GBI), and the Hypomanic Personality Scale. They also reviewed both types of the Mood Disorder Questionnaire (MDQ).
The scales were not uniformly effective, with some tools working well in clinical but not community settings. The GBI, for example, seemed effective in community settings with a sensitivity of 76 percent and specificity of 99 percent, but clinical studies showed sensitivity at 29 percent and specificity at 79 percent. In contrast, the MDQ worked well in clinical settings with sensitivity at 74 percent and specificity at 80 percent, but in community settings the sensitivity was 11 percent and specificity was at 93 percent.
Is The Solution To Utilize Two Screening Tools?
Meyer’s review shows that it’s not appropriate to use published scoring guides when assessing younger people. Until tools for younger populations can be validated, one solution could be to employ two tools – one with high specificity and one with high sensitivity. This could help in diagnosing the many individuals in the younger generation who may have symptoms of bipolar who are currently falling through the cracks.