On the occasion of World Bipolar Disorder Day, the Bipolarité France association conducted a survey of people affected by the disease: it shows in particular the heavy consequences of the delay in diagnosis on the lives of patients.
- It took between 2 to 5 years to obtain confirmation of the diagnosis for 50% of those questioned, 5 to 10 years for 18%, 10 to 15 years for 11%.
- For 20% of them, the diagnosis will have been confirmed more than 15 years after the appearance of the first symptoms.
- The delay in diagnosis had an impact on mental health for 72% of the respondents, followed by suicidal thoughts for 61% of them, 44% lost their job or stopped their studies and 36% attempted suicide.
Bipolar disorder is a chronic psychiatric illness characterized by recurrent mood disorders, alternating between manic, hypomanic, depressive or mixed episodes. Ranked among the 10 most disabling pathologies according to the World Health Organization, bipolar disorder generally begins in adolescents or young adults. It is an extremely complex disease with multifactorial causes, but there seems to be a strong familial predisposition. If the scientific literature evokes between 8 and 10 years to diagnose a disorder of bipolarity, certain testimonies evoke a diagnostic wandering which can last more than ten years.
On the occasion of World Bipolar Disorder Day, this Thursday, March 30, 2023, the Bipolarité France association and its partners are publishing the results of a survey on bipolar disorders aimed at collecting a set of data to better understand the importance of diagnosis. For this survey, conducted online from December 20, 2022 to February 19, 2023 on the website of the association Bipolarité France1,204 people diagnosed with bipolar disorder answered 20 questions.
1/5 of respondents have a diagnosis more than 15 years after the first symptoms
According to the results, 19% evoke an appearance of the first symptoms before 15 years, 32% between 15 and 20 years, and 17% between 21 and 25 years. To date, there is no objective assessment tool for the diagnosis of bipolarity disorder. The diagnosis of bipolar disorder is based solely on a clinical psychiatric examination of the patient, carried out by a medical specialist using questionnaires and various validated scales.
Based on the symptoms reported and the signs observed, the doctor can make the diagnosis. This process is generally long and complex: it will have taken between 2 and 5 years to obtain confirmation of the diagnosis for 50% of the people questioned, 5 to 10 years for 18%, 10 to 15 years for 11%. For 20% of respondents, the diagnosis will have been confirmed more than 15 years after the appearance of the first symptoms.
Bipolarity: a recurring confusion with depression
If bipolarity disorder is so difficult to diagnose, it’s because it’s often confused with depression. Many patients consult in a depressive phase (it is often the symptom that is expressed first): more than a third (37%) of respondents mention the sole presence of depressive episodes (without manic episodes) as the main cause delay in diagnosis.
Other reasons also explain the difficulty of diagnosis: the onset of manic states may not be alarming at first sight; there may be confusion with schizophrenia; toxic abuse may mask other symptoms; and mood swings in adolescence can be perceived as normal and/or transient.
“Today, there is an urgent need to make a diagnosis quickly because the person with the wrong diagnosis may receive inappropriate treatment which will not relieve their symptoms, and may even worsen their physical and mental state of health. The pathologies of bipolarity and depression do not respond to the same treatments, the wrong diagnosis can also promote risky behavior (abuse of alcohol and other substances for example) and increase the risk of suicide.alerts the association Bipolarité France.
The delay in diagnosis has serious consequences on the life of bipolar people
Indeed, the respondents are categorical: the delay in diagnosis has had serious consequences on their lives, and particularly on the level of relationships. 72% of respondents say the delay in diagnosis has affected their mental health, closely followed by suicidal thoughts for 61%. 44% have lost their job or dropped out of school and more than a third have attempted suicide (36%).
Respondents were also asked what events they believed triggered the first symptoms. If, unsurprisingly, trauma is the trigger for 39% of those questioned, others mention the arrival of a child (9%), poor working conditions (19%), an examination period (13% ), leaving the family home for studies (11%), or even moving (10%). “These data show us that depending on the emotional state of the person, an event that may seem at first glance quite ‘classic’ in a life, can actually cause dramatic consequences and potentially trigger a mental disorder. , in this case bipolar disorder. They also demonstrate that a change of life, whatever it is, is not to be taken lightly and that the slightest disturbance in mood should alert”underlines the association.
Bipolar disorder: 10 recommendations to reduce diagnosis time
In addition to the results of the survey, the Bipolarité France association and its partners have issued 10 recommendations for the short, medium and long term in order to reduce diagnosis time and improve care:
1. Raise public awareness of bipolar disorder.
2. Support innovation at the service of patients.
3. Increase the number of hours of training dedicated to mental health and to the diagnosis of mental pathologies within the framework of the initial and continuing training that is compulsory for health professionals.
4. Restore a taste for psychiatry.
5. Encourage precision psychiatry.
6. Make general practitioners aware of the challenges of the symptomatology of bipolar disorder, which is difficult to differentiate from depression, as well as the challenge of early diagnosis for the mental and physical health of their patients.
7. Create a real ecosystem around bipolar disorders.
8. Train the entourage so that they can better accompany and support.
9. Democratize the use of digital technology in psychiatry.