Bipolar Disorder and Population Health

This Open Forum addresses considerations for improving treatment of bipolar disorder. Most individuals with bipolar disorder report not receiving treatment from a psychiatrist in the past 12 months. In the United States, a large proportion of persons with bipolar disorder seek treatment in primary care. These patients have high symptom severity and functional impairment but are less likely to receive mood-stabilizing medications. In a prior study in a primary care setting, the authors found that one-third of patients with bipolar disorder improved after receiving treatment in primary care in a statewide collaborative care program. The collaborative care approach, originally developed for treating patients with depression in primary care, may need to be strengthened or adapted for treating patients with bipolar disorder. Strategies such as telehealth or enhanced collaborative care that also addresses psychosocial needs may be needed to effectively treat patients with bipolar disorder seeking treatment in primary care.