Revisiting Late-Onset Bipolar Disorder Associated With Pituitary Adenoma: A Cross-Sectional, Multidisciplinary,...

Area of Science:

• Geriatric Psychiatry
• Neurology
• Family Medicine

Background:

• Late-onset bipolar disorder (BD) presents unique diagnostic and management challenges in elderly populations.
• Effective care necessitates understanding the distinct approaches and limitations of various medical specialties.

Purpose of the Study:

• To explore and compare the diagnostic, treatment, and follow-up strategies of neurologists, psychiatrists, and family physicians for late-onset BD in elderly patients.
• To identify barriers and facilitators of interdisciplinary collaboration in managing this patient group.

Main Methods:

• A cross-sectional survey was conducted among 300 specialists (100 neurologists, 100 psychiatrists, 100 family physicians).
• The survey assessed diagnostic accuracy, treatment preferences, follow-up adherence, and interdisciplinary collaboration barriers.
• Comparative analysis using pairwise z-tests with Bonferroni correction evaluated differences across specialties.

Main Results:

• Neurologists excelled in imaging (91%) but lagged in holistic management (2%). Psychiatrists were adept at diagnosing organic causes (92%) but struggled with non-priority tests (44%) and long-term follow-up (14%).
• Family physicians demonstrated strong pharmacological management (96%) and follow-up adherence (89%) but faced stigma and referral timing issues.
• Common interdisciplinary challenges included diagnostic communication, treatment coordination, and follow-up collaboration.

Conclusions:

• A multidisciplinary approach is crucial for late-onset BD, addressing specialty-specific deficits and enhancing collaboration.
• Recommendations include improved training, integrated care models, and shared guidelines to optimize outcomes for elderly mood disorder patients.
• Future research should focus on standardized protocols and evaluating the impact of interdisciplinary interventions.