Diagnosis and treatment of patients with bipolar disorder: A review for advanced practice nurses

Abstract

Purpose: This review article provides an overview of the frequency, burden of illness, diagnosis, and treatment of bipolar disorder (BD) from the perspective of the advanced practice nurses (APNs).

Data sources: PubMed searches were conducted using the following keywords: "bipolar disorder and primary care," restricted to dates 2000 to present; "bipolar disorder and nurse practitioner"; and "bipolar disorder and clinical nurse specialist." Selected articles were relevant to adult outpatient care in the United States, with a prioritization of articles written by APNs or published in nursing journals.

Conclusions: BD has a substantial lifetime prevalence in the population at 4%. Because the manic or depressive symptoms of BD tend to be severe and recurrent over a patient's lifetime, the condition is associated with significant burden to the individual, caregivers, and society. Clinician awareness that BD may be present increases the likelihood of successful recognition and appropriate treatment. A number of pharmacological and nonpharmacological treatments are available for acute and maintenance treatments, with the prospect of achieving reduced symptom burden and increased functioning for many patients.

Implications for practice: Awareness of the disease burden, diagnostic issues, and management choices in BD has the potential to enhance outcome in substantial proportions of patients.

Keywords: Primary care; bipolar disorder; managed care; mental health; nurse practitioners.

Figure 1

Mood range and associated mood diagnosis (Vieta & Goikolea, 2005).