Most psychiatrists agree that the ideal treatment for bipolar patients includes a healthy mix of medication and therapy. But is that what usually happens? Jennifer Vande Voort, M.D., at Mayo Clinic, posed that question.
While Dr. Vande Voort found most Mayo Clinic bipolar patients are receiving quality care, the system isn't perfect. She hopes the information and data she is gathering about Mayo Clinic care will help physicians here and at other medical institutions offer better treatment plans.
Dr. Vande Voort shared these findings at the American Academy of Child & Adolescent Psychiatry conference in Toronto.
SPEAKER: There's a lot of controversy about what is bipolar disorder in the pediatric population. So some people say if the kid has irritability, they must have bipolar disorder. And other people tend to take more of a classic diagnosis approach to it, similar to what they would have with adults, where it has to be very clear cut, manic episodes that are cyclical in nature and not just a general overall irritability that is the same over time. You need to have the cycles. And so depending on which institution you go to or who you ask, it's going to vary. But here at Mayo, we've been trying to take more of a narrow phenotype in terms of trying to diagnose the disorder. So making sure that if there is irritability or manic episodes, that there are cycles to them. So we're not over diagnosing and putting kids on pretty powerful medications that they might not need. We are looking at bipolar disorder in pediatric patients and seeing what services have been offered to them when they're diagnosed with bipolar disorder. And we're looking at things such as hospital admissions, the number of ED or Emergency Department evaluations, therapy visits, different medication trials, how often the diagnosis of pediatric bipolar stays consistent throughout the years, and seeing how it can stays consistent across providers as well. So we have 85 cases that have been kids who have been at Mayo Clinic diagnosed with bipolar disorder from 2000 to 2010. And they had to receive their primary care at Mayo. And so we didn't want people who just came for consultations and then left, because then we can't really track them very well. And we looked at people for a three year window of time. So one year prior to the diagnosis, if they had previous psych history, and two years after the diagnosis. And collected information such as the number of hospital admissions, the number of emergency department evaluations, psychotherapy phone calls, medication trials, figuring out what medications they were on, how many they were on, how often the medications changed. And so that's the data that's been collected.