Health care utilization and costs among privately insured patients with bipolar I disorder

Bryant‐Comstock, Lynda; Stender, Monika; Devercelli, Giovanna

doi:10.1034/j.1399-5618.2002.01148.x

Cited by 119 publications

(60 citation statements)

References 17 publications

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“…11,17,[30][31][32][33] Although the patients screening positive on the MDQ in this study may encompass both bipolar I and bipolar II patients, it is noteworthy that a previous study found that mean 1-year allcause health care costs were nearly 4 times as high for patients with bipolar I disorder as for a comparison group of age-and sex-matched health plan members without a diagnosis of bipolar disorder ($7,663 vs. $1,962, respectively). 34 Rajagopalan et al (2006) found significantly higher all-cause annual health care service costs in employees with bipolar disorder compared with employees with other mental disorders and estimated the annual all-cause health care costs for employees with bipolar disorder at $9,983, compared with $3,147 for a matched comparison group without bipolar disorder. 33 The poor humanistic outcomes in MDQ-positive patients in this study and the burden of illness associated with bipolar disorder reported in previous studies suggest that accurate and early diagnosis of bipolar disorder may result in improved patient outcomes.…”

Section: ■■ Discussionmentioning

confidence: 99%

“…33 Major depressive affective disorder recurrent episode severe degree without psychotic behavior 296. 34 Major depressive affective disorder recurrent episode severe degree specified as with psychotic behavior 296. 35 Major SDS item and summary scale scores were reported as the proportion of patients with "marked impairment" (score of 7-10 on a scale of 0-10).…”

Section: Burden Of Disease: Humanistic Outcomesmentioning

confidence: 99%

See 1 more Smart Citation

Prevalence and Humanistic Impact of Potential Misdiagnosis of Bipolar Disorder Among Patients With Major Depressive Disorder in a Commercially Insured Population

Kamat

Rajagopalan²,

Pethick³

et al. 2008

JMCP

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BACKGROUND: Patients with bipolar disorder typically present to physicians in the depressed rather than the manic or hypomanic phase of illness. Because the depressive episodes in bipolar disorder may be indistinguishable from those in major depressive disorder (MDD), misdiagnosis may occur.OBJECTIVES: To estimate from administrative claims data and a telephone survey the prevalence of potential misdiagnosis of bipolar disorder among patients with MDD and the humanistic (health-related quality of life [HRQOL] and disability) effects associated with misdiagnosis in a managed care setting.METHODS: Administrative claims data were used to identify patients with medical claims for MDD from a database of 9 million members of commercial health plans from 3 U.S. regions. The inclusion criteria were as follows: Patients with ICD-9-CM codes for bipolar disorder at any time throughout the study period (January 1, 2000, through March 31, 2005) were excluded from this cohort. This cohort was targeted for a telephone survey that was conducted from August 1 through October 30, 2006. From the telephone survey sampling frame of 5,777, a total of 1,360 interviews were completed for a response rate of 23.5%. Respondents were screened for potential bipolar disorder using the Mood Disorder Questionnaire (MDQ). The Medical Outcomes 12-Item Short Form Survey (SF-12), Version 2, a widely used and validated instrument that assesses health-related functioning, and the Sheehan Disability Scale (SDS), which measures depression-related disability, were administered to a convenience subsample of 112 survey respondents to collect HRQOL and disability information, respectively. RESULTS: Of 1,360 adult patients aged 18 years or older with a diagnosis of MDD but without a medical claim for diagnosis of bipolar disorder, 94 (6.9%) screened positive for bipolar disorder on the MDQ. More patients with a positive screen for bipolar disorder reported lifetime histories of obsessive compulsive disorder (24.5% vs. 8.2%, P < 0.001), psychotic disorders or hallucinations (9.6% vs. 2.4%, P < 0.001), suicidal ideation (61.7% vs. 29.4%, P < 0.001), and drug abuse (34.0% vs. 11.1%, P < 0.001) than did patients with a negative screen for bipolar disorder. In the subgroup of patients who completed the SF-12 and SDS, patients with a positive screen for bipolar disorder (n = 33) had lower scores (i.e., greater impairment) on the social functioning, role emotional, and overall mental component summary scales of the SF-12 than did patients with a negative screen for bipolar disorder (n = 79, P < 0.001), but did not significantly differ on the physical component summary scale. Patients with a positive screen for bipolar disorder on the MDQ were more likely than patients who screened MDQ-negative to report severe depression-related impairment (scores of 7 and higher on the SDS scale) with work life (54.5% vs. 24.1%, respectively, P = 0.002), social life (66.7% vs. 39.2%, P = 0.008), and family life (66.7% vs. 34.2%, P = 0.002) on the SDS. CONCLUSIONS: In t...

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Section: ■■ Discussionmentioning

confidence: 99%

Section: Burden Of Disease: Humanistic Outcomesmentioning

confidence: 99%

Prevalence and Humanistic Impact of Potential Misdiagnosis of Bipolar Disorder Among Patients With Major Depressive Disorder in a Commercially Insured Population

Kamat

Rajagopalan²,

Pethick³

et al. 2008

JMCP

View full text Add to dashboard Cite

show abstract

“…It is predicted that the lifetime prevalence of bipolar disorder ranges from 1% to 8%. [1][2][3][4][5][6][7][8] As research continues into the subtypes of bipolar disorder, many experts believe that bipolar disorder may be as widespread as unipolar depression, though not as widely recognized.…”

mentioning

confidence: 99%

Quality of Life Among Bipolar Disorder Patients Misdiagnosed With Major Depressive Disorder

Ag¹,

Rajagopalan²,

Bolge³

et al. 2007

Prim. Care Companion J. Clin. Psychiatry

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Objective: Bipolar disorder is frequently misdiagnosed as major depressive disorder (MDD). We aim to quantify the prevalence of misdiagnosed bipolar disorder among the depression population and evaluate the quality-of-life (QOL) impact of misdiagnoses.Method: Data were collected from 2 selfadministered, cross-sectional studies in 2003. Patients participating in The Bipolar Disorder Misdiagnosis Study (N = 1156) were previously diagnosed with depression, experienced a depressive episode within the past year, and had no previous diagnosis of bipolar disorder or schizophrenia. Patients who experienced a manic episode in the past year, based on DSM-IV criteria, were classified as misdiagnosed. Patients participating in The Bipolar Disorder Project (N = 1214) selfreported a diagnosis of bipolar disorder and were recruited through community mental health centers and support groups. Quality of life was assessed via the Psychological General Well-Being (PGWB) Index and Medical Outcomes Study 8-Item Short-Form Health Survey (SF-8). Demographic differences between groups were controlled using linear regression models.Results: Of the diagnosed MDD sample, 14.3% met criteria for misdiagnosed bipolar disorder. When controlling for demographic differences, the PGWB overall score for the misdiagnosed averaged 12.77 (p < .001) points lower than that of MDD patients and 9.55 (p < .001) points lower than that of diagnosed bipolar disorder patients. The average SF-8 mental component summary score for the misdiagnosed was 5.85 (p < .001) points lower than that of MDD patients and 3.18 (p = .002) points lower than that of diagnosed bipolar disorder patients.Conclusion: Misdiagnosis is associated with poorer QOL than MDD or diagnosed bipolar disorder, which are recognized as having a considerable impact on QOL.(Prim Care Companion J Clin Psychiatry 2007;9:195-202) ipolar disorder, a chronic affective disorder characterized by depression and at least 1 manic episode,

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“…Recovery from episodes normally takes months and in total patients suffers from various types of affective symptoms about 50% of the time even if they are appropriately treated receiving mood stabilizing medication [5]. The burden of total health care for patients with BD is estimated at two to four times higher than for age and sex matched controls [6].…”

Section: Introductionmentioning

confidence: 99%

The Association between Affectivity, Perceived Stress and Pain in Patients with Bipolar Disorder

Karling¹,

Maripuu²,

Wikgren³

et al. 2016

J Depress Anxiety

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Objective: Patients with bipolar disorder commonly experience recurrent/chronic pain, usually associated with worsening of the psychic state. The primary aim of the study was to evaluate the association to state anxiety, depression, perceived stress and concurrent pain. A secondary aim was to determine the locations and characteristics of pain. Method:A cross-sectional study was conducted on 87 bipolar type 1 and 50 bipolar type 2 patients (mean age 50.4 years; 63% women). HADS-A and HADS-D was used to determine the levels of anxiety and depression, the Perceived Stress Questionnaire (PSQ) was used to measure the perception of stress, and experience of pain was determined using a validated pain questionnaire including the duration, characteristics and location of pain.

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Health care utilization and costs among privately insured patients with bipolar I disorder

Abstract: Treatment of bipolar disorder, particularly inpatient care, is costly to patients and health insurers. Further study is needed to find ways to reduce the overall cost of managing these patients without jeopardizing patient care.

Cited by 119 publications

References 17 publications

Prevalence and Humanistic Impact of Potential Misdiagnosis of Bipolar Disorder Among Patients With Major Depressive Disorder in a Commercially Insured Population

Prevalence and Humanistic Impact of Potential Misdiagnosis of Bipolar Disorder Among Patients With Major Depressive Disorder in a Commercially Insured Population

Quality of Life Among Bipolar Disorder Patients Misdiagnosed With Major Depressive Disorder

The Association between Affectivity, Perceived Stress and Pain in Patients with Bipolar Disorder

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