Could It Be Bipolar Disorder?
Up to 1 in 5 people diagnosed with major depression actually have bipolar disorder. Could one of your patients be among them?
The Rapid Mood Screener (RMS) can help family physicians identify these cases. Patients can complete it before appointments in under 2 minutes.
Improved bipolar disorder (BD) casefinding enables earlier treatment and better health outcomes
On average, Canadians with bipolar disorder wait roughly 6 to 10 years from the onset of symptoms to an accurate diagnosis. During that time, mood episodes go untreated, functioning and relationships suffer, and the risk of harm rises. Bipolar disorder is associated with a nearly 40% reduction in lifelong earnings, but earlier diagnosis and treatment can reduce this impact by almost a third.
Bipolar disorder is difficult to identify. Depressive episodes of bipolar disorder are commonly mistaken for major depressive disorder (MDD) because patients usually present while depressed, rarely reporting hypomania or mania. Up to 1 in 5 patients with major depression may have undiagnosed bipolar disorder, which could represent approximately 15–60 patients per primary care physician.
The Rapid Mood Screener (RMS) is a validated, practical, and effective new case-finding tool. In six succinctly worded, patient-friendly items, the RMS identifies likely cases and facilitates referrals for diagnosis. It is designed for busy clinical settings. It can be:
Self-administered by patients in under two minutes.
Automatically distributed through clinical software like Ocean before appointments, alongside tools such as the PHQ-9.
This website was created to help bring the RMS into primary care. Click here for step-by-step guidance on integrating it into your practice.
Average delay between symptom onset and accurate diagnosis
Average increase in earnings from earlier diagnosis and treatment
The Rapid Mood Screener
| Question | Yes | No |
|---|---|---|
| 1. Have there been at least 6 different periods of time (at least 2 weeks) when you felt deeply depressed? | ||
| 2. Did you have problems with depression before the age of 18? | ||
| 3. Have you ever had to stop or change your antidepressant because it made you highly irritable or hyper? | ||
| 4. Have you ever had a period of at least 1 week during which you were more talkative than normal with thoughts racing in your head? | ||
| 5. Have you ever had a period of at least 1 week during which you felt any of the following: unusually happy; unusually outgoing; or unusually energetic? | ||
| 6. Have you ever had a period of at least 1 week during which you needed much less sleep than usual? |
Five Benefits of the RMS
The RMS is designed to support bipolar I disorder case finding in routine clinical practice:
Brief: 6 questions, completed in under 2 minutes.
Easy to score: A positive score is 4 or more "yes" responses. A borderline score is 3 "yes" responses.
Designed for primary care: Can be self-administered during or outside a clinical visit, including through an EMR, patient portal, or waiting room workflow.
More comprehensive than mania-only screeners: Includes manic symptoms and clinical features associated with bipolar I disorder.
Evidence-based: Demonstrated 88% sensitivity and 80% specificity for bipolar I disorder. See more studies.
“Delay and misidentification of bipolar disorder are identified across Canada and around the world as an opportunity to improve the lives of people living with bipolar disorder. The Rapid Mood Screener is a valid, reliable, brief self-report screener for bipolar disorder that has been shown to assist in the timely identification and diagnosis of bipolar disorder, improving quality of life and potentially the outcomes of people with this illness.”
Disclaimer
Information on this website is for educational purposes only and is not intended to make recommendations for or promote any particular product(s). Information provided herein is not intended to replace healthcare professionals' clinical judgement nor constitute medical advice to patients. The RMS is a case-finding tool and a positive score does not constitute a diagnosis of bipolar I disorder. Patients are encouraged to direct any questions or concerns about their mental health to their healthcare professional.
Supported by
The Daymark Foundation