Bipolar disorder screening among adult patients in an urban emergency department setting

Objective: We sought to derive preliminary estimates of the prevalence of bipolar disorder among a sample of emergency department (ED) patients. Method: For 1 week in November 2003, consecutive patients aged ≥ 18 years presenting to an urban ED between 8:00 a.m. and midnight were screened for bipolar disorder. We used the National Depression Screening Day protocol, which includes the Mood Disorder Questionnaire. Patients who were severely ill or who had altered mental status were excluded. Demographic factors, past mental health history, and medical history also were assessed. Results: Of the 212 patients that were approached and eligible, 182 (86%) were enrolled. Our sample's point prevalence for positive screen for bipolar disorder was 6.6% (95% CI = 3.5% to 11.2%). Conclusion: Nearly 7% of ED patients screened positive for bipolar disorder, which is considerably higher than community estimates of 1.3%. Further prospective research on bipolar disorders among ED patients is needed to further define the scope of the problem and to inform the development of appropriate screening, assessment, and intervention programs.