Unipolar or bipolar depression? Improving diagnostic confidence with the adult patient

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Purpose:The purpose of this article is to inform advanced practice nurses in primary care about the differential diagnosis of bipolar disorder (BD), when depression is identified in the adult patient.Data sources:Selected research and clinical articles.Conclusions:Adult patients with BD are much more likely to seek treatment for depression than for mania or hypomania. Recognition of BD is improved when the primary care clinician is alerted to the factors indicating bipolarity and utilizes available screening tools.Implications for practice:Misdiagnosis of a bipolar spectrum disorder delays proper treatment and precludes adequate management both pharmacologically and psychotherapeutically.

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