title: The impact of being newly diagnosed with a bipolar disorder and the short-term outcome of disorder-specific management.
abstract: OBJECTIVE
  The aim of the study was to determine the impact of a first-time diagnosis of bipolar disorder in patients previously generally managed as having a unipolar disorder, and to quantify the impact of disorder-specific management strategies for such newly diagnosed patients over the following three months.
  
  
  METHODS
  A total of 157 patients receiving a diagnosis of bipolar disorder for the first time by a psychiatrist at a specialist depression clinic completed a research interview and questionnaires, with 106 (68%) also completing 12-week quantitative and qualitative evaluations. Assessing psychiatrists undertook baseline and follow-up assessments recording management changes, reactions to the diagnosis and global changes in functioning over time.
  
  
  RESULTS
  The majority of patients had a positive response to receiving a diagnosis of bipolar disorder, and most implemented a number of clinician-suggested bipolar management strategies. Patients showed improvement on five of the six self-report measures over the three-month study period. Multivariate analyses quantified lamotrigine as making the most distinctive contribution to 'improver' status, particularly for the bipolar II disorder subset.
  
  
  CONCLUSIONS
  Results are encouraging in identifying a generally positive acceptance of a diagnosis of bipolar disorder, improved outcome following the introduction of diagnostic-specific management components, and a distinctive contribution of lamotrigine to improved three-month outcome.
authors.affiliation: School of Psychiatry, University of New South Wales; Black Dog Institute, Sydney, NSW, Australia.
authors.forename: Gordon B
authors.initials: GB
authors.lastname: Parker
authors.forename: Rebecca K
authors.initials: RK
authors.lastname: Graham
authors.forename: Kathryn
authors.initials: K
authors.lastname: Fletcher
authors.forename: Shulamit M
authors.initials: SM
authors.lastname: Futeran
authors.forename: Paul
authors.initials: P
authors.lastname: Friend
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001364:Awareness; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology*; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007600:Judgment / Q000502:physiology*; D000077213:Lamotrigine; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires; D014227:Triazines / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D018691:Excitatory Amino Acid Antagonists; D014227:Triazines; D000077213:Lamotrigine
keywords: bipolar disorder; impact of diagnosis; lamotrigine