title: Collaborative care psychiatrists' views on treating bipolar disorder in primary care: a qualitative study.
abstract: OBJECTIVE
  To understand collaborative care psychiatric consultants' views and practices on making the diagnosis of and recommending treatment for bipolar disorder in primary care using collaborative care.
  
  
  METHODS
  We conducted a focus group at the University of Washington in December 2013 with nine psychiatric consultants working in primary-care-based collaborative care in Washington State. A grounded theory approach with open coding and the constant comparative method revealed categories where emergent themes were saturated and validated through member checking, and a conceptual model was developed.
  
  
  RESULTS
  Three major themes emerged from the data including the importance of working as a collaborative care team, the strengths of collaborative care for treating bipolar disorder and the need for psychiatric consultants to adapt specialty psychiatric clinical skills to the primary care setting. Other discussion topics included gathering clinical data from multiple sources over time, balancing risks and benefits of treating patients indirectly, tracking patient care outcomes with a registry and effective care.
  
  
  CONCLUSIONS
  Experienced psychiatric consultants working in collaborative care teams provided their perceptions regarding treating patients with bipolar illness including identifying ways to adapt specialty psychiatric skills, developing techniques for providing team-based care and perceiving the care delivered through collaborative care as high quality.
authors.affiliation: University of Washington School of Medicine Department of Psychiatry and Behavioral Sciences, Seattle, WA, USA. Electronic address: cerimele@uw.edu.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Cerimele
authors.affiliation: University of Washington School of Public Health Department of Health Services, Seattle, WA, USA; University of Washington School of Medicine Department of Family Medicine, Seattle, WA, USA.
authors.forename: Abigail C
authors.initials: AC
authors.lastname: Halperin
authors.affiliation: University of Washington School of Public Health Department of Health Services, Seattle, WA, USA.
authors.forename: Clarence
authors.initials: C
authors.lastname: Spigner
authors.affiliation: University of Washington School of Medicine Department of Psychiatry and Behavioral Sciences, Seattle, WA, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Ratzliff
authors.affiliation: University of Washington School of Medicine Department of Psychiatry and Behavioral Sciences, Seattle, WA, USA.
authors.forename: Wayne J
authors.initials: WJ
authors.lastname: Katon
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001714:Bipolar Disorder / Q000628:therapy*; D019090:Case Management; D003299:Cooperative Behavior; D019468:Disease Management; D017144:Focus Groups; D006801:Humans; D008875:Middle Aged; D010865:Pilot Projects; D011320:Primary Health Care; D011570:Psychiatry; D036301:Qualitative Research; D012017:Referral and Consultation
keywords: Bipolar disorder; Collaborative care; Mood disorders; Primary care