title: Collaborative care for a patient with bipolar disorder in primary care: a case example.
abstract: OBJECTIVE
  The objective was to describe the process of care and treatment outcomes of a 36-year-old man with bipolar disorder treated using a collaborative care model in primary care.
  
  
  METHODS
  We reviewed and summarized relevant clinical data describing the patient's care including the medical record, consultant's reports and discussions with treating clinicians. A meeting was held with experienced consulting psychiatrists to discuss the case.
  
  
  RESULTS
  Several barriers to delivery of high-quality care existed including initial loss to follow-up, few social supports and lack of follow-through at the community mental health center existed, along with presence of factors that negatively influence bipolar disorder outcomes including initial unopposed antidepressant use at baseline, concurrent alcohol use and co-occurring anxiety symptoms. Despite these barriers, the collaborative care team was able to engage the patient in care and achieve the patient's and team's treatment goals.
  
  
  CONCLUSIONS
  Delivery of primary-care-based collaborative care was associated with reduction of bipolar disorder symptoms and improved functioning in a patient with bipolar disorder.
authors.affiliation: University of Washington School of Medicine Dept. of Psychiatry and Behavioral Sciences, Seattle WA. Electronic address: cerimele@uw.edu.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Cerimele
authors.affiliation: University of Washington School of Medicine Dept. of Psychiatry and Behavioral Sciences, Seattle WA.
authors.forename: Anna
authors.initials: A
authors.lastname: Ratzliff
authors.affiliation: University of Washington School of Medicine Dept. of Psychiatry and Behavioral Sciences, Seattle WA.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Sexton
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000628:therapy*; D019033:Delivery of Health Care, Integrated / Q000592:standards*; D006801:Humans; D008297:Male; D011320:Primary Health Care; D016896:Treatment Outcome
keywords: Bipolar disorder; Collaborative care; Integrated care; Primary care