Evidence map›Paper›PMID 40842333›Full record

ArticleHealth expectations : an international journal of public participation in health care and health policy2025

Reducing the Delay in the Diagnosis of Bipolar Disorder: A Qualitative Study.

Hoppe, S Watson, N Ahuja, L Azim, A Cipriani, E Clark, J Evans, T Gergel, J Gibson, J Hall and 6 more

Abstract read
In one paragraph

Article in Health expectations : an international journal of public participation in health care and health policy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Improving diagnosis and support for people with bipolar in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

HoppeSchool of Medicine, Keele University, Keele, UK.ORCID 0009-0001-2593-3937
S WatsonTranslational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.ORCID 0000-0002-2558-3367
N AhujaRegional Affective Disorders Service, Cumbria, Northumberland, Tyne and Wear NHS Trust, Newcastle upon Tyne, UK.ORCID 0000-0002-4949-7893
L AzimCumbria, Northumberland, Tyne and Wear NHS Trust, Newcastle upon Tyne, UK.ORCID 0000-0003-3094-5366
A CiprianiUniversity of Oxford, Oxford, UK.ORCID 0000-0001-5179-8321
E ClarkCumbria, Northumberland, Tyne and Wear NHS Trust, Newcastle University, Newcastle upon Tyne, UK.
J EvansBristol University, Bristol, UK.ORCID 0000-0003-3171-640X
T GergelBipolar, London, UK.ORCID 0000-0001-9155-8277
J GibsonMcPin Foundation, London, UK.ORCID 0000-0003-1731-4869
J HallNewcastle University, Newcastle upon Tyne, UK.
T KabirDepartment of Psychiatry, University of Oxford, Oxford, UK.ORCID 0000-0001-8908-0964
A MathiasCumbria, Northumberland, Tyne and Wear NHS Trust, Newcastle University, Newcastle upon Tyne, UK.
N NixonSchool of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0002-7880-0118
PrasadUniversity of Nottingham, Nottingham, UK.ORCID 0000-0001-5470-276X
L WallCumbria, Northumberland, Tyne and Wear NHS Trust, Newcastle University, Newcastle upon Tyne, UK.
C Chew-GrahamSchool of Medicine, Keele University, Keele, UK.ORCID 0000-0002-9722-9981

Funding

The ASCEnD study is funded by the NIHR HTA Programme (NIHR132773). C.C.-G. is partly funded by WM ARC (NIHR200165). A.C. is supported by the National Institute for Health Research (NIHR) Oxford Cognitive Health Clinical Research Facility, by an NIHR Research Professorship (grant RP-2017-08-ST2-006), by the NIHR Oxford and Thames Valley Applied Research Collaboration, by the NIHR Oxford Health Biomedical Research Centre (grant NIHR203316) and by the Welcome Trust (GALENOS Project).
6 · The paper itself

Abstract

introductionPatients living with bipolar disorder in the UK face, on average, a delay of 9.5 years from initial presentation of symptoms to confirmation of diagnosis. The aim of this qualitative study was to understand the challenges and facilitators involved in diagnosing individuals with BD from the perspectives of GPs and psychiatrists and how the delay in diagnosis of BD from the first presentation might be reduced.

methodsSemi-structured interviews with clinicians (GPs and psychiatrists) were used to explore attitudes and perspectives towards diagnosing, managing, and accessing or delivering specialist opinion for BD within the current NHS systems and pathways. Thematic analysis was conducted.

resultsGPs report a lack of confidence in identifying BD due to limited understanding of the condition, resources, and lack of continuity of care. Both primary and secondary care clinicians expressed frustrations with the referral pathway in relation to high thresholds for secondary care acceptance and long waiting times for assessments. Clinicians suggest that further education and training in primary care supported by psychometric tools and mood diaries to improve identification of BD. Clinicians also advocated for enhanced communication and collaboration between primary and secondary care to streamline and reduce delays in the diagnostic process.

conclusionWe suggest a number of strategies which could reduce the harmful delay in diagnosis of bipolar. PATIENT OR PUBLIC CONTRIBUTION: A Lived Experience Advisory Panel (LEAP) was convened with the support of the McPin Foundation. LEAP members have contributed towards the development of public-facing documents, including the topic guides, qualitative data analysis and dissemination of findings.

Indexed as

Attitude of Health PersonnelBipolar DisorderDelayed DiagnosisAdultFemaleGeneral PractitionersHumansInterviews as TopicMaleMiddle AgedPrimary Health CarePsychiatryQualitative ResearchReferral and ConsultationState MedicineUnited Kingdombipolar disorderdiagnosispatient journeyprimary caresecondary care

Identifiers

PMID40842333
PMCPMC12371200

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.