An Online Survey Among Patients and Physicians

Approximately 8 million American adults may be affected with bipolar disorder (1,2). People with bipolar disorder experience extreme mood swings from lows called bipolar depression to highs called bipolar mania (3). To further explore the impact of bipolar depression on people’s lives, the National Council for Community Behavioral Healthcare and AstraZeneca commissioned a new online survey of 2,005 patients living with bipolar disorder and 500 physicians who treat patients with bipolar disorder (4). Findings are as follows:
 
Despite being treated for bipolar disorder, some patients continue to struggle with functioning in their day-to-day lives, particularly as a result of bipolar depression (4).

• The greatest concerns among people living with bipolar disorder are that their symptoms will have an impact on daily life, such as family, relationships, or job (73%), and that they will have long periods of depressive episodes (63%) (4).

• Ninety percent of people living with bipolar disorder said that they have difficulty managing or completing day-to-day tasks due to their bipolar depression symptoms (4).
• Approximately nine in 10 patients (89%) said they have cancelled social engagements because of bipolar depression (4).
• When asked how they felt most of the time, only 27 percent of people living with bipolar disorder said they felt well-balanced and just 23 percent felt their depression was well-controlled (4). 
• The majority of people living with bipolar disorder agreed that bipolar depression causes difficulty in their ability to manage housework (73%), run errands (59%), groom themselves (53%), and pay bills (49%) (4).

For most people with bipolar disorder, bipolar depression lasts longer and occurs more frequently than bipolar mania (4).

• Sixty-one percent of people with bipolar disorder said their depressive episodes last longer than their manic episodes (4).
• Eighty-three percent of physicians said their patients tend to have more depressive episodes than manic episodes, and 88 percent also noted that their patients’ depressive episodes last longer than their manic episodes (4).
  

The survey revealed some communication challenges that people with bipolar disorder have with their physicians (4).

• Forty-one percent of people living with bipolar disorder said they wished they could be more open with their physicians about their depressive symptoms (4).
• Seventy-two percent of physicians agreed that many of their patients don’t know how to accurately describe their bipolar depression symptoms (4).
  
• Almost half of people living with bipolar disorder (49%) said they don’t know how to accurately describe their symptoms of bipolar depression to their health care provider (4).
  

A barrier that some people with bipolar disorder have faced is previous misdiagnosis and improper treatment resulting from the misdiagnosis (4).

• Forty-two percent of people living with bipolar disorder said they have been misdiagnosed with and improperly treated for another mental health condition (4).
• One-third of patients (31%) said more than five years had elapsed from the time they first sought advice from a medical professional to the time they were diagnosed with bipolar disorder (4).
  

People living with bipolar disorder listed the following as a few of the reasons for their delayed diagnoses: “I thought I was just depressed” (67%) and “I did not know that people with bipolar disorder experienced depression as much as I did” (45%) (4).

• More patients with bipolar disorder (40%) said their depressive symptoms first motivated them to seek medical advice, rather than both depressive and manic symptoms (35%) and manic symptoms alone (12%) (4).

Eighty percent of physicians said that depressive symptoms first prompted their patients with bipolar disorder to seek medical attention (4).

Most people living with bipolar disorder feel that their medication does not fully treat all their depressive symptoms. However, many are hesitant to change their medication (4).

• Sixty-five percent of people living with bipolar disorder agreed that they don’t feel like their medication fully treats their feelings of bipolar depression (4).
• Eighty-nine percent of people living with bipolar disorder surveyed agreed with the statement, “I would like to feel better than I do.” (4).
• Seventy percent of physicians said their patients with bipolar disorder would prefer to stay on a familiar medication even if it does not completely resolve their symptoms than switch to an unfamiliar medication (4).
• Fifty-three percent of people living with bipolar disorder agreed that they would rather feel “less than perfect” than go through another medication switch (4).

To learn more about bipolar disorder, visit www.facingbipolar.com.

About the Online Survey

The Bipolar Depression Treatment Dynamic was conducted by StrategyOne, an applied research consulting firm, on behalf of the National Council for Community Behavioral Healthcare and AstraZeneca. The online survey polled 2,005 American bipolar disorder patients (25 to 64 years of age) and 500 clinicians  who treat patients with bipolar disorder (250 psychiatrists; 250 primary care physicians) to determine how they view the personal toll of depressive symptoms of bipolar disorder.1  The online surveys, which for the patient sample had a margin of error of ±2.2% and for the physician sample had a margin of error of ±4.4%, were conducted using the field services of Harris Interactive Service Bureau from February 11, 2009, through February 27, 2009 and February 19, 2009, respectively. 4  As with all surveys of this type, this survey was not designed to be a scientific survey. Surveys of this type are by their nature limited due to potential sampling inconsistencies and other factors.

References
1.   Hirschfeld RMA, Calabrese JR, Weissman MM, et al. Screening for Bipolar in the Community. J Clin Psychiatry. 2003; 64:53-59.
2.   US Bureau of the Census. Available at: http://www.census.gov/popest/national/asrh/NC-EST2005/NC-EST2005-02.xls. Accessed on March 20, 2009.
3.   American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC: APA; 2000.
4.   Data on file, 278295, AstraZeneca Pharmaceuticals LP.