Self-reported assessment tools and questionnaires in bipolar I disorder

How do you feel about the use of patient self-reported assessment tools and questionnaires in bipolar I disorder?

I think they can be helpful. When I am assessing a patient before diagnosis, if I think they have bipolar disorder I will often give them a questionnaire, such as the Mood Disorders Questionnaire, which brings out features of a manic state historically. If the diagnosis is bipolar I disorder, the questionnaires will depend on which stage of the illness they are at – during a manic phase, an additional assessment tool I would use would be the Young Mania Rating Scale, which depends on them answering questions about how they are feeling, including the observations of others, such as nurses to gain a severity score for their manic state.

I think that self-reported assessment tools are very helpful in following patients’ progress, especially as in-patients. They can be administered by nurses talking with the patients in one-to-ones, or by medical staff on the ward. When their mania has improved, we can easily start a process of psycho-education and as part of that we’d want them to fill out mood scales, in the form of a daily mood chart. This is useful as it illustrates the changes in the patient’s mood and helps them to convey it to their doctor, especially in the early stages of their illness. Then I would look at the chart with them, perhaps connecting some of the dots on their mood chart and see what the pattern had been. After that we could relate that to anything that had been happening in their life which might be affecting their mood. We’d have a think about what their mood has predominantly been previously, what their current mood is and whether medication could have had an effect. It’s important to give patients an opportunity to talk about whether changes to their medication and possible side effects have had an effect in relation to the changes in their mood.