Assessing Medical Students’ Knowledge in Differentiating the Diagnosis and Treatment of Unipolar Vs Bipolar Depression

Abstract

Background

Depression is one of the leading causes of premature death and disability. However, both unipolar and bipolar depression are under-diagnosed and undertreated. The aims of this study were to assess medical students’ level of confidence in and knowledge of diagnosing and treating depression before and after completing a psychiatry clerkship, and their knowledge of differentiating unipolar vs bipolar depression.

Methods

Third-year medical students at Augusta University (Georgia, USA) completed an online questionnaire to assess confidence in and knowledge of diagnosing and treating unipolar and bipolar depression.

Results

Students who completed a psychiatry clerkship were statistically significantly more comfortable/confident with diagnosing (P < .0001) and treating (P < .0001) unipolar depression. Regarding bipolar depression, 73% of students who completed a psychiatry clerkship correctly diagnosed bipolar disorder, vs 59% of students who did not complete a psychiatry clerkship. This difference was not statistically significant (P = .181).

Conclusions

Students who completed a psychiatry clerkship were more confident in diagnosing and treating unipolar depression compared with those who did not complete a psychiatry clerkship. However, there was no statistically significant difference between students who had completed a psychiatry clerkship and those who had not completed a psychiatry clerkship in making the correct diagnosis of bipolar depression. Neither group had a very high rate of correct diagnosis.

Get full access to this article

View all access options for this article.

References

Broadhead

Blazer

George

Depression, disability days, and days lost from work in a prospective epidemiologic survey. JAMA. 1990; 264: 2524–2528.

Greenberg

Stiglin

Finkelstein

Depression: a neglected major illness. J Clin Psychiatry. 1993; 54: 419–424.

Herrman

Patrick

Diehr

Longitudinal investigation of depression outcomes in primary care in six countries: the LIDO study. Functional status, health service use and treatment of people with depressive symptoms. Psychol Med. 2002; 32: 889–902.

Wittchen

Pittrow

Prevalence, recognition and management of depression in primary care in Germany: the Depression 2000 study. Hum Psychopharmacol. 2002;17 suppl 1:S1–S11.

Harman

Veazie

Lyness

. Primary care physician office visits for depression by older Americans. J Gen Intern Med. 2006; 21: 926–930.

Depression in primary care: detection, diagnosis, and treatment. US Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research. J Psychosoc Nurs Ment Health Serv. 1993; 31: 19–28.

Hirschfeld

Keller

Panico

The National Depressive and Manic-Depressive Association consensus statement on the undertreatment of depression. JAMA. 1997; 277: 333–340.

Mitchell

Rao

Vaze

Do primary care physicians have particular difficulty identifying late-life depression? A meta-analysis stratified by age. Psychother Psychosom. 2010; 79: 285–294.

Mitchell

Rao

Vaze

Can general practitioners identify people with distress and mild depression? A meta-analysis of clinical accuracy. J Affect Disord. 2011; 130: 26–36.

10.

Mitchell

Vaze

Rao

Clinical diagnosis of depression in primary care: a meta-analysis. Lancet. 2009; 374: 609–619.

11.

Qin

Wang

Jin

Prevalence and rates of recognition of depressive disorders in internal medicine outpatient departments of 23 general hospitals in Shenyang, China. J Affect Disord. 2008; 110: 46–54.

12.

Craig

Boardman

A P

. ABC of mental health. Common mental health problems in primary care. BMJ. 1997; 314: 1609–1612.

13.

Payne

Harvey

Jessopp

Knowledge, confidence and attitudes towards mental health of nurses working in NHS Direct and the effects of training. J Adv Nurs. 2002; 40: 549–559.

14.

Ghaemi

Sachs

Chiou

Is bipolar disorder still underdiagnosed? Are anti-depressants overutilized?

J Affect Disord. 1999; 52: 135–144.

15.

Mitchell

Rao

Vaze

International comparison of clinicians’ ability to identify depression in primary care: meta-analysis and meta-regression of predictors. Br J Gen Pract. 2011; 61: e72–e80.

16.

Goldberg

J F

Ernst

. Features associated with the delayed initiation of mood stabilizers at illness onset in bipolar disorder. J Clin Psychiatry. 2002; 63: 985–991.

17.

Goldberg

Truman

. Antidepressant-induced mania: an overview of current controversies. Bipolar Disord. 2003; 5: 407–420.

18.

Sidor

Macqueen

. Antidepressants for the acute treatment of bipolar depression: a systematic review and meta-analysis. J Clin Psychiatry. 2011; 72: 156–167.

19.

Rong

Luscombe

Davenport

Recognition and treatment of depression: a comparison of Australian and Chinese medical students. Soc Psychiatry Psychiatr Epidemiol. 2009; 44: 636–642.

20.

Rong

Glozier

Luscombe

Improving knowledge and attitudes towards depression: a controlled trial among Chinese medical students. BMC Psychiatry. 2011; 11: 36.

21.

Kuzman MR Bosnjak

Vokal

Can medical students recognize depression? A survey at the Zagreb School of Medicine. Acad Psychiatry. 2014; 38: 312–315.