Reducing the delay in the diagnosis of bipolar disorder: A qualitative study

Hoppe, I., Watson, S., Ahuja, N., Azim, L., Cipriani, A., Clark, E., Evans, J., Gergel, T., Gibson, J., Hall, J., Kabir, T., Mathias, A., Nixon, N., Prasa, Prasad, Wall, L. and Chew‐Graham, C. 2025. Reducing the delay in the diagnosis of bipolar disorder: A qualitative study. Health Expectations 28 (4) , e70398. 10.1111/hex.70398

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Abstract

Introduction: Patients 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. Methods: Semi‐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. Results: GPs 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. Conclusion: We 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.

Item Type:	Article
Date Type:	Published Online
Status:	Published
Schools:	Schools > Medicine
Additional Information:	License information from Publisher: LICENSE 1: URL: http://creativecommons.org/licenses/by/4.0/
Publisher:	Wiley
ISSN:	1369-6513
Date of First Compliant Deposit:	26 August 2025
Date of Acceptance:	25 July 2025
Last Modified:	26 Aug 2025 15:45
URI:	https://orca.cardiff.ac.uk/id/eprint/180674

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