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Presenter: Sergio A. Strejilevich, M.D., “AREA, research and development in clinical neurosciences”

Training Latin American primary care professionals in Bipolar Disorder’s Detection  

Authors:  Sergio Strejilevich, Colom Francesc

Background: 
Two thirds of the people affected by bipolar disorders suffer long delays between their first health contact for these disorders and the moment when they access to a correct diagnosis. A similar percentage receives misdiagnosis and treatments which increase the burden of the disease. These serious problems have been identified as a main barrier in the treatment of bipolar disorders. Recent data show that people who suffer bipolar disorders in Latin-America have similar problems regarding access a fast and correct diagnosis of their illness. This problem probably is more serious at the primary level. Improving the capacity of detecting early and correctly the people who suffer bipolar disorders is an urgent challenge.

Methods: 
We developed a series of “one-day training sessions” with the objective of improving the capacity to detect bipolar disorders in a primary level of health. These training sessions were carried out in several locations of Argentina and Bolivia. Assistants completed a survey before and after the training.

Results:
More than 500 people did the training and 204 completed both surveys correctly. Only the 15% of the assistants reported having enough information about bipolar disorders (without differences between clinical psychologists, health assistants and physicians). Although 65,5% reported having depressive patients among their assisted ones and 48% reported having friends or relatives who suffer bipolar disorders, only 35,5% reported assisting people with bipolar disorder’s diagnosis (Fischer’s test p = 0,002). In the pre-training 53% believed that psychological traumas were the causes of bipolar disorders and only 11% could correctly identify a brief list of basic bipolar symptoms. In the post training 98% reported genetic causes and 58% could identify the symptoms list correctly. In the post-training 84% reported knowing friends or relatives who suffer bipolar disorders and 86% believed having patients who suffer from these disorders but do not have the correct diagnosis until this moment. Only the 7,5% of the assistants reported having psycho educational material about bipolar disorders to distribute.