Date of Award

5-2025

Degree Type

Dissertation

Degree Name

Doctor of Nursing (ND)

Department

Nursing

Chair

Leslie K. Robbins, PhD, APRN, PMHCNS-BC, PMHNP-BC, FAANP, ANEF

Co-Chair

Karen Fowler PhD, RN, CENP, CNE

Abstract

Background: Bipolar disorder is a life-long, disabling mental health condition that affects people universally, without discrimination. Its symptoms often overlap with those of depression, making accurate diagnosis particularly challenging. As a result, many individuals receive inappropriate treatment, leading to poorer health outcomes and a prolonged path to effective management.

Problem: Studies show that up to 70% of people with bipolar disorder are initially misdiagnosed, resulting in a delay of 5 to 10 years between the onset of symptoms and an accurate diagnosis, which leads to poorer health outcomes

Intervention: This project aims to enhance the diagnostic accuracy of Bipolar I disorder by implementing the Rapid Mood Screener (RMS) for patients presenting with depressive symptoms. The RMS offers a substantial advantage, with an 88% sensitivity, 80% specificity, and 84% overall accuracy in differentiating between depression and bipolar disorder. The screening tool was administered in a behavioral health acute inpatient setting for patients endorsing depressive symptoms during their initial visits.

Results: The implementation of the RMS screening tool into practice proved effective in enhancing the accuracy of Bipolar I disorder diagnosis.

Conclusion: This quality improvement (QI) project demonstrated the potential of the RMS to improve diagnostic accuracy for Bipolar I disorder in patients presenting with depressive symptoms. By distinguishing between depression and bipolar disorder more effectively, the RMS can help reduce misdiagnoses and promote timely and appropriate treatment.

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