Detecting bipolar disorder earlier: Dr Daniel Smith

Issued: Wed, 26 Jun 2013 15:27:00 BST

It was as a trainee psychiatrist that Dr Daniel Smith was first drawn to bipolar disorder, in part because of its complexity but also because of its unique position as a mental illness associated with certain positive aspects. Through his current research, Dr Smith hopes to find ways to improve the early recognition and early treatment of bipolar disorder, which will in turn improve long-term outcomes.

‘We know that if you give people the right treatment sooner rather than later they can, over time, develop strategies that ultimately prevent relapse, keep them out of hospital and help them to live more meaningful lives,’ Dr Smith explains. ‘Research suggests that bipolar disorder probably isn’t as rare as most people imagine, and there’s a big problem in not detecting it early enough. Most people with bipolar disorder will say it takes ten years or more to finally get the right diagnosis.

‘In terms of treatment, we’ve been very interested in developing psychoeducational approaches to help people with bipolar disorder self-manage their condition more effectively. A lot of this is about teaching people ways to monitor their mood for signs of relapse and to take steps to get help sooner rather than later. Taking medications earlier when they feel they are becoming unwell could be one route, but we also want to encourage longer-term lifestyle modifications. Individuals can help to prevent a relapse by making sure they are sleeping properly, exercising, eating well and managing stress.’

Dr Smith is keen to further explore the feasibility of using the internet to disseminate high-quality educational material around self-management. The potential public health benefits of delivering interventions to large numbers of patients at a relatively low cost are significant. Glasgow Professor of Primary Care Research Frances Mair shares similar interests, and Dr Smith hopes to collaborate with her as he investigates e-health interventions for bipolar disorder over the next few years.

He also plans to draw on the cross disciplinary strengths of the University to conduct more epidemiological research – an area that may give rise to PhD opportunities in the coming years. With colleague Professor Jill Pell from Public Health, Dr Smith will examine data from the UK BioBank database to investigate associations between mental health problems such as bipolar disorder and depression and physical problems like cardiovascular disease, obesity and diabetes.

‘We know that people with serious mental illnesses die many years before people who don’t have serious mental illnesses, but we don’t really understand why,’ says Dr Smith. ‘This is an opportunity to think about how things like medical morbidity, social deprivation and mental health problems interact to cause poor long-term outcomes for some people and to address the issue by tackling inequalities.’