Collaborative care for a patient with bipolar disorder in primary care: a case example.

OBJECTIVE: The objective was to describe the process of care and treatment outcomes of a 36-year-old man with bipolar disorder treated using a collaborative care model in primary care. METHODS: We reviewed and summarized relevant clinical data describing the patient's care including the medical record, consultant's reports and discussions with treating clinicians. A meeting was held with experienced consulting psychiatrists to discuss the case. RESULTS: Several barriers to delivery of high-quality care existed including initial loss to follow-up, few social supports and lack of follow-through at the community mental health center existed, along with presence of factors that negatively influence bipolar disorder outcomes including initial unopposed antidepressant use at baseline, concurrent alcohol use and co-occurring anxiety symptoms. Despite these barriers, the collaborative care team was able to engage the patient in care and achieve the patient's and team's treatment goals. CONCLUSION: Delivery of primary-care-based collaborative care was associated with reduction of bipolar disorder symptoms and improved functioning in a patient with bipolar disorder.