Some interventions work better when we get the timing right, and this new series is going to highlight windows of opportunity you won't want to miss.

Welcome to the Carlet Psychiatry Podcast, keeping psychiatry honest since 2003.

I'm Chris Akin, the editor-in-chief of the Carlat's Psychiatry Report.

And I'm Kelly Newsom, a psychiatric MP and a dedicated reader of every issue.

Life is short, the art is long, opportunity fleeting, experiment treacherous, and judgment difficult.

With those sobering words, Hippocrates summed up medical practice as it was in 400 BC,

and as it very much is today.

In the next few episodes, we're going to focus on those fleeting opportunities

where you might just save a life if you act with good speed.

For First, a faster way to diagnose bipolar disorder.

In 1992, Robert Hirschfield and colleagues took a look at what was happening in the real world of bipolar treatment.

They surveyed 500 members of DBSA, the Depression and Bipolar Support Alliance, which was known back then as the National Depression and Manic

Depressive Association. And what they found was pretty discouraging. Only one in three got

diagnosed correctly in their first year of treatment, and 34% waited

another 10 years to get accurately diagnosed.

Ten years later, Dr. Hirschfeld's group ran the same survey to see if things had changed,

but the results were nearly identical. This time, Hirschfeld took action.

He developed a brief screening instrument that tallied 13 symptoms of mania on paper,

called the Mood Disorder Questioner or MDQ.

It enjoyed widespread use.

When this screening instrument was positive, it was often right, with a 79%

specificity, which rivals the accuracy of the average psychiatric interview. But the

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