# Revisiting Late‐Onset Bipolar Disorder Associated With Pituitary Adenoma: A Cross‐Sectional, Multidisciplinary, Case‐Based Analysis

## TL;DR

This study examines how different medical specialists manage late-onset bipolar disorder in elderly patients and highlights the need for better interdisciplinary collaboration.

## Contribution

The study identifies specialty-specific strengths and gaps in managing late-onset bipolar disorder and advocates for integrated care models.

## Key findings

- Neurologists excel in imaging and treatment initiation but struggle with holistic management.
- Psychiatrists are strong in diagnosis but face challenges in long-term follow-up strategies.
- Family physicians show strong pharmacological skills but encounter barriers in referrals for high-risk cases.

## Abstract

This study explores the diagnostic, treatment, and follow‐up approaches of neurologists, psychiatrists, and family physicians in managing late‐onset bipolar disorder (BD) in elderly patients, emphasizing the role of interdisciplinary collaboration.

A cross‐sectional survey involved 300 specialists (100 from each discipline). The survey assessed diagnostic accuracy, treatment preferences, follow‐up adherence, and barriers to interdisciplinary collaboration. A pairwise z‐test with Bonferroni correction was applied for comparative analysis across specialties to evaluate differences in response proportions.

Neurologists demonstrated high proficiency in imaging and treatment initiation (91% correct imaging responses) but faced challenges in holistic management and follow‐up adherence (2%). Psychiatrists excelled in diagnosing organic causes of mood disorders (92%) and therapeutic decisions but struggled with non‐priority diagnostic tests (44%) and long‐term follow‐up strategies (14%). Family physicians showed strong skills in pharmacological management (96%) and follow‐up adherence (89%) but encountered barriers like stigma and referral timing for high‐risk cases. Common interdisciplinary challenges included diagnostic communication, treatment coordination, and follow‐up collaboration.

Late‐onset BD management requires a multidisciplinary approach to address specialty‐specific gaps and foster effective interdisciplinary collaboration. Enhanced training, integrated care models, and shared guidelines are recommended to optimize outcomes for elderly patients with mood disorders. Future research should focus on developing standardized protocols and evaluating the long‐term impact of interdisciplinary interventions.

Surveying 300 neurologists, psychiatrists, and family physicians, this study demonstrates discipline‐specific strengths‐imaging (neurology), diagnosis (psychiatry), and pharmacological follow‐up (family medicine)‐yet persistent gaps in holistic care of late‐onset bipolar disorder in elders. Shared guidelines and integrated, cross‐disciplinary training are essential to bridge gaps and improve outcomes for elderly patients.