{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T06:46:47Z","timestamp":1792392407313,"version":"4.4.0"},"reference-count":14,"publisher":"Royal College of Psychiatrists","issue":"6","license":[{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    Lithium is a first-line maintenance treatment for bipolar disorder yet delays in diagnosis and lithium initiation remain common. This retrospective cohort study examined whether time to bipolar disorder diagnosis and lithium initiation differ by ethnicity, gender or age among 88 patients at South London and Maudsley National Health Service Foundation Trust. Delay outcomes were non-normally distributed and log-transformed before analysis. No demographic characteristic was significantly associated with time to lithium initiation. Ethnicity was significantly associated with diagnostic delay, with individuals from minority ethnic groups experiencing longer delays than White individuals (median 556\n                    <jats:italic>v<\/jats:italic>\n                    . 50.5 days; IQR [89.8, 1342]\n                    <jats:italic>v<\/jats:italic>\n                    . [6.25, 222]), which persisted after adjustment for age, gender, substance use and illness severity, and remained robust to outlier removal. Although social deprivation was not accounted for, these findings suggest possible systematic diagnostic inequities in bipolar disorder, calling for culturally informed diagnostic practices and further investigation in larger, multi-site samples.\n                  <\/jats:p>","DOI":"10.1192\/bjo.2026.12132","type":"journal-article","created":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T06:28:10Z","timestamp":1792391290000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Ethnic disparities in time to bipolar disorder diagnosis: retrospective cohort study"],"prefix":"10.1192","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-0279-0793","authenticated-orcid":false,"given":"Maria","family":"Richards-Brown","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0220mzb33","id-type":"ROR","asserted-by":"publisher"}],"name":"King\u2019s College London Institute of Psychiatry Psychology & 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Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3601-0580","authenticated-orcid":false,"given":"Sophie M.","family":"Allan","sequence":"additional","affiliation":[{"name":"University of Cambridge"},{"name":"University of East Anglia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashmi","family":"Patel","sequence":"additional","affiliation":[{"name":"University of Cambridge"},{"name":"King\u2019s College London Institute of Psychiatry Psychology & Neuroscience"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2984-1124","authenticated-orcid":false,"given":"Rebecca","family":"Strawbridge","sequence":"additional","affiliation":[{"name":"King\u2019s College London Institute of Psychiatry Psychology & Neuroscience"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2769-8237","authenticated-orcid":false,"given":"Katherine","family":"Beck","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0220mzb33","id-type":"ROR","asserted-by":"publisher"}],"name":"King\u2019s College London Institute of Psychiatry Psychology & Neuroscience"},{"id":[{"id":"https:\/\/ror.org\/015803449","id-type":"ROR","asserted-by":"publisher"}],"name":"South London and Maudsley Mental Health NHS Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2928-1972","authenticated-orcid":false,"given":"Oliver D.","family":"Howes","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0220mzb33","id-type":"ROR","asserted-by":"publisher"}],"name":"King\u2019s College London Institute of Psychiatry Psychology & 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London"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2026,10,19]]},"reference":[{"key":"S2056472426121322_ref3","doi-asserted-by":"publisher","DOI":"10.1186\/s40345-014-0015-8"},{"key":"S2056472426121322_ref5","doi-asserted-by":"publisher","DOI":"10.1097\/01.pra.0000407962.49851.ef"},{"key":"S2056472426121322_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2020.06.017"},{"key":"S2056472426121322_ref6","doi-asserted-by":"publisher","DOI":"10.1111\/acps.13490"},{"key":"S2056472426121322_ref7","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.2012.01917.x"},{"key":"S2056472426121322_ref10","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12638"},{"key":"S2056472426121322_ref11","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.20230226"},{"key":"S2056472426121322_ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2019.09.022"},{"key":"S2056472426121322_ref14","doi-asserted-by":"publisher","DOI":"10.64719\/pb.4512"},{"key":"S2056472426121322_ref8","doi-asserted-by":"publisher","DOI":"10.1017\/cts.2024.632"},{"key":"S2056472426121322_ref1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.116.186833"},{"key":"S2056472426121322_ref4","doi-asserted-by":"publisher","DOI":"10.1177\/02698811251408749"},{"key":"S2056472426121322_ref13","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201200590"},{"key":"S2056472426121322_ref9","author":"Mehra","year":"2024","journal-title":"Reasons for Diagnostic Delays in Bipolar Disorder: Systematic Review and Narrative Synthesis"}],"container-title":["BJPsych 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Published by Cambridge University Press on behalf of Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e268"}}