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Adult Psychiatric Unit: Bipolar Disorder
Noreen A Reilly-Harrington, Richard C Shelton, Masoud Kamali, Dustin J Rabideau, Leah W Shesler, Madhukar H Trivedi, Susan L McElroy, Louisa G Sylvia, Charles L Bowden, Terence A Ketter, Joseph R Calabrese, Michael E Thase, William V Bobo, Thilo Deckersbach, Mauricio Tohen, Melvin G McInnis, James H Kocsis, Alexandra K Gold, Vivek Singh, Daniel M Finkelstein, Gustavo Kinrys, Andrew A Nierenberg
BACKGROUND: Few brief, self-report measures exist that can reliably predict adverse suicidality outcomes in patients with BD. This study utilized the Concise Health Risk Tracking Self-Report (CHRT) to assess suicidality in patients with BD and examined its psychometric performance, clinical correlates, and prospective value in predicting adverse events related to suicidality. METHODS: The CHRT was administered at baseline and follow-up to 482 adult patients in Bipolar CHOICE, a 6-month randomized comparative effectiveness trial...
March 1, 2016: Journal of Affective Disorders
Joseph F Goldberg, Marlene P Freeman, Richard Balon, Leslie Citrome, Michael E Thase, John M Kane, Maurizio Fava
BACKGROUND: Optimal successive treatment decisions are not well established after an initial medication nonresponse in major depressive disorder or bipolar disorder. While practice guidelines offer consensus-based expert treatment recommendations, little is known about "real world" pharmacology decision making by practicing psychopharmacologists. MATERIALS AND METHODS: We surveyed via Internet the national membership of the American Society of Clinical Psychopharmacology (ASCP) to study preferred pharmacotherapy strategies and factors that influence medication choices for patients with mood disorders...
August 2015: Depression and Anxiety
Joseph F Goldberg, Roy H Perlis, S Nassir Ghaemi, Joseph R Calabrese, Charles L Bowden, Stephen Wisniewski, David J Miklowitz, Gary S Sachs, Michael E Thase
OBJECTIVE: Practice guidelines have advised against treating patients with antidepressants during bipolar mixed states or dysphoric manias. However, few studies have examined the outcomes of patients with co-occurring manic and depressive symptoms who are treated with antidepressants plus mood stabilizing drugs. METHOD: The authors compared outcomes in patients with bipolar disorder who received a mood stabilizing agent with versus without an antidepressant for a bipolar depressive episode accompanied by > or = 2 concurrent manic symptoms...
September 2007: American Journal of Psychiatry
Roy H Perlis, Michael J Ostacher, Joseph F Goldberg, David J Miklowitz, Edward Friedman, Joseph Calabrese, Michael E Thase, Gary S Sachs
Some individuals with bipolar disorder transition directly from major depressive episodes to manic, hypomanic, or mixed states during treatment, even in the absence of antidepressant treatment. Prevalence and risk factors associated with such transitions in clinical populations are not well established, and were examined in the Systematic Treatment Enhancement Program for Bipolar Disorder study, a longitudinal cohort study. Survival analysis was used to examine time to transition to mania, hypomania, or mixed state among 2166 bipolar I and II individuals in a major depressive episode...
December 2010: Neuropsychopharmacology
Isabella Pacchiarotti, David J Bond, Ross J Baldessarini, Willem A Nolen, Heinz Grunze, Rasmus W Licht, Robert M Post, Michael Berk, Guy M Goodwin, Gary S Sachs, Leonardo Tondo, Robert L Findling, Eric A Youngstrom, Mauricio Tohen, Juan Undurraga, Ana González-Pinto, Joseph F Goldberg, Ayşegül Yildiz, Lori L Altshuler, Joseph R Calabrese, Philip B Mitchell, Michael E Thase, Athanasios Koukopoulos, Francesc Colom, Mark A Frye, Gin S Malhi, Konstantinos N Fountoulakis, Gustavo Vázquez, Roy H Perlis, Terence A Ketter, Frederick Cassidy, Hagop Akiskal, Jean-Michel Azorin, Marc Valentí, Diego Hidalgo Mazzei, Beny Lafer, Tadafumi Kato, Lorenzo Mazzarini, Anabel Martínez-Aran, Gordon Parker, Daniel Souery, Ayşegül Ozerdem, Susan L McElroy, Paolo Girardi, Michael Bauer, Lakshmi N Yatham, Carlos A Zarate, Andrew A Nierenberg, Boris Birmaher, Shigenobu Kanba, Rif S El-Mallakh, Alessandro Serretti, Zoltan Rihmer, Allan H Young, Georgios D Kotzalidis, Glenda M MacQueen, Charles L Bowden, S Nassir Ghaemi, Carlos Lopez-Jaramillo, Janusz Rybakowski, Kyooseob Ha, Giulio Perugi, Siegfried Kasper, Jay D Amsterdam, Robert M Hirschfeld, Flávio Kapczinski, Eduard Vieta
OBJECTIVE: The risk-benefit profile of antidepressant medications in bipolar disorder is controversial. When conclusive evidence is lacking, expert consensus can guide treatment decisions. The International Society for Bipolar Disorders (ISBD) convened a task force to seek consensus recommendations on the use of antidepressants in bipolar disorders. METHOD: An expert task force iteratively developed consensus through serial consensus-based revisions using the Delphi method...
November 2013: American Journal of Psychiatry
Thomas Scheidemantel, Irina Korobkova, Soham Rej, Martha Sajatovic
Asenapine (Saphris(®)) is an atypical antipsychotic drug which has been approved by the US Food and Drug Administration for the treatment of schizophrenia in adults, as well as the treatment of acute manic or mixed episodes of bipolar I in both adult and pediatric populations. Asenapine is a tetracyclic drug with antidopaminergic and antiserotonergic activity with a unique sublingual route of administration. In this review, we examine and summarize the available literature on the safety, efficacy, and tolerability of asenapine in the treatment of bipolar disorder (BD)...
2015: Neuropsychiatric Disease and Treatment
J Sloan Manning
Managing patients with bipolar disorder remains a challenge due to its chronic nature. In addition, bipolar depression remains understudied even though patients spend more time in depressive episodes than in manic ones. Effective treatment requires an accurate and timely diagnosis, psychoeducation, psychotherapy, pharmacotherapy, and implementation of elements of the chronic care model. Pharmacologic strategies for treating bipolar depression differ from those for bipolar mania as well as those for unipolar depression and require knowledge of the efficacy and safety of agents including mood stabilizers, atypical antipsychotics, and antidepressants both as monotherapy and in combination...
November 2015: Journal of Clinical Psychiatry
J Sloan Manning
Patients with bipolar disorder require diligent management involving psychoeducation, a strong therapeutic alliance, and ongoing monitoring with rating scales to achieve the best outcomes. Clinicians should monitor symptom response, functioning, and quality of life to determine if treatment needs to be be adjusted. Assessing adverse effects must be done regularly to improve treatment adherence. Because effective acute phase treatments are often continued in maintenance treatment, clinicians must find the right balance of efficacy and tolerability for long-term success...
December 2015: Journal of Clinical Psychiatry
E Hollander
Obsessive-compulsive disorder (OCD) is one of the most common psychiatric disorders, occurring in 2% to 3% of the U.S. population. Borderline personality disorder is found in 2% of the U.S. population. These disorders denote the endpoints on a spectrum of compulsive and impulsive disorders. One endpoint marks compulsive or risk-aversive behaviors characterized by overestimation of the probability of future harm, highlighted by OCD. The other endpoint designates impulsive action characterized by the lack of complete consideration of the negative results of such behavior, such as borderline and antisocial personality disorders...
1999: Journal of Clinical Psychiatry
Trisha Suppes, Robert Silva, Josephine Cucchiaro, Yongcai Mao, Steven Targum, Caroline Streicher, Andrei Pikalov, Antony Loebel
OBJECTIVE: Accumulating evidence indicates that manic symptoms below the threshold for hypomania (mixed features) are common in individuals with major depressive disorder. This form of depression is often severe and is associated with an increased risk for recurrence, suicide attempts, substance abuse, and functional disability. This study evaluated the efficacy and safety of lurasidone in major depressive disorder with mixed features. METHODS: Patients meeting DSM-IV-TR criteria for major depressive disorder who presented with two or three protocol-defined manic symptoms were randomly assigned to 6 weeks of double-blind treatment with either lurasidone at 20-60 mg/day (N=109) or placebo (N=100)...
April 1, 2016: American Journal of Psychiatry
Iria Grande, Michael Berk, Boris Birmaher, Eduard Vieta
Bipolar disorder is a recurrent chronic disorder characterised by fluctuations in mood state and energy. It affects more than 1% of the world's population irrespective of nationality, ethnic origin, or socioeconomic status. Bipolar disorder is one of the main causes of disability among young people, leading to cognitive and functional impairment and raised mortality, particularly death by suicide. A high prevalence of psychiatric and medical comorbidities is typical in affected individuals. Accurate diagnosis of bipolar disorder is difficult in clinical practice because onset is most commonly a depressive episode and looks similar to unipolar depression...
April 9, 2016: Lancet
Richard Wesseloo, Astrid M Kamperman, Trine Munk-Olsen, Victor J M Pop, Steven A Kushner, Veerle Bergink
OBJECTIVE: Women with a history of bipolar disorder, postpartum psychosis, or both are at high risk for postpartum relapse. The aim of this meta-analysis was to estimate the risk of postpartum relapse in these three patient groups. METHOD: A systematic literature search was conducted in all public medical electronic databases, adhering to the PRISMA guidelines. Studies were included if they reported postpartum relapse in patients diagnosed with bipolar disorder and/or a history of postpartum psychosis or mania according to DSM or ICD criteria or the Research Diagnostic Criteria...
February 1, 2016: American Journal of Psychiatry
Andrew A Nierenberg, Louisa G Sylvia, Kristen K Ellard, Sharmin Ghaznavi, Thilo Deckersbach
No abstract text is available yet for this article.
September 2015: Journal of Clinical Psychiatry
A J Bayes, G McClure, K Fletcher, Y E Román Ruiz Del Moral, D Hadzi-Pavlovic, J L Stevenson, V L Manicavasagar, G B Parker
OBJECTIVE: To identify features differentiating bipolar disorder (BP) from borderline personality disorder (BPD) and with each condition variably defined. METHOD: Participants were assigned a BP or BPD diagnosis on the basis of DSM criteria and, separately, by clinical judgment, and undertook a diagnostic interview and completed self-report measures. RESULTS: Predictors of BPD status varied according to diagnostic decisions, but with the most consistent items being childhood sexual abuse, childhood depersonalization, personality variables relating to relationship difficulties and sensitivity to criticism, and the absence of any BP family history...
March 2016: Acta Psychiatrica Scandinavica
James Conor Kinahan, Aoife NiChorcorain, Sean Cunningham, Aideen Freyne, Colm Cooney, Siobhan Barry, Brendan D Kelly
OBJECTIVES: Polyuria increases the risk of dehydration and lithium toxicity in lithium-treated patients. Risk factors have been inconsistently described and the variance of this adverse effect remains poorly understood. This study aimed to establish independent risk factors for polyuria in a community, secondary-level lithium-treated sample of patients. METHODS: This was a cross-sectional study of the lithium-treated patients attending a general adult and an old age psychiatry service...
February 2015: Bipolar Disorders
A Wichniak, M Jarkiewicz, Ł Okruszek, A Wierzbicka, J Holka-Pokorska, J K Rybakowski
INTRODUCTION: Sleep-promoting antidepressants are of interest because they are used not only as antidepressants, but also to promote sleep. METHODS: We reviewed case reports describing the switch to mania during treatment with trazodone, mirtazapine, or agomelatine. RESULTS: Trazodone, mirtazapine, and agomelatine may induce manic symptoms. However, the risk of switching is related, first of all, to doses recommended for antidepressant treatment, administered without mood-stabilizer co-therapy...
May 2015: Pharmacopsychiatry
Rajnish Mago, Dileep Borra, Rajeev Mahajan
Nonadherence to medications is common and associated with poor or limited clinical outcomes in the treatment of bipolar disorder. A review of the literature discloses that adverse effects are one of the commonly reported reasons for nonadherence to mood stabilizers by patients with bipolar disorder. Nevertheless, other than such broad summaries, relatively little attention has been given to the role of adverse effects in relation to nonadherence. This review article is the first to consolidate the available data on this topic...
November 2014: Harvard Review of Psychiatry
Jutta M Stoffers, Klaus Lieb
Drug treatment of patients with borderline personality disorder (BPD) is common but mostly not supported by evidence from high-quality research. This review summarises the current evidence up to August 2014 and also aims to identify research trends in terms of ongoing randomised controlled trials (RCTs) as well as research gaps. There is some evidence for beneficial effects by second-generation antipsychotics, mood stabilisers and omega-3 fatty acids, while the overall evidence base is still unsatisfying. The dominating role SSRI antidepressants usually play within the medical treatment of BPD patients is neither reflected nor supported by corresponding evidence...
January 2015: Current Psychiatry Reports
Sara Dallaspezia, Francesco Benedetti
Multiple lines of evidence suggest that psychopathological symptoms of bipolar disorder arise in part from a malfunction of the circadian system, linking the disease with an abnormal internal timing. Alterations in circadian rhythms and sleep are core elements in the disorders, characterizing both mania and depression and having recently been shown during euthymia. Several human genetic studies have implicated specific genes that make up the genesis of circadian rhythms in the manifestation of mood disorders with polymorphisms in molecular clock genes not only showing an association with the disorder but having also been linked to its phenotypic particularities...
August 2015: Current Psychiatry Reports
Jeffrey J Rakofsky, Boadie W Dunlop
OBJECTIVE: To review the evidence for treating anxiety in patients with bipolar disorder. DATA SOURCES: A literature search from 1950 to week 1 of August 2009 was conducted via OVID and the National Institutes of Health's clinical trials online databases. Search terms included anxiety, anxiety disorders, bipolar disorder, panic disorder, generalized anxiety disorder, social phobia, social anxiety, obsessive compulsive disorder, specific phobia, posttraumatic stress disorder, and treatment...
January 2011: Journal of Clinical Psychiatry
2015-10-10 07:47:10
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