Collections Adult Psychiatric Unit: Bipola...

Adult Psychiatric Unit: Bipolar Disorder
Vanamoorthy Umamaheswari, Ajit Avasthi, Sandeep Grover
OBJECTIVE: To identify the risk factors for suicidal ideation in subjects with bipolar depression. METHODS: One-hundred and thirty subjects diagnosed with bipolar depression were evaluated on the following scales: Beck Depression Inventory (BDI), Beck Hopelessness Scale (BHS), Patient Health Questionnaire-15 (PHQ-15), Barrat's Impulsivity Scale (BIS), Irritability, Anxiety, and Depression (IDA) Scale, Young Mania Rating Scale (YMRS), Buss-Durke Hostile Inventory (BDHI), and Brief Psychiatric Rating Scale (BPRS)...
September 2014: Bipolar Disorders
Mauricio Tohen, Christopher C Abbott
No abstract text is available yet for this article.
January 2015: American Journal of Psychiatry
Susan L McElroy
Patients with bipolar disorder spend more time depressed than manic, but fewer clinical trials have been conducted investigating treatments for bipolar depression than for bipolar mania. Olanzapine-fluoxetine combination, quetiapine, and lurasidone are the only FDA-approved treatments for bipolar depression. Clinical trials of these drugs show similar efficacy but different side effect profiles. Clinicians, therefore, should consider possible adverse events and individual patient characteristics when selecting treatments...
October 2014: Journal of Clinical Psychiatry
A Peters, L G Sylvia, P V da Silva Magalhães, D J Miklowitz, E Frank, M W Otto, N S Hansen, D D Dougherty, M Berk, A A Nierenberg, T Deckersbach
BACKGROUND: The course of bipolar disorder progressively worsens in some patients. Although responses to pharmacotherapy appear to diminish with greater chronicity, less is known about whether patients' prior courses of illness are related to responses to psychotherapy. METHOD: Embedded in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) was a randomized controlled trial of psychotherapy for bipolar depression comparing the efficacy of intensive psychotherapy with collaborative care (a three-session psycho-educational intervention)...
December 2014: Psychological Medicine
Janusz K Rybakowski
About one-third of lithium-treated, bipolar patients are excellent lithium responders; that is, lithium monotherapy totally prevents further episodes of bipolar disorder for ten years and more. These patients are clinically characterized by an episodic clinical course with complete remission, a bipolar family history, low psychiatric comorbidity, mania-depression episode sequences, a moderate number of episodes, and a low number of hospitalizations in the pre-lithium period. Recently, it has been found that temperamental features of hypomania (a hyperthymic temperament) and a lack of cognitive disorganization predict the best results of lithium prophylaxis...
November 2014: Harvard Review of Psychiatry
Marc Valentí, Isabella Pacchiarotti, C Mar Bonnín, Adriane R Rosa, Dina Popovic, Alessandra M A Nivoli, José Manuel Goikolea, Andrea Murru, Juan Undurraga, Francesc Colom, Eduard Vieta
OBJECTIVE: Treatment of bipolar depression with antidepressants is strongly debated on the basis of the methodologically poor and insufficient data supporting their use and the widely held belief that antidepressants can induce new episodes of abnormal mood elevation or accelerate the rate of cycling. The present study aimed at identifying clinical risk factors for switch into hypomania, mania, or mixed states, within 8 weeks after introduction of an antidepressant or after increasing its dosage, in a prospective, longitudinal design...
February 2012: Journal of Clinical Psychiatry
Alexander Viktorin, Paul Lichtenstein, Michael E Thase, Henrik Larsson, Cecilia Lundholm, Patrik K E Magnusson, Mikael Landén
OBJECTIVE: This study examined the risk of antidepressant-induced manic switch in patients with bipolar disorder treated either with antidepressant monotherapy or with an antidepressant in conjunction with a mood stabilizer. METHOD: Using Swedish national registries, the authors identified 3,240 patients with bipolar disorder who started treatment with an antidepressant and had no antidepressant treatment during the previous year. Patients were categorized into those receiving antidepressant monotherapy and those receiving an antidepressant plus a mood stabilizer...
October 2014: American Journal of Psychiatry
Xian-Bin Li, Yi-Lang Tang, Chuan-Yue Wang, Jose de Leon
OBJECTIVE: To evaluate the efficacy and safety of clozapine for treatment-resistant bipolar disorder (TRBD). METHODS: A systematic review of randomized controlled studies, open-label prospective studies, and retrospective studies of patients with TRBD was carried out. Interventions included clozapine monotherapy or clozapine combined with other medications. Outcome measures were efficacy and adverse drug reactions (ADRs). RESULTS: Fifteen clinical trials with a total sample of 1,044 patients met the inclusion criteria...
May 2015: Bipolar Disorders
Massimiliano Buoli, Marta Serati, A Carlo Altamura
BACKGROUND: Bipolar Disorder (BD) long-term treatment is aimed to prevent relapses associated with worsening cognitive impairment and chronicity. Available mood stabilizers, including lithium, fail to prevent relapses in about 40% of bipolar patients. Purpose of the present paper is to review the available data about the efficacy and tolerability of mood stabilizer plus antipsychotic combined treatments. METHOD: A research in the main database sources has been conducted to obtain an overview about the efficacy and tolerability of the combination of a mood stabilizer plus an antipsychotic in the long-term treatment of BD...
January 2014: Journal of Affective Disorders
Adam Bayes, Gordon Parker, Kathryn Fletcher
PURPOSE OF REVIEW: Differentiating bipolar II disorder (BP II) from borderline personality disorder (BPD) is a common diagnostic dilemma. The purpose of this review is to focus on recent studies that have considered clinical differences between the conditions including family history, phenomenology, longitudinal course, comorbidity and treatment response, and which might advance their clinical distinction. RECENT FINDINGS: Findings suggest key differentiating parameters to include family history, onset pattern, clinical course, phenomenological profile of depressive and elevated mood states, and symptoms of emotional dysregulation...
January 2014: Current Opinion in Psychiatry
Cherise Rosen, Robert Marvin, James L Reilly, Ovidio Deleon, Margret S H Harris, Sarah K Keedy, Hugo Solari, Peter Weiden, John A Sweeney
OBJECTIVE: This study sought to identify similarities and differences in symptom characteristics at initial presentation of first psychotic episodes in schizophrenia, bipolar disorder and unipolar depression. METHODS: The Structured Interview for DSM-IV (SCID) and Positive and Negative Syndrome Scale (PANSS) were administered to consecutive admission study-eligible patients (n=101) presenting for treatment during their first acute phase of psychotic illness. Forty-nine percent of patients met diagnostic criteria for schizophrenia, 29% for psychotic bipolar disorder and 22% for unipolar depression with psychosis...
October 2012: Clinical Schizophrenia & related Psychoses
Lars Vedel Kessing, Eleni Vradi, Per Kragh Andersen
BACKGROUND: No study has investigated when preventive treatment with lithium should be initiated in bipolar disorder. AIMS: To compare response rates among patients with bipolar disorder starting treatment with lithium early v. late. METHOD: Nationwide registers were used to identify all patients with a diagnosis of bipolar disorder in psychiatric hospital settings who were prescribed lithium during the period 1995-2012 in Denmark (n = 4714)...
September 2014: British Journal of Psychiatry
Helle K Schoeyen, Ute Kessler, Ole A Andreassen, Bjoern H Auestad, Per Bergsholm, Ulrik F Malt, Gunnar Morken, Ketil J Oedegaard, Arne Vaaler
OBJECTIVE: Electroconvulsive therapy (ECT) is regarded by many clinicians as the most effective treatment for treatment-resistant bipolar depression, but no randomized controlled trials have been conducted, to the authors' knowledge. They compared efficacy measures of ECT and algorithm-based pharmacological treatment in treatment-resistant bipolar depression. METHOD: This multicenter, randomized controlled trial was carried out at seven acute-care psychiatric inpatient clinics throughout Norway and included 73 bipolar disorder patients with treatment-resistant depression...
January 2015: American Journal of Psychiatry
Isabella Soreca
PURPOSE OF REVIEW: Multiple lines of evidence support the conceptualization of bipolar disorder as a disorder of circadian rhythms. Considering bipolar disorder in the framework of circadian disturbances also helps understand the clinical phenomenology pointing toward a multisystemic involvement. RECENT FINDINGS: Patients with bipolar disorder show altered rhythmicity in body temperature and melatonin rhythms, high day-to-day variability in activity and sleep timing, persistent disturbances of sleep or wake cycles, including disturbances of sleep continuity...
November 2014: Current Opinion in Psychiatry
Terence A Ketter
Patients with bipolar disorder are symptomatic about half of the time, experiencing depression more often than mania/hypomania. Because patients usually seek treatment during a depressive episode (rather than a manic episode), bipolar depression is commonly misdiagnosed as unipolar depression. Providing an accurate and timely bipolar depression diagnosis is critical for the proper treatment of the patient. Some FDA-approved treatments are helpful during acute and maintenance phases of therapy, but there is a significant unmet need for effective bipolar depression treatments with favorable side-effect profiles...
April 2014: Journal of Clinical Psychiatry
Othman Mohammad, David N Osser
This new algorithm for the pharmacotherapy of acute mania was developed by the Psychopharmacology Algorithm Project at the Harvard South Shore Program. The authors conducted a literature search in PubMed and reviewed key studies, other algorithms and guidelines, and their references. Treatments were prioritized considering three main considerations: (1) effectiveness in treating the current episode, (2) preventing potential relapses to depression, and (3) minimizing side effects over the short and long term...
2014: Harvard Review of Psychiatry
Andrea Cipriani, Jennifer M Rendell, John Geddes
BACKGROUND: Many patients with bipolar disorder require long-term treatment to prevent recurrence. Antipsychotic drugs are often used to treat acute manic episodes. It is important to clarify whether olanzapine could have a role in long-term prevention of manic and depressive relapses. OBJECTIVES: To assess the effects of olanzapine, as monotherapy or adjunctive treatment, in preventing manic, depressive and mixed episodes in patients with bipolar affective disorder...
January 21, 2009: Cochrane Database of Systematic Reviews
Trisha Suppes, Ellen B Dennehy, Robert M A Hirschfeld, Lori L Altshuler, Charles L Bowden, Joseph R Calabrese, M Lynn Crismon, Terence A Ketter, Gary S Sachs, Alan C Swann
BACKGROUND: A panel consisting of academic psychiatrists and pharmacist administrators of the Texas Department of State Health Services (formerly Texas Department of Mental Health and Mental Retardation), community mental health physicians, advocates, and consumers met in May 2004 to review new evidence in the pharmacologic treatment of bipolar I disorder (BDI). The goal of the consensus conference was to update and revise the current treatment algorithm for BDI as part of the Texas Implementation of Medication Algorithms, a statewide quality assurance program for the treatment of major psychiatric illness...
July 2005: Journal of Clinical Psychiatry
V Selle, S Schalkwijk, G H Vázquez, R J Baldessarini
BACKGROUND: Optimal treatments for bipolar depression, and the relative value of specific drugs for that purpose, remain uncertain, including agents other than antidepressants. METHODS: We searched for reports of placebo-controlled, monotherapy trials of mood-stabilizing anticonvulsants, second-generation antipsychotics, or lithium for acute major depressive episodes in patients diagnosed with type I or II bipolar disorder and applied random-effects meta-analysis to evaluate their efficacy, comparing outcomes based on standardized mean drug-placebo differences (SMD) in improvement, relative response rates (RR), and number-needed-to-treat (NNT)...
March 2014: Pharmacopsychiatry
Mauricio Tohen, Roger S McIntyre, Shigenobu Kanba, Shinji Fujikoshi, Hideaki Katagiri
BACKGROUND: These analyses compared efficacy of olanzapine in patients with bipolar mania with or without mixed features, as defined in the DSM-5. METHODS: Pooled data from 3 placebo-controlled olanzapine studies in patients having bipolar I disorder with manic/mixed episode were analyzed (N=228 olanzapine; N=219 placebo). Patients were categorized for mixed features by number of concurrent depressive symptoms at baseline (0, 1, and 2 [category A; without mixed features], and ≥3 [category B; with mixed features]), as determined by HAM-D17 item score ≥1...
October 2014: Journal of Affective Disorders
2014-07-31 07:26:48
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