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James Phelps, MD

James Phelps, MD

James Phelps, MD, is Director of the Mood Disorders Program at Samaritan Mental Health in Corvallis, Ore. He is the Bipolar Disorder Section Editor for Psychiatric Times. His Web site, PsychEducation.org, gathers no information on visitors and produces no income for him or others. He is the author of Why Am I Still Depressed? Recognizing and Managing the Ups and Downs of Bipolar II and Soft Bipolar Disorder (New York: McGraw-Hill; 2006), from which he receives royalties. Dr Phelps stopped accepting honoraria from pharmaceutical companies in 2008.

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Must clinicians presume that all their female patients of reproductive age are potentially going to become pregnant? And if so, what treatment option should be offered?

An instructive case that ties in to an APA presentation on "Treatment and Research of Treatment-Resistant Depression and Bipolar Disorder."

The Neural Basis of Bipolar Disorder

Selected for clinical implications, here are some highlights from the recent acceleration in understanding of the mechanisms of bipolar disorder.

The authors—both well-known specialists—attempt to integrate the two fundamental ingredients of psychotherapy and pharmacology in the treatment of bipolar disorders.

After thorough examination and history-taking, bipolar II disorder was suspected in a 19-year-old college student. What psychiatric screening tools might be used to further confirm the diagnosis for this patient?

There is very little evidence for the efficacy of antidepressants in bipolar disorder, particularly for longer-term use. However, there are at least 9 alternatives to conventional antidepressants.

If your practice or your advocacy efforts place you anywhere near people encountering the mental health system for the first time, please have a look at this book.

With DSM-5, one more examination of bipolar diagnosis is warranted. After all, if a diagnosis is inaccurate, treatment efforts, however well-intentioned, may misfire.

Overdiagnosis of bipolar disorder is an increasing concern, particularly since a widely cited study that indicates a problem with overdiagnosis as well as with the much less publicized parallel finding of 30% underdiagnosis.

This essay begins an ongoing series on bipolar disorder focused on clinical utility.

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