Bipolar Disorder

Staying empathic and keeping the conflict within the patient instead of between the patient and health care provider, is a key to successful management.

The paradigm for modern psychiatry is evidence-based medicine (EBM)-it represents proven treatments for defined diagnoses. But there are major problems with this position, starting with the fact that while they are superior to placebo, evidence-based treatments too often are ineffective.

In a recent interview on 60 Minutes, Harvard psychologist Irving Kirsch, PhD, commented, “the difference between the effect of a placebo and the effect of an antidepressant is minimal for most people.”

Insight can be assessed in the course of a typical evaluation or follow-up interview with augmentation by questions borrowed from any of the validated insight rating scales.

When thinking about recent advances in psychopharmacology, we often point to new molecules with similar mechanisms of action but with better safety and tolerability profiles, or to molecules with novel mechanisms that effect positive change greater than that with existing treatments.

Adequate treatment of the underlying psychiatric illness consistently appears to be the most effective use of medication in suicidal patients.

Several studies have been undertaken to test the efficacy of drugs in the management of aggression and hostility in patients with schizophrenia and other mood disorders.

The diagnostic boundary between Major Depressive Disorder and Bipolar II Disorder is one of the most difficult and also one of the most important in psychiatry.

During their time in Ayacucho, these visiting psychiatrists learned that American psychiatric training has wide-reaching cultural value.

With DSM-5 scheduled for publication a little more than a year from now, we may safely assume that, barring unannounced surprises from, say, the APA Scientific Review Committee, what we will see on the DSM-5 Web site is what we will get. With that in mind it’s time to review what we will indeed get.

The responsibility for improvement was placed on psychiatrists: diagnostic skills had to be improved and patients and their families and caregivers as well as the general public needed to be better educated about the disorder and treatment options.

Three twin studies published between 1977 and 1995, which provided the main body of knowledge on heritability of autism, showed a concordance rate of 72% for a total of 36 monozygotic pairs and a concordance rate of 0% for 30 dizygotic pairs.

In this article the topic addressed are the primary reasons for the American public’s disenchantment with psychiatry; how the profession ought to address these issues; and how we need to replace the DSM’s categorical system with one that is clinically useful for both clinicians and patients.

Effective, early intervention and appropriate support for and treatment of the caregivers of these vulnerable children will improve short-term outcomes and also may provide positive lifelong benefits.

Much of the controversy on the relationship between grief and depression following recent bereavement has focused on whether the so-called “bereavement exclusion” in DSM-IV should be eliminated, as some have proposed, in the DSM-5.

Each of the boys in question could meet criteria for the DSM-5 proposed criteria for Disruptive Mood Dysregulation Disorder (DMDD). But do you think that these presentations are all the same syndrome that share a similar neurobiological basis, family history, and response to treatment?

Charles Dickens might well say of American psychiatry, “These are the best of times and the worst of times.”

Comorbid obesity and bipolar disorder together affect the executive functioning of patients.

Do you know someone that has fought the brave fight against serious mental illness? They deserve recognition and applause. Do nominate them or let them know of the Reintegration Awards.

Dr Roger McIntyre answers a reader's question. How would you answer? Take the quiz.

Philadelphia will host this year’s annual meeting that will take place from May 3 to 5, 2012. The chosen location will be at the Loews Philadelphia Hotel at 1200 Market Street, with easy access to many of the city’s main attractions.

Special Report chairs discuss patient education and provide a brief overview of materials that provide an opportunity for patients to help themselves.

Patients with bipolar disorder need a great deal of information about the illness. Without this education, adherence to your recommendations is uncertain; with it, outcomes will likely be better (and your job easier).

This essay is a brief update on an earlier Psychiatric Times article by Dr James Phelps. Several major studies have appeared since the publication of the original article, which shed further light on this issue.

But I still have bottles of pretty pills . . . I throw like life rafts to keep them afloat . . .in choppy seas, me passing my doctor-days