Bipolar Disorder

Many adolescents have taken to the Internet to discuss their struggles with psychiatric disorders not ordinarily diagnosed in persons under 18 years old (eg, bipolar disorder).

If telling patients they have “pre-clinical Alzheimer’s” or “MCI due to Alzheimer’s Disease”-absent effective treatment-produces more emotional suffering than it relieves, a difficult ethical question arises; namely, can such a disclosure be justified under the foundational principle of non-malfeasance?

In a decade-long study of antipsychotic prescribing for hospitalized children and adolescents, researchers found that antipsychotics were used in 44.3% of patients and were often prescribed for behavioral disorders, PTSD, and other anxiety disorders as well as psychotic disorders.

Researchers are developing a scale to measure a clinically identified emotional “trigger state” that puts individuals with suicidal ideation at increased risk of acting on their ideations.

If Blake were alive today, maybe he’d start one of his famous stanzas with something like, “To see meaning in a 15-minute med check…” If not, I will. Here’s how I’ve come to justify this.

Psychiatry is a wonderful specialty. We have highly effective medication and psychotherapy tools. Forty years of accumulated clinical research have given us a pretty clear idea of optimal treatment guidelines. With an accurate diagnosis and an appropriate treatment, most of our patients benefit greatly and many recover completely.

Excellence in psychopharmacology demands sensitivity to the associated ethical considerations. The key considerations of psychiatry are both complex and dynamic, and psychiatrists who develop and refine their ethics skill set will be in a better position to anticipate and respond to ethical dilemmas as they arise in their practice.

Like every drug or technology that has therapeutic value, MDMA (3,4-methylenedioxymethamphetamine) has potential risks and benefits. Unlike most other drugs under clinical investigation, MDMA has a complex and controversial history that has delayed dispassionate scientific investigation into its therapeutic use.

If ketamine is able to turn off a patient’s depression, even for one day, you have accomplished something important, whether or not you can maintain it. This is because you have at least given the patient hope . . . that in itself is very significant from a therapeutic perspective.

I would recommend it for medical students who have been thrust into the role of primary decision maker for their patients, and clinicians who would appreciate a pocket supervisor to help them make treatment decisions.

Anyone working in the mental health field will recognize that in patients with extreme irritability, explosive behavior, or quick mood changes, bipolar disorder (BD) is often unquestionably diagnosed.

When my clinic manager told me that prison may be the best place to practice psychiatry nowadays, I didn’t believe him. After all, prisons often seem like a world apart, often in isolated rural areas or in windowless, nondescript urban buildings.

The evidence-based approach to bipolar depression symptoms includes treatment with lithium, conventional unimodal antidepressants, lamotrigine, or divalproex.

The focus of this Special Report is on some future-oriented aspects of psychopharmacology. First, it is an eclectic set of articles that cover treating resistant depression, using currently illegal drugs to treat psychiatric problems, and finally the potential of using vaccines to treat substance use disorders.

Mixed depression is defined as a major depressive episode (MDE) with concurrent manic or hypomanic symptoms that are insufficient in number for a patient to meet the criteria for mixed hypomania.

Mixed states constitute a wondrously variegated universe of psychopathology. These states are characterized by the intrusion of features characteristic of depression into states of hypomania or mania and the converse. Mixed states assume a myriad of forms that as a family may be among the most commonly encountered states of affective illness.

All members of the mental health community opposed the use of standardized testing to determine deviations from the mean. But the consensus fell apart thereafter.

Dr McIntyre discusses bipolar disorder and several studies in medical comorbidity in general and more specifically neurological comorbidity.

In previous blogs and papers, I have done my level best to skewer the misuse of the misdiagnosis "Paraphilia NOS." I regard it as no more than a flimsy justification, concocted to allow the psychiatric incarceration of rapists who would otherwise have to be released from prison to the street.

What were the key findings in the BALANCE study of bipolar 1 disorder? This and more in this quiz.

Major mood disorders have been associated with increased suicidal behavior. This is especially true in patients with a mixed, manic-depressive, or dysphoric-agitated state.

Are you familiar with Google Ngrams? If not, you may find the graphs it produces to be a very visual and interesting way to look back at terms used in psychiatry.

I would like to start off this blog with two stories that happened many years ago.

In my previous blog, The Missing Person in the DSM, I questioned whether the DSM diagnostic manual classifies psychiatric disorders or the individuals suffering from diagnostic disorders-Ms Smith’s bipolar disorder, or Ms Smith, a person with bipolar disorder.

The recent mass murders in Arizona are the latest in our country's epidemic of horrible, hate inspired crimes. The 24/7 media punditry and political spinning has been disappointingly off point in a way suggesting that once again we will learn nothing from our mistakes and that such tragedies will continue to recur with distressing frequency.