Bipolar Disorder

After reading this article, you will be familiar with:The function of the hypothalamic-pituitary-adrenalaxis and the significance of cortisolin the etiology of depression.

Psychopharmacologic management has become increasingly complex, and physicians run the risk of precipitating drug-drug interactions when certain drugs interact via the cytochrome P450 system. In addition, the P-glycoprotein transporter may play a role in certain drug-drug interactions. While physicians currently rely on Web sites and textbooks to avoid potentially morbid and lethal interactions, electronic medical records may play a crucial role in the future.

Anorexia nervosa, bulimia nervosa and binge-eating disorder remain challenging disorders for the practicing psychiatrist. While psychopharmacological agents play an important role in the overall treatment of eating disorders, current empirical evidence does not support their sole use. A recipe consisting of evidence-based psychopharmacological agents together with evidence-based psychotherapeutic approaches is usually required for a successful outcome.

According to a large international study, BD-II mixed depression can easily be misdiagnosed as major depressive disorder. Proper assessment and treatment of mixed depression in BD-II could have a positive impact on outcomes in bipolar disorder.

While the symptoms of somatoform and dissociative disorders are influenced by the patient's culture, these syndromes are heterogeneous and may have overlapping features. Although more frequently reported in non-Western cultures and thought of as exotic and culture-bound, multiple personality disorder may be a North American example of one such disorder.

One of the spin-offs of the consensus statement is a study of the risk for metabolic disorders with antipsychotic use in children and adolescents. Here, the lead researcher discusses some of the group's initial findings.

Research presented at an international meeting in Australia found that lamotrigine may be beneficial against depressive relapse for patients either currently or recently in a manic phase.

A new consensus statement has been issued regarding the high risk of diabetes and associated disorders with use of atypical antipsychotics. Several of the major pharmaceutical companies have responded negatively to this statement.

Will the most effective treatments be available for your patients? Atypical antipsychotics and antidepressants that are being marketed or developed worldwide are reviewed.

How is it that anti-anxiety drugs can cause anxiety and insomnia, sometimes within the first day or two of treatment? These are not the soothing qualities we expect for anti-anxiety medications.

Although there are many social impediments to the use of ECT, it appears to meet the four ethical principles of health care.

In looking at the history of ECT, it appeared to have been quite successful in treating a variety of psychiatric disorders. If that is the case, then why did it disappear from the "psychiatric map" for a number of years? What obstacles need to be overcome to return ECT to its place as a viable treatment option?

This year marks the 70th anniversary of the first use of induced seizures to treat mental disorders. Read about the career of Ladislas Meduna, M.D., the Hungarian neuropathologist who pioneered this treatment method. Although his theory that convulsive therapy is effective because it increases glial cell function was disproved, it remains one of the

According to a recent Human Rights Watch report, U.S. prisons hold three times as many people with mental illness as psychiatric hospitals. The majority of these individuals are there because community-based treatments are not available, they have co-occurring substance abuse problems or they have previous involvement with the criminal justice system. Partnering with law enforcement agencies is key to devising workable solutions that ensure individuals with mental illnesses get the treatment they need.

It's often believed--even by mental health care professionals--that people with mental illnesses could be employed in low-level jobs. Studies and demonstration projects have shown, however, that these individuals can sustain employment in high-level positions with the proper training and support.

Hispanics are now officially the largest minority in the United States. They are also highly prone to psychiatric disorders. What are the unique challenges of treating this ethnic population?

Results from three statewide studies of the clinical practices for assessing and treating children and adolescents with a primary diagnosis of conduct disorder, ADHD or bipolar I disorder demonstrate gender and ethnic differences only for those diagnosed with conduct disorder. The implications of these findings and their similarities to the literature on adults with psychiatric disorders are discussed.

The chief psychiatrist of the Community-University Health Care Clinic in Minneapolis reflects on what he's learned caring for refugees from Southeast Asia and Somalia. His experiences can educate others caring for immigrants and refugees.

An increasing amount of systemic research has galvanized opinions regarding pediatric-onset bipolar disorder (BD). Although originally thought to be a rare condition, the number of pediatric-onset BD diagnoses is rising. This article summarizes current thinking regarding pediatric BD, including work focusing on presentation, psychiatric comorbidity and recent treatment data

Stereotypical portrayals of people with mental illness are as old as Hollywood itself. What are some of the clinical implications of the continued stigmatization of the mentally ill in television and film?

In presenting the subject of dangerousness assessments at my hospital, I told a story about my grandchildren that illustrated the fact that we all make such assessments and act on them regularly in various contexts.

The idea that drug response could be based on a patient's genetic background first surfaced over 100 years ago. Since then, technology has advanced to the point where prescribing medications based on a patient's genetic makeup no longer seems like science fiction. This article looks at the latest research on the pharmacogenetics of psychotropic medications and shows how far we still have to go.

Increasing variations in mechanisms of action of atypical antipsychotics, side-effect profiles, and efficacy among the atypicals enable clinicians to tailor treatments to individual response, side-effect history, and current medical conditions.

The DSM may be flawed, but it is the best available system for organizing and diagnosing mental disorders, and it remains a model for other medical specialties.

While housing problems for the mentally ill are usually associated with patients receiving public care, private patients also face obstacles over obtaining and keeping adequate housing. What are the issues, and what can agencies do to ensure all patients, regardless of socioeconomic status, have adequate housing?