Bipolar Disorder

Bipolar disorder is a longitudinal disorder defined by multiple episodes that may occur years apart. As a result, the proper diagnosis requires careful evaluation of both the current symptoms and the patient’s history.

This child's behaviors suggested ADHD-combined or primarily hyperactive type and conduct disorder. However, there was a strong history of trauma and affective disturbance. A structured interview format indicated that he formally met criteria for both PTSD and mixed episode. Without this format, features defining these disorders might have been missed and the child treated only for ADHD.

Some attorneys have argued that SSRIs cause serious adverse events, capable of compelling defendants to engage in strikingly complex criminal behavior. On close examination, however, these phenomena may be clearly distinguished from criminal behavior.

Behavioral problems “masquerade” as physical symptoms. The time has come to treat the whole patient and to make psychiatry part and parcel of primary care.

Most persons who use CAM modalities to self-treat a mental health problem take prescription antidepressants concurrently. Combined use can result in serious supplement-drug interactions.

What is truth? In the end, it is not a forensic psychiatrist's place to judge. He or she is a cog in a bigger machine that is supposed to treat psychiatric illness.

A risk to benefit ratio of treatment must be established to determine the optimal treatment for perimenopausal depression. Untreated depression during the perimenopause exacerbates heart disease, diabetes, and osteoporosis. Details about management options here.

While the growing evidence base for the positive effects of lithium on brain health is compelling, the evidence remains preliminary.

Dr Gerard Sanacora discusses novel antidepressant agents with potential clinical relevance for the treatment of major depressive disorder and bipolar disorder.

A recent meta-analysis supports evidence of the effectiveness of the fixed olanzapine/fluoxetine combination (Symbyax) in treating the depressive phase of bipolar disorder. Response was ranked higher, but with no more adverse effects, than with treatment with olanzapine alone.

Hypothyroidism is a common clinical disorder that psychiatrists frequently encounter. However, symptoms of thyroid dysfunction are often vague and nonspecific, which can lead to delayed or missed diagnosis.

This article highlights evidence-based treatment with herbs and nutrients with good tolerability and potential benefit when integrated into psychiatric practices.

Before recommending any natural product to a patient with bipolar disorder, the clinician should be familiar with important safety considerations. This article summarizes provisional guidelines for the use of CAM and integrative therapies in patients with bipolar disorder.

The aggregation of psychiatric diagnoses in individual psychiatric patients, ie, the presence of multiple disorders in one individual, is a curious and sometimes disturbing observation in psychiatry.

The major challenges for epigenetic therapies are target specificity of the drugs-an issue that is also true for most of the currently used drugs in medicine, especially in psychiatry.

Impulse control disorders are common psychiatric conditions in which affected individuals typically report significant impairment in social and occupational functioning, and may incur legal and financial difficulties as well.

"Psychiatric diagnosis is certainly imperfect -- but so is much of diagnosis throughout medicine. And whatever the current limitations, psychiatric diagnosis is useful and essential. There are no 'paradigm shifts possible til we learn a lot more. To imply otherwise is misleading and confusing to patients."

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.

With ECT‚ the response rate for treatment-refractory patients is sobering‚ and the treatment is not without risks and adverse effects.

Lamotrigine is an important option in bipolar disorders. However, many clinicians also use it in patients with a (unipolar) depressive disorder who have not responded adequately to conventional antidepressants.

This article explains and demonstrates the importance of psychiatric advance directives and the benefits and obstacles involved in implementing them.

In our time, it seems that the number of psychiatrists who believe in a God are increasing, parallel with the decreasing influence of Freud’s ideas.

When critics of psychiatric diagnosis insist that terms like “schizophrenia” or “bipolar disorder” are inherently stigmatizing, they are unwittingly perpetuating the very prejudice they wish to end. It is time to shine a bright light on this self-fulfilling prophecy.

Medication side effects of weight gain and increased appetite, together with non-adherence often found in persons with schizophrenia, bipolar disorder, and other serious mental illnesses, have challenged clinicians in the past.

While the diagnostic categories of DSM-III and DSM-IV (and soon DSM-5) have provided the basis for much useful research, little has been written about how much of DSM-and how much “evidence-based medicine”-is built on a foundation of fantasy.

Historically, there has been conflict between psychiatry and religion.

Preliminary evidence shows that dialectical behavior therapy may be beneficial in treating patients with bipolar disorder.

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.

Shakespeare's understanding of the human condition miraculously transcends his culture, time, and place.