Bipolar Disorder

J Psychopharmacol. 2009 Jun;23(4):346-88. Epub 2009 Mar 27

Goodwin GM; Consensus Group of the British Association for Psychopharmacology.Collaborators (30)

Chandler S, Anderson I, Colom F, Coghill D, Cookson J, Ferrier N, Geddes J, Goodwin G, Haddad P, Hunt N, Kapur N, Jones I, Lam D, Lingford-Hughes A, Miklowitz D, Morriss R, Sahakian B, Scott J, Taylor D, Thakore J, Thapar A, Thomas A, McGuire P, Cooper S, Cowen P, Manning C, Ebmeier K, Cavanagh J, Barnes T, Aitchison KJ.

University Department of Psychiatry, Warneford Hospital, Oxford, UK.

The British Association for Psychopharmacology guidelines specify the scope and target of treatment for bipolar disorder. The second version, like the first, is based explicitly on the available evidence and presented, like previous Clinical Practice guidelines, as recommendations to aid clinical decision making for practitioners: they may also serve as a source of information for patients and carers. (More)

CNS Drugs. 2009;23(3):225-40

Grandjean EM, Aubry JM.

Phidalsa Institute for Clinical Investigation, Geneva, Switzerland.

Although there has been a decrease in lithium use over several years, it is still recommended as a first-line mood stabilizer in all recent guidelines. It has been argued that many studies of lithium were conducted at a time when study design, assessment standards and the diagnostic criteria for patient selection were not as established as they presently are. However, recent placebo-controlled data from three-arm trials have demonstrated a definite efficacy of lithium in bipolar disorder. (More)

J Psychiatr Pract. 2008 May;14 Suppl 2:18-30

Golden WE, Hermann RC, Jewell M, Brewster C.

University of Arkansas for Medical Sciences, Little Rock, AR, USA. goldenwilliame@uams.edu

The STAndards for BipoLar Excellence (STABLE) Project was organized in 2005 to improve quality of care for bipolar disorder by developing and testing a set of evidence-based clinical process performance measures related to identifying, assessing, managing, and coordinating care for bipolar disorder. (More)

J Clin Psychiatry. 2008;69 Suppl 3:31-7

Beyer JL.

Duke Mood and Anxiety Disorder Clinic, Duke University Medical Center, Durham, NC 27710, USA. beyer001@mc.duke.edu

Controlled trials have demonstrated the efficacy of several classes of drugs for achieving acute response in bipolar mania and depression. For many years, clinical response has been the primary outcome in the majority of short-term efficacy studies.  (More)

J Clin Psychiatry. 2008 Mar;69(3):495-6

Goldberg JF.

Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA. JFGoldberg@yahoo.com

Br J Psychiatry. 2007 Dec;191:474-6

Young AH, Hammond JM.

Institute of Mental Health, University of British Columbia, University Boulevard, Vancouver, British Columbia, Canada V6T 1Z3. allan.young@ubc.ca

Use of lithium for the treatment of bipolar disorder may be declining even as knowledge of the efficacy and side-effects of lithium has increased. Recent meta-analyses confirm the benefits of maintenance lithium treatment and show that it reduces suicide and suicidality. Psychiatrists should continue to utilise this efficacious treatment for bipolar disorder. (More)

J Affect Disord. 2008 Mar;106(3):265-72. Epub 2007 Aug 16

Farren CK, Mc Elroy S.

Trinity College Dublin, Department of Psychiatry, St. Patrick’s Hospital, James Street, Dublin 8, Ireland

BACKGROUND: Depressed and bipolar alcoholics represent a significant affective subgroup that has a poorer prognosis than either diagnosis alone. To date few systematic treatment programs have been developed to treat dual diagnosis. METHODS: An inpatient treatment program was developed at St Patrick’s Hospital Dublin to treat dual diagnosis clients with alcohol dependence and either unipolar or bipolar affective disorder. Clients (N=232) were assessed for depression, anxiety, elation, cravings, drink and drug intake on admission, discharge, 3 and 6 months post-discharge from the program.

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 J Clin Psychiatry. 2007 Dec;68(12):1982-3

Goldberg JF.

Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA. JFGoldberg@yahoo.com

NPR’s Talk of the Nation, September 4, 2007

The number of children and teens being treated for bipolar disorder has dramatically increased in the last decade. Was the disorder under-diagnosed in the past and is it over-diagnosed today? Dr. Mark Olfson, a professor of clinical psychiatry at Columbia University, discusses what’s behind the jump in bipolar diagnoses.

J Clin Psychol. 2007 May;63(5):417-24

Leahy RL

American Institute for Cognitive Therapy, New York, NY 10022, USA. aict@aol.com

Bipolar disorder is a chronic and often devastating illness that may go undiagnosed because of its complex and diverse presentation. Clinicians can provide psychological treatments, in conjunction with pharmacotherapy, that can reduce the frequency, severity, and duration of manic and depressive episodes.

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 J Clin Psychol. 2007 May;63(5):491-506

Rizvi S, Zaretsky AE

Department of Psychiatry, University of Toronto, Head Cognitive Behavior Therapy Clinic, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.

The obstacle facing pharmacotherapy for bipolar disorder is that almost half of the patients do not achieve recovery over the duration of treatment. Although the reason for this disappointing clinical outcome remains unclear, structured psychotherapy has helped to fill these gaps in the treatment of bipolar disorder. Psychoeducation, family-focused therapy, interpersonal and social rhythm therapy, and cognitive behavior therapy have all received attention in the research literature. In this review, by assessing the outcomes from randomized control trials across the phases of bipolar disorder, we demonstrate that psychotherapy is an effective adjunctive treatment. We also show that the use of psychotherapy for bipolar disorder has differential results depending on when and under what conditions it is administered.

Comment on:

• BMJ. 2006 Jan 7;332(7532):30-2.

Geddes J.

University of Oxford, Warneford Hospital, Oxford OX10 0RU. john.geddes@psych.ox.ac.uk

Publication Types:

• Comment

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Hellewell JS.

Trafford General Hospital, Manchester, UK. jonathan.hellewell@trafford.nhs.uk

Antipsychotic agents have long had a place in the clinical treatment of bipolar disorder, in both acute and maintenance phases. Recent clinical research conducted with the new generation of antipsychotic agents has contributed enormously to the data available on antipsychotic agents in bipolar disorder. Even now, however, the clinical trial data relates principally to the short-term treatment of acute mania.

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Streeruwitz A, Barnes TR, Fehler J, Ohlsen R, Curtis VA.

Department of Psychological Medicine, Institute of Psychiatry, London, UK.

The records of 70 inpatients with an acute manic episode were audited, to examine the relationship between current prescribing practice, the recommendations of recent clinical guidance and short-term clinical outcomes.

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