The National Comorbidity Study showed that bipolar disorder was associated with the highest risk for coexistence with a drug or alcohol use disorder (over 60% for bipolar I and 48% for bipolar II) and a lifetime prevalence of over 90 percent. 1 Alcohol and marijuana are most frequently used, with alcohol higher in women. Generally, there are higher rates of mixed episodes, cycling, impulsivity, and Cited by: 28 Jul 14, · Bipolar Disorders, 14 (6), – doi: /jx. [PMC free article] [Google Scholar] Sublette, M. E., Carballo, J. J., Moreno, C., Galfalvy, H. C., Brent, D. A., Birmaher, B., Oquendo, M. A. (). Substance use disorders and Cited by: 22 According to the National Institute Mental Health (NIMH) booklet (), Bipolar disorder is commonly known for a manic-depressive illness. This is caused by a brain disorder that usually shifts in mood, energy, activity levels, and carried out day by day. The symptoms of bipolar disorder are severe
A Review of Bipolar Disorder in Adults
Try out PMC Labs and tell us what you think. Learn More, bipolar disorder research paper. Hilty is Associate Professor of Clinical Bipolar disorder research paper and Behavioral Sciences at University of Califorinia, Davis. Leamon is Associate Professor of Clinical Psychiatry and Behavioral Sciences at University of Califorinia, Davis. Kelly is Intructor, Department of Psychiatry, and Faculty, Certificate Program in Infant Mental Health, University of Washington.
Hales is Joe Tupin Professor and Chair of Psychiatry and Behavioral Sciences, University of California, Davis. Objective: This article reviews the epidemiology, etiology, assessment, bipolar disorder research paper, and management of bipolar disorder. Special attention is paid to factors that complicate treatment, including nonadherence, comorbid disorders, mixed mania, and depression. Methods: A Medline search was conducted from January of through December of using key terms of bipolar disorder, diagnosis, and treatment.
Papers selected for further review included those published in English in peer-reviewed journals, with preference for articles based on randomized, controlled trials and consensus guidelines. Citations de-emphasized original mania trials as these are generally well known. Results: Bipolar disorder is a major public health problem, with diagnosis often occurring years after onset of the disorder.
comorbid conditions are common and difficult to treat. Management includes a lifetime course of medication, usually more than one, and attention to psychosocial issues for patients and their families. Management of mania is well-established. Research is increasing regarding management of depressive, mixed and cycling episodes, bipolar disorder research paper, as well as combination therapy.
Conclusions: Bipolar disorder is a complex psychiatric disorder to manage, even for psychiatrists, because of its many episodes and comorbid disorders and nonadherence to treatment. Bipolar spectrum disorders are a major public health problem, with estimates of lifetime prevalence in the general population of the United States at 3. Review articles for adults 67 and pediatric patients 8 imply progress, but we have not fully researched depressive episodes, combination treatment, health services interventions, and special populations.
Practice guidelines, bipolar disorder research paper, 9 decision trees, 10 and elaborate algorithms 1112 are well written, but are not user friendly.
More pharmacologic options are now available, and psychoeducation, self-help, and psychotherapy individual, couple, and family interventions are frequently utilized. The National Alliance of the Mentally Ill NAMI has also sought information by surveying family members about utilization and value of mental health services, bipolar disorder research paper. Bipolar I disorder starts on average at 18 years and bipolar II disorder at 22 years. Bipolar disorder has not consistently been associated with sociodemographic factors.
Males and females are equally affected by bipolar I, whereas bipolar II is more common in women. There is a higher rate of bipolar disorder in unmarried people. Economic analyses usually include direct treatment costs, indirect costs arising from mortality, and indirect costs related to morbidity and lost productivity. This is the model for bipolar disorder and others that are long-term or lifetime disorders.
Misdiagnosis leads to exorbitant costs and mistreatment. There is not a single hypothesis that unifies genetic, biochemical, bipolar disorder research paper, anatomical, and sleep data on bipolar disorder. Imaging studies, emerging throughout medicine, may shed light. Epidemiological evidence, particularly studies of concordance in identical and fraternal twins, implies that affective disorders are heritable.
For family members of bipolar probands, the morbid risk is between 2. Concerns of patients and their relatives can be dealt with through counseling. Biochemical and pharmacologic studies led to catecholamine hypothesis bipolar disorder research paper explain bipolar disorder, particularly mania, presuming that mania is due to an excess and depression is due to a depletion of catecholamines.
Norepinephrine has been implicated mainly because of abnormalities linked with depression including its modulation by tricyclic antidepressants TCAs. Dopamine has been implicated because the dopamine precursor L-dopa, amphetamines, and TCAs often produce hypomania in bipolar patients. Antipsychotic medications that selectively block dopamine receptors e.
A number of serotonin hypotheses have been proposed, in isolation, or in relationship to other systems. A wide range of neuroanatomical and neuroimaging studies are being conducted to learn more bipolar disorder research paper bipolar disorder.
Left-sided lesions tend to be associated with depression and right-sided lesions with mania, though differences may be reversed in the posterior regions of the brain e. No abnormalities have been found consistently via computed tomography CT studies, though ventricular enlargement has been suspected.
Magnetic resonance imaging MRI studies reveal an increase in white matter intensities associated with bipolar disorder and correlated with age, 21 though the clinical significance is unknown. Overall, bipolar disorder research paper functional imaging studies single-photon emission computer tomography [SPECT] and positron emission tomography [PET] have noted prefrontal bipolar disorder research paper anterior paralimbic hypoactivity in bipolar depression, while preliminary studies of manic patients have yielded inconsistent findings.
There are two other important biochemical models for bipolar disorder. Post and collaborators have proposed a model that electrophysiological kindling and behavioral sensitization underlie bipolar disorder, particularly the increasing frequency of episodes over time.
Circadian rhythm desynchronization has also been implicated in bipolar disorder. Animal data indicate that periodic physiological disturbances can occur if two rhythms become desychronized i. Cognitive processing is often impaired in bipolar patients, even in euthymic patients. This may be a primary feature of bipolar disorder, secondary to other dysregulation e.
Cognitive assessment is underutilized in assessing medication side effects, the return to the outpatient sector from inpatient, and employing vocational rehabilitation in preparation for work. The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders Text Revision DSM-IV-TR includes bipolar I disorder, bipolar disorder research paper, bipolar II disorder, cyclothymic disorder, and bipolar disorder not otherwise specified.
By definition, patients with bipolar I disorder have had at least one episode of mania. Those with bipolar II have had depressive and hypomanic episodes. Rapid cycling is technically four or more episodes per year, though many clinicians use the term to describe mood oscillations day to day. Mania occurring in the context of medication, substances, or medical illness is known as secondary mania and classified separately.
This is an important determination, since many already responded adversely to standard antidepressants prescribed because the patients were previously diagnosed with depression. The differential diagnosis of bipolar disorder is quite extensive and complex. First, the presentation of patients bipolar disorder research paper be similar to other mood and psychotic disorders, including major depression, schizoaffective disorder, and schizophrenia.
A positive family history of mood disorder is suggestive of a mood disorder, even when patients present with prominent psychotic symptoms. Second, bipolar disorder symptoms of recklessness, impulsivity, truancy, and other antisocial behavior are not unique versus substance, personality borderline, antisocial, and othersand attention deficit hyperactivity disorders.
Third, the relationship between affective illness and personality must be considered in making the diagnosis of bipolar disorder. Bipolar disorder should always be considered in the differential diagnosis of patients with depression, as 3. The evaluation of a bipolar patient involves a number of important clinical and psychosocial issues.
The primary tool is the neuropsychiatric assessment with the history and physical examination. Brief histories less than 30 minutes may be a liability, due to the complexity of the mood course in patients not already diagnosed. Collateral information is required in most cases from family, friends, or prior places of treatment.
A delineation of episodic versus chronic symptoms is helpful, except with patients with cycling of mood day-to-day, in a mixed episode, or otherwise very unstable course. Screening instruments can be used for manic episodes e.
Mood Disorder Questionnaire [MDQ]though they may have more utility in primary care settings, bipolar disorder research paper. The clinician must also assess for the presence of psychotic features, cognitive impairment, risk of suicide, risk of violence to persons or property, bipolar disorder research paper, risk-taking behavior, sexually inappropriate behavior, and substance abuse.
In addition, it is important to assess for the patient's ability to care for himself or herself, childbearing status or plans, housing, financial resources, and psychosocial supports. Again, accurate assessment depends on information from several sources since self-report of symptoms may conflict with observation by others. Laboratory tests are used on a case-by-case basis and include level of thyroid stimulating hormone TSHurine or blood toxicology, a complete blood count CBCserum chemistries, electroencephalograms EEGsimaging studies, and erythrocyte sedimentation rate ESR.
Generally, head imaging is done early in the course to ensure a central cause is not missed, though rates of positive studies are low in community samples. It is particularly important to detect episodes of secondary mania, previously recognized as a subtype of mania, 1928 bipolar disorder research paper now as a substance-induced mania or mania due to a general medical condition.
Correction of the underlying organic factor infectious, toxic, and metabolic may effectively reverse the manic presentation, but some factors are not reversible e.
Bipolar disorder research paper with mania originating in late life are more likely to have the following: a negative family history of affective disorder; irritability; treatment resistance; and a higher rate of mortality. Treatment guidelines. The American Psychiatric Association APA developed the Practice Guideline for the Treatment of Patients with Bipolar Disorder. A therapeutic alliance is crucial for understanding and managing the patient, bipolar disorder research paper, detecting recurrence of illness, enhancing adherence, and addressing psychosocial stressors.
Patients require ongoing education regarding the illness, treatment options, and the impact of the illness on social and family relationships, bipolar disorder research paper, vocation, and financial issues. Graphic representation of the illness is a method to consolidate information episode sequence, polarity, severity, frequency, and relationship to stressors and treatmentbipolar disorder research paper, educate the patient, and may help to develop an alliance.
Promote understanding of and adapatation to the psychosocial effects of bipolar disorder. Discussion on an ongoing process, use of educational brochures, and use of literature written by peers is useful for patient. The Expert Consensus Guideline Series is another well-known guideline. Levels of evidence vary for all medications. Treatment selections are bipolar disorder research paper based on efficacy data than tolerability.
The section for older adults is substantially more detailed compared with other guidelines. A summary of guidelines for episodes is in Table 3.
Psychosocial treatments for bipolar disorder. Psychotherapeutic treatments, provided individually or through groups and families, are beneficial to nearly all patients with bipolar disorder and provide the context in which psychiatric management and pharmacotherapy work best.
Bipolar inpatients were surveyed about their informational needs in one study, and they requested information about bipolar disorder, how to obtain support, how to manage symptoms e. Bipolar disorder research paper summary of psychotherapeutic treatments reveals better outcomes and improved adherence to treatment. Easy bipolar disorder research paper to a primary nurse provider increases outpatient utilization without increasing costs.
Medication selection. The choice of a mood stabilizer for the treatment of mania can be guided by predictors of response, which are usually determined by the patient's history and the type of episode Bipolar disorder research paper 1. Proportion of depression to mania : A high ratio implies eventual need for lithium, lamotrigine, or quetiapine, though others are effective for depression.
Cycling or mixed episodes : Mood stabilizer combination is bipolar disorder research paper, with an atypical for sleep and the other, probably an anticonvulsant, good for depression.
Bipolar disorder (depression \u0026 mania) - causes, symptoms, treatment \u0026 pathology
, time: 6:55Bipolar Disorder - Words | Essay Example
Bipolar Disorder research papers on psychological disorders can be custom written for college and university students. Bipolar disorder research papers point out that the disease affects nearly one percent of the United States population. Since this is such a prolific psychological disorder, bipolar disorder research papers will want to include elements of the disease and its subcategories According to the National Institute Mental Health (NIMH) booklet (), Bipolar disorder is commonly known for a manic-depressive illness. This is caused by a brain disorder that usually shifts in mood, energy, activity levels, and carried out day by day. The symptoms of bipolar disorder are severe The National Comorbidity Study showed that bipolar disorder was associated with the highest risk for coexistence with a drug or alcohol use disorder (over 60% for bipolar I and 48% for bipolar II) and a lifetime prevalence of over 90 percent. 1 Alcohol and marijuana are most frequently used, with alcohol higher in women. Generally, there are higher rates of mixed episodes, cycling, impulsivity, and Cited by: 28
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