Bipolar DisorderPub Date : 2020-03-01DOI: 10.3109/9780203427583-2
E. Youngstrom, Jessica A. Janos, Joshua A. Langfus
{"title":"Assessment Tools","authors":"E. Youngstrom, Jessica A. Janos, Joshua A. Langfus","doi":"10.3109/9780203427583-2","DOIUrl":"https://doi.org/10.3109/9780203427583-2","url":null,"abstract":"Bipolar disorders are difficult to diagnose and treat, despite their global prevalence and pervasiveness. With the proper tools, however, clinicians and researchers alike are able to detect bipolar disorders in their patients and establish the proper treatment plans. Knowing the prevalence of bipolar disorders and other common diagnoses in a specific setting, gathering predictive information before the first visit, and screening patients with efficient, low-cost assessment options are a few of the ways that clinicians can be better prepared to detect bipolar disorders in their patients. Further, assessment should not halt once a diagnosis is established; brief, recurring measures to collect data about a patient’s current state throughout treatment offer important information about symptoms, progress, and how a treatment plan can be tailored to meet a client’s ongoing needs. This chapter equips clinicians and researchers with the tools to confidently diagnose their patients with bipolar disorders, suggesting tips to establish diagnostic hypotheses as well as specific assessments for both adults and youths for whom the diagnosis seems likely. Technology in particular offers the opportunity to access low-cost assessment options and administer ongoing measures to ensure that clinicians continue to meet their patients’ needs throughout the treatment process.","PeriodicalId":131972,"journal":{"name":"Bipolar Disorder","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124422562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bipolar DisorderPub Date : 2020-03-01DOI: 10.1093/med/9780190908096.003.0005
R. Post
{"title":"Making a Diagnosis","authors":"R. Post","doi":"10.1093/med/9780190908096.003.0005","DOIUrl":"https://doi.org/10.1093/med/9780190908096.003.0005","url":null,"abstract":"Bipolar disorder often has long delays to first diagnosis and treatment. Both early onset and treatment delay are risk factors for a poor outcome in adulthood. Poor recognition and treatment of the illness can lead to an accumulation of episodes with their attendant risks for cycle acceleration, neurobiological abnormalities, treatment resistance, cognitive dysfunction, and premature loss of many years of life expectancy. Complicating the appropriate diagnosis is the highly variable presentation of the illness and its multiple imitators and comorbidities, including anxiety disorders, attention-deficit/hyperactivity disorder, oppositional defiant disorder, depression, and substance abuse. One of the most critical keys to correct diagnosis is the longitudinal perspective, both retrospectively assessed in detail and systematically continued prospectively. Awareness of the high incidence of childhood-onset bipolar disorder in the United States compared with Canada and most European countries will hopefully lead to correction of one of the remedial risk factors for a poor outcome—the duration of delay to first treatment. With early and sustained treatment of a first episode of mania, episode recurrence and its attendant cognitive dysfunction may be prevented. Episodes, stressors, and bouts of substance abuse can accumulate and sensitize to further and more severe occurrences, likely on an epigenetic basis. Early diagnosis and treatment are imperative to stopping these mechanisms of illness progression in bipolar disorder.","PeriodicalId":131972,"journal":{"name":"Bipolar Disorder","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125522330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bipolar DisorderPub Date : 2020-03-01DOI: 10.1093/med/9780190908096.003.0002
M. Maj
{"title":"Clinical Presentation","authors":"M. Maj","doi":"10.1093/med/9780190908096.003.0002","DOIUrl":"https://doi.org/10.1093/med/9780190908096.003.0002","url":null,"abstract":"This chapter reviews the clinical presentation of bipolar I and bipolar II disorders, and in particular of manic, hypomanic, depressive, and mixed episodes. The DSM-5 operational criteria and the ICD-11 clinical descriptions and diagnostic guidelines are summarized, but several aspects that emerge from the literature and are not considered by those diagnostic systems are also covered. The divergences between those systems and the issues that remain controversial are pointed out, and the limitations of “specifiers” (or “qualifiers”) in accounting for the heterogeneity of depressive episodes are emphasized. Different clinical presentations of manic and depressive episodes in children and adolescents are also briefly described. It is concluded that the familiarity with the DSM-5 and/or the ICD-11 is not sufficient to ensure an appropriate approach to the diagnosis of mood episodes and disorders, in the absence of adequate training and clinical expertise.","PeriodicalId":131972,"journal":{"name":"Bipolar Disorder","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121557798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bipolar DisorderPub Date : 2020-03-01DOI: 10.1093/med/9780190908096.003.0001
S. Strakowski
{"title":"Introduction and Overview","authors":"S. Strakowski","doi":"10.1093/med/9780190908096.003.0001","DOIUrl":"https://doi.org/10.1093/med/9780190908096.003.0001","url":null,"abstract":"Bipolar disorder is a common psychiatric condition that is one of the leading causes of disability worldwide. As a dynamic, recurrent, and chronic illness, it can be complex to identify and manage. In this Primer on text, leading international authors explore aspects of clinical presentation epidemiology, etiology, neurobiology, and treatment of bipolar disorder. The text provides a readable but comprehensive overview of this common illness. The book has been organized into three major sections describing different aspects of bipolar disorder: Clinical Presentation and Epidemiology; Etiology and Neurobiology; and Treatment. This organization is not intended to imply that these various components are truly distinct but rather allows readers to quickly locate specific areas of interest. Treating bipolar disorder is challenging but is ultimately rewarding because good care can make it possible for these individuals to succeed in all aspects of life.","PeriodicalId":131972,"journal":{"name":"Bipolar Disorder","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130467518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bipolar DisorderPub Date : 2020-03-01DOI: 10.1093/med/9780190908096.003.0012
D. Kirsch, E. Lippard
{"title":"Genetics of Bipolar Disorder","authors":"D. Kirsch, E. Lippard","doi":"10.1093/med/9780190908096.003.0012","DOIUrl":"https://doi.org/10.1093/med/9780190908096.003.0012","url":null,"abstract":"An individual’s genetic makeup has the power to inform medical practice and shape disease prevention, diagnosis, and treatment to improve lifelong outcomes. Genetics has integrated into some aspects of general medicine; however, there has been less success in incorporating genetics into psychiatry. This chapter discusses the genetics of bipolar disorder. As revealed from family, twin, and adoption studies, bipolar disorder is highly heritable, with estimates suggesting the disorder coincides with the highest heritability compared with other psychiatric disorders. While association studies have identified genes of interest that may contribute to risk for the disorder, these studies have been difficult to replicate, and genes identified have shown small effect sizes on their own. More recent approaches to studying polygenic risk and epigenetics modifications of the genome are starting to be applied to bipolar disorder. Early findings utilizing these approaches are discussed. Additionally, this chapter discusses emerging work suggesting genetic associations that may cross diagnostic boundaries in psychiatry and genetic endophenotypes that may one day be incorporated into clinical practice for improving prediction, diagnosis, and treatment of bipolar disorder. While more work is needed to understand the genetics of bipolar disorder and ways to integrate genetics into clinical practice, there is hope on the horizon, and familial information can already guide clinical practice.","PeriodicalId":131972,"journal":{"name":"Bipolar Disorder","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128683455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bipolar DisorderPub Date : 2020-03-01DOI: 10.1093/med/9780190908096.003.0010
F. Romo-Nava, S. McElroy
{"title":"Neurobiology of Bipolar Disorder","authors":"F. Romo-Nava, S. McElroy","doi":"10.1093/med/9780190908096.003.0010","DOIUrl":"https://doi.org/10.1093/med/9780190908096.003.0010","url":null,"abstract":"As frequently occurs in science, progress made on the neurobiology of bipolar disorder has followed a nonlinear course that often revisits deserted concepts. The neurobiological blueprint of bipolar disorder continues to unfold from a neurotransmitter-based hypothesis to include peptides and intracellular signaling pathways, and into a broader neuronal network perspective that involves cortical and subcortical regions in the brain. Moreover, new evidence makes it increasingly clear that the mechanisms of disease in bipolar disorder extend beyond the brain, providing plausible “missing links” between psychopathology and the elevated medical comorbidities. This is illustrated by the expanding role of the circadian system in bipolar disorder and the emerging evidence on the contribution of spinal afferents to the construct of mood, portraying that brain–body communication pathways are relevant to the pathophysiology of bipolar disorder. This chapter provides an overview of the current and emerging neurobiological frameworks for bipolar disorder.","PeriodicalId":131972,"journal":{"name":"Bipolar Disorder","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134112573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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