By David J. Miklowitz
Winner (First Place)--American magazine of Nursing e-book of the yr Award, Psychiatric and psychological future health Nursing Category
Read or Download Clinician's Guide to Bipolar Disorder: Integrating Pharmacology and Psychotherapy PDF
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Additional info for Clinician's Guide to Bipolar Disorder: Integrating Pharmacology and Psychotherapy
If a patient has only 1 to 3 day episodes, does the diagnosis of bipolar disorder apply? 1. Bipolar Variants and Clinical Features Suggested to Be Associated with Bipolar Spectrum Disorders Bipolar variants •• Hypomanias of less than 4 days’ duration a •• Hypomanic episode without mood symptoms but with hyperactivity •• Pharmacological manias/hypomaniasa Suggested clinical features of bipolar spectrum disorders •• Major depression with bipolar family history •• Mixed depressive syndromesa •• Early age of onset of depression •• Highly recurrent depressions •• Psychotic depression •• Atypical depressive features •• Treatment-resistant depressions •• Recurrent antidepressant tolerance aDescribed in DSM-5.
As clinicians, we need to be vigilant in addressing any and all factors associated with a poorer long-term course of our patients’ illnesses. Knowledge of how this material applies to specific life situations can be of immeasurable help to the clinician in assisting patients and families during the most difficult periods of illness. For example, younger patients and their families may not be aware of the highly recurrent course of the disorder, and may expect that after a major episode life should resume as before.
A thorough intake evaluation involves understanding the degree to which the patient’s current and past mood episodes have affected and been affected by work, family, and social factors. To do so, one needs to evaluate the psychosocial context of the illness. , becoming overly enmeshed in a new relationship) that in turn have led to more severe symptoms. Different clinical settings dictate different time frames for a diagnostic evaluation. For instance, many managed care contracts only reimburse for an hour of diagnostic evaluation.