再普乐治疗双相情感障碍ppt课件.pptVIP

Key Point: This graphic shows an overview of the spectrum of high and low mood states for a patient with bipolar disorder. Before accurate diagnosis is made, there is often a period of “subsyndromal” highs and lows before acute mania or major depressive episodes occur. These highs and lows may be associated with reduced occupational and social functioning, but may not be accurately diagnosed. Bipolar disorder poses a unique challenge for clinicians, since they must manage both the mania and the depression, and strive to prevent relapse. During the high and low episodes, patients see a decrease in their ability to engage in therapy, work, and social interaction with family and friends. Between these two extremes, patients try to get some semblance of normalcy in their life. But even in these times of euthymia, they live with the threat of slipping back into an acute high or low that is extremely disruptive to their life. The clinician plays a critical role throughout the treatment process in developing a trusting relationship that can enhance engagement in therapy, compliance, and better outcomes for the patient. Reference: 1. Manning JS, Ahmed S, McGuire HC, et al. Mood Disorders in Family Practice: Beyond Unipolarity to Bipolarity. The Primary Care Companion J Clin Psychiatry 2002;4(4):142-150. * Key Point: It is possible to meet criteria for mixed mood states, which when rigorously defined (criteria for manic AND major depressed episodes must be met concurrently) may be presenting syndromes in up to 30-40% of bipolar I patients. Even more commonly, in the majority of patients with bipolar disorder, combinations of manic/hypomanic and depressive symptoms occur concurrently. Another syndrome to be aware of is rapid cycling. These patients tend not to respond well to lithium treatment. Both mixed and rapid cycling are more commonly found in women. References: 1. Evans DL. Bipolar Disorder: Diagnostic Challenges and Treatment Considerations. J Clin Psych