P01-297-Clinical characteristics of pediatric patients with bipolar disorders in china

2011 ◽  
Vol 26 (S2) ◽  
pp. 298-298
Author(s):  
M. Huang ◽  
L. Guo ◽  
M. Ran
Keyword(s):  
Bipolar Disorder ◽  
Clinical Characteristics ◽  
Pediatric Patients ◽  
Age Groups ◽  
Bipolar Disorders ◽  
Mood Stabilizers ◽  
Pediatric Bipolar Disorder ◽  
Diagnosis System ◽  
Family Aggregation ◽  
Core Symptoms

ObjectiveTo explore the clinical characteristics, assessment, biological and psychosocial correlates, and treatment of pediatric bipolar disorder (BD) in China.MethodAll the studies published during the past 20 years on pediatric bipolar disorder in China were reviewed.ResultsThere is a lack of a unified diagnosis system in China. A serial of genetic researches showed the family aggregation and genetic predisposition of BD. There are consistent findings on the core symptoms of the disorder. BD has the characteristic of comorbidity with other disorders such as ADHD and OCD. Mood stabilizers and combined use of antipsychotics and TCA are still the main choice of psychiatrists to treat the pediatric patients with BD. The effectiveness of specific psychotherapy does need further studies.ConclusionA unified diagnosis system and criteria of BD for different age groups is crucial for further work. Combination of various treatments, such as mood stabilizers, AC, TCA and traditional Chinese medicine is effective for these patients. More studies, especially randomized controlled trials should be conducted to explore the etiology, pharmacotherapy and psychotherapy of this disease.

Update on the treatment of bipolar disorder in children and adolescents

2005 ◽  
Vol 20 (2) ◽  
pp. 87-91 ◽  
Author(s):  
Robert L. Findling
Keyword(s):  
Bipolar Disorder ◽  
High Risk ◽  
Genetic Risk ◽  
Pediatric Patients ◽  
Treatment Strategies ◽  
Pharmacological Intervention ◽  
Pediatric Bipolar Disorder ◽  
Symptom Remission ◽  
Affected Parent ◽  
Maintenance Study

AbstractAs the phenomenology of pediatric bipolar disorder has become better delineated, clinicians are now able to more accurately assess and treat young people suffering from this condition. For pediatric patients with bipolar I disorder and symptoms of mania, medication monotherapy has been shown to lead to symptom amelioration. However, this treatment modality oftentimes does not lead to full symptom remission. In an attempt to address this observation, combination treatment strategies have recently been investigated. Recently, a maintenance study has shown that in youths who achieved remission on a combination of lithium and divalproate therapy, either of these agents alone was equally effective as a treatment strategy. In youths identified as being at genetic high risk for bipolarity who also had problematic affective symptomatology, treatment with divalproate was not found to be superior to placebo; however, those with the greatest degree of genetic risk for familial psychopathology remained in the trial longer than those with more modest amounts of familial psychopathology. These data suggest that intervention in youths with only one affected parent may not be a rational prevention strategy for pharmacological intervention in bipolar disorder, and that cohorts more genetically at risk may be a more appropriate group for preventative pharmacotherapy.

Treatment and Prevention of Depression

2002 ◽  
Vol 3 (2) ◽  
pp. 39-77 ◽  
Author(s):  
Steven D. Hollon ◽  
Michael E. Thase ◽  
John C. Markowitz
Keyword(s):  
Bipolar Disorder ◽  
Behavioral Interventions ◽  
Combined Treatment ◽  
Bipolar Disorders ◽  
Mood Stabilizers ◽  
Delayed Effect ◽  
Convulsive Therapy ◽  
Adequate Treatment ◽  
Acute Distress ◽  
Reduce Risk

Depression is one of the most common and debilitating psychiatric disorders and is a leading cause of suicide. Most people who become depressed will have multiple episodes, and some depressions are chronic. Persons with bipolar disorder will also have manic or hypomanic episodes. Given the recurrent nature of the disorder, it is important not just to treat the acute episode, but also to protect against its return and the onset of subsequent episodes. Several types of interventions have been shown to be efficacious in treating depression. The antidepressant medications are relatively safe and work for many patients, but there is no evidence that they reduce risk of recurrence once their use is terminated. The different medication classes are roughly comparable in efficacy, although some are easier to tolerate than are others. About half of all patients will respond to a given medication, and many of those who do not will respond to some other agent or to a combination of medications. Electro-convulsive therapy is particularly effective for the most severe and resistant depressions, but raises concerns about possible deleterious effects on memory and cognition. It is rarely used until a number of different medications have been tried. Although it is still unclear whether traditional psychodynamic approaches are effective in treating depression, interpersonal psychotherapy (IPT) has fared well in controlled comparisons with medications and other types of psychotherapies. It also appears to have a delayed effect that improves the quality of social relationships and interpersonal skills. It has been shown to reduce acute distress and to prevent relapse and recurrence so long as it is continued or maintained. Treatment combining IPT with medication retains the quick results of pharmacotherapy and the greater interpersonal breadth of IPT, as well as boosting response in patients who are otherwise more difficult to treat. The main problem is that IPT has only recently entered clinical practice and is not widely available to those in need. Cognitive behavior therapy (CBT) also appears to be efficacious in treating depression, and recent studies suggest that it can work for even severe depressions in the hands of experienced therapists. Not only can CBT relieve acute distress, but it also appears to reduce risk for the return of symptoms as long as it is continued or maintained. Moreover, it appears to have an enduring effect that reduces risk for relapse or recurrence long after treatment is over. Combined treatment with medication and CBT appears to be as efficacious as treatment with medication alone and to retain the enduring effects of CBT. There also are indications that the same strategies used to reduce risk in psychiatric patients following successful treatment can be used to prevent the initial onset of depression in persons at risk. More purely behavioral interventions have been studied less than the cognitive therapies, but have performed well in recent trials and exhibit many of the benefits of cognitive therapy. Mood stabilizers like lithium or the anticonvulsants form the core treatment for bipolar disorder, but there is a growing recognition that the outcomes produced by modern pharmacology are not sufficient. Both IPT and CBT show promise as adjuncts to medication with such patients. The same is true for family-focused therapy, which is designed to reduce interpersonal conflict in the family. Clearly, more needs to be done with respect to treatment of the bipolar disorders. Good medical management of depression can be hard to find, and the empirically supported psychotherapies are still not widely practiced. As a consequence, many patients do not have access to adequate treatment. Moreover, not everyone responds to the existing interventions, and not enough is known about what to do for people who are not helped by treatment. Although great strides have been made over the past few decades, much remains to be done with respect to the treatment of depression and the bipolar disorders.

scholarly journals Clinical Characteristics of Pediatric Bipolar Disorder by Subtype in a Korean Inpatient Sample

2015 ◽  
Vol 26 (4) ◽  
pp. 251-257
Author(s):  
Subin Park ◽  
Soo-Churl Cho ◽  
Ohyang Kwon ◽  
Jeong-Hoon Bae ◽  
Jae-Won Kim ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Clinical Characteristics ◽  
Pediatric Bipolar Disorder

Mood Stabilizers: Implementing Combined Treatment Regimens in Bipolar Disorder

2018 ◽  
Author(s):  
Charles Bowden ◽  
Melissa Martinez
Keyword(s):  
Bipolar Disorder ◽  
Treatment Planning ◽  
Rating Scale ◽  
Bipolar Depression ◽  
Combined Treatment ◽  
Bipolar Disorders ◽  
Maintenance Phase ◽  
Mood Stabilizers ◽  
Outcome Analysis ◽  
Treatment Regimens

Patients with bipolar disorders spend a greater proportion of their illness in a depressed or mixed state rather than experiencing either mania or hypomania. Over the past 20 years, most major pharmaceutical companies have either reduced or abandoned the research and development of novel psychiatric drugs, exiting the development of new, safe, efficacious, and tolerable treatment regimens for bipolar disorder. Therefore, optimizing the current treatments available is critical. We review studies of the last 15 years that provide guidance relevant to managing the maintenance phase of bipolar disorders. Based on these data, we provide recommendations for effective treatment planning and implementation, principally for the maintenance phase care of persons with bipolar disorder. We also discuss strategies for implementing medication regimens, differentiating strategies for maintenance phase treatment from those of acute phase treatment. Assessing key symptoms that are sensitive to change is critical for longitudinal assessments and treatment planning for patients with bipolar disorders. In most studies, only a subset of rating scale items differentiate patients with good responses from those without. Identified symptoms include racing thoughts, less need for sleep, hyperactivity, increased activity, and increased energy. We developed a procedure for using Multistate Outcome Analysis of Treatment (MOAT) in bipolar disorders. MOAT integrates efficacy and tolerability data during studies to provide information about the quantity and quality of time spent in distinct mood states. The protocol developed will be useful for assessing treatment strategies in bipolar disorder. This review contains 4 figures, 7 tables and 32 references Key words: bipolar, depression, lithium, mania, mixed, mood stabilizer, survival analysis, symptom domains, valproate

Clinical Characteristics of Pediatric Patients with Ocular Toxocariasis in China

2016 ◽  
Vol 235 (2) ◽  
pp. 97-105 ◽  
Author(s):  
Yalu Liu ◽  
Qi Zhang ◽  
Jing Li ◽  
Xunda Ji ◽  
Yu Xu ◽  
...  
Keyword(s):  
Rural Areas ◽  
Clinical Characteristics ◽  
Pediatric Patients ◽  
Age Of Onset ◽  
Age Groups ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Enzyme Linked Immunosorbent Assay ◽  
Ocular Toxocariasis

Objective: The aim of the study was to analyze the clinical characteristics of pediatric patients with ocular toxocariasis. Methods: Ocular toxocariasis was diagnosed and treated in 46 children from Shanghai and surrounding provinces. The diagnosis of ocular toxocariasis was confirmed immunologically by performing an enzyme-linked immunosorbent assay on serum and/or intraocular fluid. All pediatric patients and their guardians completed a questionnaire concerning their cases and living habits. Results: The mean age of onset was 6 ± 3 years. Most children (85%) resided in rural areas, and 91% of the children had contact with adult dogs or puppies. At the first visit, visual acuity (VA) was <20/200 in 36 cases, and we detected peripheral granuloma in 36 patients. In our study, the most common signs were vitritis, vitreous strands, and tractional retinal detachment. The Optomap 200Tx device detected granuloma with an 85% sensitivity, which is much higher than that of other techniques. We treated 40 cases (87%) with topical corticosteroids, while 28 patients (61%) were treated with systemic corticosteroids. Only 18 children (39%) required surgical intervention. All patients were examined and treated by the same ophthalmologists. Conclusions: Preschool children in China are more often affected by toxocariasis compared with other age groups. The most common signs included unilateral granuloma and ocular inflammation. In our study, clinical manifestations were severe and complicated. At the first visit, VA was <20/200 in most patients. Ocular toxocariasis was diagnosed on the basis of clinical signs and symptoms; the diagnosis was confirmed by immunological testing. Techniques using the Optomap 200Tx device can facilitate the early detection and lead to better visual prognosis.

scholarly journals DNA Methylation as a Biomarker of Treatment Response Variability in Serious Mental Illnesses: A Systematic Review Focused on Bipolar Disorder, Schizophrenia, and Major Depressive Disorder

2018 ◽  
Vol 19 (10) ◽  
pp. 3026 ◽  
Author(s):  
Charanraj Goud Alladi ◽  
Bruno Etain ◽  
Frank Bellivier ◽  
Cynthia Marie-Claire
Keyword(s):  
Dna Methylation ◽  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Treatment Response ◽  
Bipolar Disorders ◽  
Mental Illnesses ◽  
Mood Stabilizers ◽  
Major Depressive ◽  
Meta Analyses

So far, genetic studies of treatment response in schizophrenia, bipolar disorder, and major depression have returned results with limited clinical utility. A gene × environment interplay has been proposed as a factor influencing not only pathophysiology but also the treatment response. Therefore, epigenetics has emerged as a major field of research to study the treatment of these three disorders. Among the epigenetic marks that can modify gene expression, DNA methylation is the best studied. We performed a systematic search (PubMed) following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA guidelines for preclinical and clinical studies focused on genome-wide and gene-specific DNA methylation in the context of schizophrenia, bipolar disorders, and major depressive disorder. Out of the 112 studies initially identified, we selected 31 studies among them, with an emphasis on responses to the gold standard treatments in each disorder. Modulations of DNA methylation levels at specific CpG sites have been documented for all classes of treatments (antipsychotics, mood stabilizers, and antidepressants). The heterogeneity of the models and methodologies used complicate the interpretation of results. Although few studies in each disorder have assessed the potential of DNA methylation as biomarkers of treatment response, data support this hypothesis for antipsychotics, mood stabilizers and antidepressants.

The Use of Topiramate in Mood Stabilization

2002 ◽  
Vol 36 (7-8) ◽  
pp. 1277-1281 ◽  
Author(s):  
Ian D Maidment
Keyword(s):  
Bipolar Disorder ◽  
Bipolar Disorders ◽  
Mood Stabilizer ◽  
Mood Stabilizers ◽  
Double Blind ◽  
Data Synthesis ◽  
Complex Disorder ◽  
Search Terms ◽  
Clinical Literature ◽  
Mood Stabilization

OBJECTIVE: To review data on the effectiveness of topiramate as a mood stabilizer. DATA SOURCES: Clinical literature accessed through MEDLINE (1985–September 2001) and the manufacturer. Key search terms included topiramate, mania, mood stabilizer, and bipolar disorder. DATA SYNTHESIS: The traditional standard therapy for bipolar disorder has been lithium. Other mood stabilizers are increasingly being used to manage this complex disorder. Studies that used topiramate in bipolar disorders were evaluated. CONCLUSIONS: The present data from open trials suggest that topiramate may possibly possess antimanic properties. Controlled, double-blind studies are required to confirm this efficacy.

scholarly journals The International Society for Bipolar Disorders Task Force report on pediatric bipolar disorder: Knowledge to date and directions for future research

2017 ◽  
Vol 19 (7) ◽  
pp. 524-543 ◽  
Author(s):  
Benjamin I Goldstein ◽  
Boris Birmaher ◽  
Gabrielle A Carlson ◽  
Melissa P DelBello ◽  
Robert L Findling ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
International Society ◽  
Task Force ◽  
Bipolar Disorders ◽  
Future Research ◽  
Pediatric Bipolar Disorder ◽  
Task Force Report

scholarly journals Management of schizophrenia and bipolar disorder in pediatric practice

2019 ◽  
Vol 27 (2 (99)) ◽  
pp. 38-47
Author(s):  
Igor Martsenkovsky ◽  
Inna Martsenkovska
Keyword(s):  
Bipolar Disorder ◽  
Children And Adolescents ◽  
Psychological Treatment ◽  
Controlled Trial ◽  
Bipolar Disorders ◽  
Mood Stabilizers ◽  
European Medicines Agency ◽  
Schizophrenia Spectrum Disorders ◽  
Pediatric Practice ◽  
Ministry Of Health

The article presents the features of diag nosis and treatment of schizophrenia and bipolar disorders (BD) with early manifestation in adolescence. Management of disorders includes the complex use of pharmacological, psychological treatment and special forms of social care. The treatment program should include the psychoeducation of the child and his parents and the mobilization of family support. The article also discusses the effi cacy of atypical antipsychotics (risperidone, aripiprazole, olanzapine) and mood stabilizers (valproate, lithium, lamotrigine, and carbamazepine) based on recommendations Food and Drug Administration (FDA) USA, European Medicines Agency (EMA) and the Expert Center of the Ministry of Health of Ukraine. The obtained results of own conducted controlled trials on the effi cacy and safety of olanzapine use are discussed by the authors. Since 2010, 22 cases of olanzapine (Zolafren®) use for adolescents with schizophrenia spectrum disorders aged 13—17 years have been registered in the department of mental disorders of children and adolescents at the Institute of Psychiatry of the Ministry of Health of Ukraine. The period of controlled administration for olanzapine at a dose of 5—20 mg per day ranged from 44 to 70 weeks. As a result of the study were highlighted clinical situations in which the characteristics of the olanzapine action profi le demonstrated its greater effi cacy compared to risperidone and conventional antipsychotics in adolescents. The aim of another controlled trial conducted by the Institute of Psychiatry of the Ministry of Health of Ukraine in 2015—2018 was to evaluate the efficacy of olanzapine at a dose of 5—20 mg per day in adolescents with fi rst time diagnosed acute manic/mixed episode of BD. Nine adolescents aged from 14 to18 years old were assigned. Olanzapine in dose 5 to 20 mg was an eff ective medication for treatment of acute/mixed affective episodes in adolescents with BD and was an acceptable alternative to conventional antipsycho tics and risperidone treatment. Various side eff ects were observed in patients receiving olanzapine therapy, the average number of side eff ects per patient was 2.86, while the most frequent side eff ect was weight gain. Keywords: schizophrenia, bipolar disorder, antipsychotic medication, pediatric practice, children and adolescents

Pharmacological Treatments for Bipolar Disorder

2007 ◽  
pp. 323-350 ◽  
Author(s):  
Paul E. Keck ◽  
Susan L. McElroy
Keyword(s):  
Bipolar Disorder ◽  
Bipolar Depression ◽  
Antidepressant Treatment ◽  
Bipolar Disorders ◽  
Mood Stabilizers ◽  
Pharmacological Management ◽  
Randomized Controlled ◽  
Bipolar Ii ◽  
Depressive Episodes ◽  
Subsyndromal Symptoms

The vast majority of clinical trials in patients with bipolar disorders have been conducted in groups with bipolar I illness, although a few trials have recently emerged specifically in patients with bipolar II disorder. The pharmacological management of bipolar disorder involves the treatment of acute manic, hypomanic, mixed, and depressive episodes, as well as the prevention of further episodes and subsyndromal symptoms. Lithium, divalproex, carbamazepine, risperidone, olanzapine, quetiapine, ziprasidone, and aripiprazole have demonstrated efficacy in the treatment of acute mania in randomized, controlled (Type 1) trials. Although the pharmacological treatment of acute bipolar depression remains understudied, data from randomized, controlled trials indicate that lithium, olanzapine, olanzapine-fluoxetine, quetiapine, lamotrigine, tricyclics, MAOIs, fluoxetine, and pramipexole have efficacy in this phase of the illness. The optimal duration of antidepressant treatment, in combination with mood stabilizers, is still unknown. Lithium, lamotrigine, olanzapine, and aripiprazole have been shown to have efficacy in relapse prevention. Less extensive data suggest that divalproex and carbamazepine are also efficacious as preventative treatments.

Sign in / Sign up

Export Citation Format

Share Document