Mood Stabilizers in the Treatment of Substance Use Disorders

CNS Spectrums ◽  
2010 ◽  
Vol 15 (2) ◽  
pp. 95-109 ◽  
Author(s):  
Icro Maremmani ◽  
Matteo Pacini ◽  
Francesco Lamanna ◽  
Pier Paolo Pani ◽  
Giulio Perugi ◽  
...  
Keyword(s):  
Substance Use ◽  
Dual Diagnosis ◽  
Substance Abusers ◽  
Bipolar Disorders ◽  
Preliminary Evidence ◽  
Mood Stabilizers ◽  
Bipolar Spectrum ◽  
Bipolar Spectrum Disorders ◽  
Spectrum Disorders

ABSTRACTIndividuals suffering from drug addiction may also manifest features of bipolar spectrum disorders. Hyperthymic and cyclothymic temperaments may render individuals vulnerable to later development of substance abuse. Bipolar disorders themselves may be altered or precipitated by substance use, most notably by stimulants (amphetamines), alcohol, and cannabinoids.The clinical usefulness of mood stabilizers, particularly antiepileptics, has been established as safe and effective in substance abusers with and without comorbid mood disorders. Most studies on this issue have been of short duration and focused on the resolution of a currently manifest period of illness. Few studies have been conducted on the usefulness of these drugs on the long-term longitudinal course of these diseases, such as frequently encountered recurrent relapses into states of agitation, impulsivity, and/or dissatisfaction. As opposed to the clinical experience with traditional antidepressants and neuroleptics, antiepileptics do not induce counter-polar states (depressed patients abruptly turning manic or hypomanic; nor patients currently hypomanic or manic turning abruptly depressed). Many clinicians consider antiepileptic mood stabilizers to be the preferred category of medications for the treatment of such patients. Valproate appears to be a potentially fruitful medication to study in these dual diagnosis patients due to preliminary evidence demonstrating its anticraving efficacy.

scholarly journals Predictors of First-Onset Substance Use Disorders During the Prospective Course of Bipolar Spectrum Disorders in Adolescents

2013 ◽  
Vol 52 (10) ◽  
pp. 1026-1037 ◽  
Author(s):  
Benjamin I. Goldstein ◽  
Michael Strober ◽  
David Axelson ◽  
Tina R. Goldstein ◽  
Mary Kay Gill ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Bipolar Spectrum ◽  
Bipolar Spectrum Disorders ◽  
First Onset ◽  
Spectrum Disorders

scholarly journals Validity of the Brazilian Portuguese version of the bipolar spectrum diagnostic scale

2010 ◽  
Vol 59 (4) ◽  
pp. 266-270 ◽  
Author(s):  
Milena S. Castelo ◽  
Eduardo R. Carvalho ◽  
Emília S. Gerhard ◽  
Danielle Silveira Macêdo ◽  
Eduardo D. Ferreira ◽  
...  
Keyword(s):  
Predictive Value ◽  
Bipolar Disorders ◽  
Psychiatric Clinic ◽  
Bipolar Spectrum ◽  
Bipolar Spectrum Disorders ◽  
Brazilian Version ◽  
Valid Instrument ◽  
Dsm Iv ◽  
Spectrum Disorders ◽  
Development And Validation

OBJECTIVE: Bipolar spectrum disorders (BSDs) are prevalent and frequently unrecognized and undertreated. This report describes the development and validation of the Brazilian version of the bipolar spectrum diagnostic scale (B-BSDS), a screening instrument for bipolar disorders, in an adult psychiatric population. METHOD: 114 consecutive patients attending an outpatient psychiatric clinic completed the B-BSDS. A research psychiatrist, blind to the B-BSDS scores, interviewed patients by means of a modified version of the mood module of the Structured Clinical Interview for DSM-IV ("gold standard"). Subthreshold bipolar disorders were defined as recurrent hypomania without a major depressive episode or with fewer symptoms than those required for threshold hypomania. RESULTS: The internal consistency of the B-BSDS evaluated with Cronbach's alpha coefficient was 0.89 (95% CI; 0.86-0.91). On the basis of the modified SCID, 70 patients (61.4%) of the sample received a diagnosis of BSDs. A B-BSDS screening score of 16 or more items yielded: sensitivity of 0.79 (95% CI; 0.72-0.85), specificity of 0.77 (95% CI; 0.70-0.83), a positive predictive value of 0.85 (95% CI; 0.78-0.91) and a negative predictive value of 0.70 (95% CI; 0.63-0.75). CONCLUSION: The present data demonstrate that the B-BSDS is a valid instrument for the screening of BSDs.

scholarly journals Substance use disorders among adolescents with bipolar spectrum disorders

2008 ◽  
Vol 10 (4) ◽  
pp. 469-478 ◽  
Author(s):  
Benjamin I Goldstein ◽  
Michael A Strober ◽  
Boris Birmaher ◽  
David A Axelson ◽  
Christianne Esposito-Smythers ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Bipolar Spectrum ◽  
Bipolar Spectrum Disorders ◽  
Spectrum Disorders

The assessment and management of suicide risk in bipolar disorder

2017 ◽  
Author(s):  
Zoltán Rihmer ◽  
Xénia Gonda ◽  
Péter Döme
Keyword(s):  
Bipolar Disorder ◽  
Suicide Risk ◽  
Bipolar Disorders ◽  
Evidence Based ◽  
Bipolar Spectrum ◽  
Bipolar Spectrum Disorders ◽  
Spectrum Disorders ◽  
Bipolar Patients ◽  
Routine Assessment ◽  
Commit Suicide

Bipolar spectrum disorders are among the most frequent psychiatric ailments associated with a considerable risk of suicidal behaviour. Approximately 4–19% of (mostly untreated) patients with bipolar disorders ultimately commit suicide, and about 20–60% of them make at least one suicide attempt in their lifetime. Compared with the general population, the risk of committing suicide is about 10–30 times higher in patients with bipolar disorder. However, the majority of bipolar patients never attempt or commit suicide. Therefore, the routine assessment of several risk factors for suicide in clinical practice may aid in the recognition of those patients who are at the highest risk. This chapter summarizes the clinically most relevant suicide risk and protective factors in bipolar disorders. In addition, we review evidence-based strategies for suicide prevention in bipolar disorder.

scholarly journals Validity of the Mood Disorder Questionnaire in a Brazilian psychiatric population

2010 ◽  
Vol 32 (4) ◽  
pp. 424-428 ◽  
Author(s):  
Milena S. Castelo ◽  
Eduardo R. Carvalho ◽  
Emília S. Gerhard ◽  
Carlos Maurício C. Costa ◽  
Eduardo D. Ferreira ◽  
...  
Keyword(s):  
Mood Disorder ◽  
Predictive Value ◽  
Bipolar Disorders ◽  
Psychiatric Clinic ◽  
Bipolar Spectrum ◽  
Bipolar Spectrum Disorders ◽  
Brazilian Version ◽  
Mood Disorder Questionnaire ◽  
Psychiatric Population ◽  
Spectrum Disorders

OBJECTIVE: Bipolar spectrum disorders are prevalent and frequently underdiagnosed and undertreated. This report describes the development and validation of the Brazilian version of the Mood Disorder Questionnaire, a screening instrument for bipolar spectrum disorders, in an adult psychiatric population. METHOD: A total of 114 consecutive patients attending an outpatient psychiatric clinic completed the Brazilian version of the Mood Disorder Questionnaire. A research psychiatrist, blind to the Mood Disorder Questionnaire results, interviewed patients by means of the mood module of the Structured Clinical Interview for DSM-IV ('gold standard'). RESULTS: The internal consistency of the Brazilian Mood Disorder Questionnaire, evaluated with Cronbach's alpha coefficient was 0.76 (95% CI; 0.69-0.92). Principal component analysis with varimax rotation indicated an 'irritability-racing thoughts' factor and 'energized-activity' factor, which explained 39.1% of variance. On the basis of the SCID, 69 (60.5%) individuals received a diagnosis of bipolar disorders. A Brazilian Mood Disorder Questionnaire screening score of 8 or more items yielded sensitivity of 0.91 (95% CI; 0.85-0.98), specificity of 0.70 (95% CI; 0.62-0.75), a positive predictive value of 0.82 (95% CI; 0.75-0.88) and a negative predictive value of 0.84 (95% CI; 0.77-0.90). CONCLUSION: The present data demonstrate that the Brazilian Mood Disorder Questionnaire is a valid instrument for the screening of bipolar disorders. The instrument needs to be validated in other settings (e.g., in general practice).

Bipolar Disorder During Childhood and Adolescence

2015 ◽  
pp. 286-298
Author(s):  
Mary Fristad ◽  
Elizabeth Nick
Keyword(s):  
Bipolar Disorder ◽  
Mood Stabilizers ◽  
Childhood And Adolescence ◽  
Bipolar Spectrum ◽  
Not Otherwise Specified ◽  
Bipolar Spectrum Disorders ◽  
Professional Interest ◽  
Evidence Based Treatments ◽  
History Of ◽  
Spectrum Disorders

This chapter reviews bipolar spectrum disorders (bipolar I, bipolar II, bipolar disorder not otherwise specified, and cyclothymic disorder) in childhood and adolescence. The history of the diagnosis in youth, including recent increased public and professional interest, and surrounding controversy is reviewed. Attention is given to prevalence, incidence, similarities and differences in presentation, course, and comorbidities among child, adolescent, and adult bipolar spectrum disorders. Assessment issues are reviewed, including longitudinal and multiinformant perspectives, instruments, strategies, tools, and assessment challenges with youth. Examples of symptom manifestation in youth are provided. Genetic, cognitive, neuroanatomical, psychosocial, and environmental risks for youth bipolar spectrum disorders are discussed. Evidence-based treatments reviewed include commonly prescribed mood stabilizers and atypical antipsychotics, alternative biological treatments, adjunctive psychotherapies, and complementary and alternative treatments. Finally, future directions for the study, assessment, monitoring, and treatment of youth bipolar spectrum disorders are discussed.

scholarly journals Systematic review of the prevalence of bipolar disorder and bipolar spectrum disorders in population-based studies

2013 ◽  
Vol 35 (2) ◽  
pp. 99-105 ◽  
Author(s):  
José Caetano Dell'Aglio Jr. ◽  
Lissia Ana Basso ◽  
Irani Iracema de Lima Argimon ◽  
Adriane Arteche
Keyword(s):  
Bipolar Disorder ◽  
Bipolar Disorders ◽  
Population Based ◽  
Lifetime Prevalence ◽  
Bipolar Spectrum ◽  
Community Based ◽  
Cross Sectional ◽  
Bipolar Spectrum Disorders ◽  
Final Sample ◽  
Spectrum Disorders

This paper describes the findings of a systematic literature review aimed at providing an overview of the lifetime prevalence of bipolar disorder and bipolar spectrum disorders in population-based studies. Databases MEDLINE, ProQuest, Psychnet, and Web of Science were browsed for papers published in English between 1999 and May 2012 using the following search string: bipolar disorders OR bipolar spectrum disorders AND prevalence OR cross-sectional OR epidemiology AND population-based OR non-clinical OR community based. The search yielded a total of 434 papers, but only those published in peer-reviewed journals and with samples aged ≥ 18 years were included, resulting in a final sample of 18 papers. Results revealed rather heterogeneous findings concerning the prevalence of bipolar disorders and bipolar spectrum disorders. Lifetime prevalence of bipolar disorder ranged from 0.1 to 7.5%, whereas lifetime prevalence of bipolar spectrum disorders ranged from 2.4 to 15.1%. Differences in the rates of bipolar disorder and bipolar spectrum disorders may be related to the consideration of subthreshold criteria upon diagnosis. Differences in the prevalence of different subtypes of the disorder are discussed in light of diagnostic criteria and instruments applied.

scholarly journals The Dual-System Theory of Bipolar Spectrum Disorders: A Meta-Analysis

2020 ◽  
Author(s):  
Benjamin A Katz ◽  
Hadar Naftalovich ◽  
Kathryn Matanky ◽  
Cognition and Psychopathology Lab - Iftah Yovel
Keyword(s):  
System Theory ◽  
Positive Relationship ◽  
Meta Analysis ◽  
Bipolar Disorders ◽  
Dual System ◽  
Self Report ◽  
Bipolar Spectrum ◽  
Bipolar Spectrum Disorders ◽  
Reinforcement Sensitivity ◽  
Spectrum Disorders

Bipolar spectrum disorders are characterized by alternating intervals of extreme positive and negative affect. We performed a meta-analysis to test the hypothesis that such disorders would be related to dysregulated reinforcement sensitivity. First, we reviewed 23 studies that reported the correlation between self-report measures of (hypo)manic personality and measures of reinforcement sensitivity. A large relationship was found between (hypo)manic personality and BAS sensitivity (g = .74), but not with BIS sensitivity (g = -.08). This stands in contrast to self-reported depression which has a small, negative relationship with BAS sensitivity and a large positive one with BIS sensitivity (Katz et al., 2020). Next, we reviewed 33 studies that compared reinforcement sensitivity between euthymic, bipolar participants and healthy controls. There, bipolar disorder had a small, positive relationship with BAS sensitivity (g = .20) and a medium, positive relationship with BIS sensitivity (g = .64). These findings support a dual-system theory of bipolar disorders, wherein BAS sensitivity is more closely related to mania and BIS sensitivity more closely to bipolar depression. Bipolar disorders show diatheses for both states with euthymic participants being BAS- and BIS- hypersensitive. Implications for further theory and research practice are expounded upon in the discussion.

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