The role of psychoeducation in the management of bipolar disorder

2017 ◽  
Author(s):  
Francesc Colom
Keyword(s):  
Bipolar Disorder ◽  
Bipolar Disorders ◽  
Warning Signs ◽  
Psychological Interventions ◽  
Smartphone Applications ◽  
Future Directions ◽  
Preventive Efficacy

Psychological interventions play a major role in the prophylaxis of recurrences in bipolar disorders, always as an add-on to pharmacological care as none of them works in monotherapy. So far, the evidence for psychotherapy in the management of acute episodes is very limited so its use should be constrained to prevention. A common aspect of the majority of psychological interventions tested in bipolar disorder is that they are much more efficacious for patients with a low number of episodes prior to the treatment. Interestingly, all the psychological interventions showing preventive efficacy share psychoeducative ingredients including illness awareness, adherence enhancement, habits regularity, and warning signs identification. Future directions of psychoeducation should enhance its implementation worldwide, probably by using newer technologies such as smartphone applications. However, these need a proper testing before being included in clinical routines.

Psychological Treatments and Prevention in Bipolar Disorder - Recent Developments

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
C. Kuehner
Keyword(s):  
Bipolar Disorder ◽  
Bipolar Disorders ◽  
Behavioural Therapy ◽  
Psychological Interventions ◽  
Cognitive Behavioural ◽  
Recent Developments ◽  
Social Rhythm ◽  
Future Work ◽  
High Risk Children

This contribution provides a systematic review on recent developments in psychological interventions for bipolar disorder. The main focus of research to date has investigated the role of different psychotherapeutic approaches (cognitive behavioural therapy, family focused therapy, interpersonal and social rhythm therapy, psychoeducation) as an adjunct to pharmacotherapy for remission and relapse prevention. The review will assess efficacy and effectiveness of these interventions, their common ingredients, limitations and predictors of outcome. It will further explore the potential role of psychological interventions for primary prevention of bipolar disorders in high risk children and adolescents. Suggestions will be made for future work in these areas.

The treatment of bipolar disorder in its early stages: current techniques, challenges, and future outlook

2017 ◽  
Author(s):  
Ajeet B. Singh ◽  
Harris A. Eyre ◽  
Edward Callaly ◽  
Michael Berk
Keyword(s):  
Bipolar Disorder ◽  
Early Intervention ◽  
Early Stage ◽  
Bipolar Disorders ◽  
Future Directions ◽  
Future Outlook ◽  
Tailored Treatment ◽  
Psychosocial Impacts ◽  
Diet And Lifestyle ◽  
Lines Of Evidence

The early intervention in psychiatry paradigm has offered the promise of improved tailored treatment. While pioneered in early psychosis, lines of evidence also suggest utility in early bipolar. A challenge is that the emergence of elevated states may post-date depression—preventing early diagnosis. Nonetheless, data suggests neuroprogression and an escalating diathesis to relapse occurs with successive episodes which may be impeded by early intervention. Mitigating psychosocial impacts, improving engagement, reducing the consequences of the progressive nature of the disorder, and enhancing adherence are key potential dividends of early intervention. This chapter provides an overview of the current literature, expert clinical opinions, and hints at future directions pertinent to early intervention. As genomics, informatics, and better appreciation of the importance of diet and lifestyle gain salience, there’s hope for a future rich with technologically enhanced tools to both sooner detect and intervene in early stage bipolar disorders to mitigate consequences.

scholarly journals Evaluation of the Role of ABCB1gene Polymorphic Variants on Psychiatric Disorders Predisposition in Macedonian Population

PRILOZI ◽  
2017 ◽  
Vol 38 (3) ◽  
pp. 71-88
Author(s):  
Zorica Naumovska ◽  
Aleksandra K. Nestorovska ◽  
Zoran Sterjev ◽  
Ana Filipce ◽  
Aleksandra Grozdanova ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Psychiatric Disorders ◽  
Psychiatric Illness ◽  
Cell Activation ◽  
Bipolar Disorders ◽  
Control Group ◽  
Microglia Cell ◽  
Increased Risk ◽  
And Function

Abstract The psychiatric and other CNS disorders are characterized with unregulated neuro-inflammatory processes and chronic microglia cell activation resulting with detrimental effect. ABCB1gene polymorphismsC1236T, G2677T/Aand C3435T are associated with P-glycoprotein expression and function andare linked with predisposition to psychiatric disorders such as schizophrenia and bipolar disorders. The relationship between mood disorders and glucocorticoids has been confirmed and ABCB1 SNPs influence the glucocorticoids access to the brain. The aim of the study is evaluation of the influence of the three most common ABCB1SNPs on predisposition to psychiatric disorders in Macedonian population. In the study 107 unrelated healthy Macedonians of both sexes were enrolled as a control group and patient population of 54 patients (22 to 65 years old) diagnosed with schizophrenia or bipolar disorder. ABCB1 for three polymorphisms were analyzed by Real-Time PCR in both groups. The results have confirmed the role of the ABCB1 gene in predisposition to psychiatric disorders and increased risk of developing bipolar disorder in carriers of the heterozygotes and mutant homozygotes for polymorphic variations in 1236 and 2677 in comparison to the normal genotype carriers. Three-fold higher risk was estimated for psychiatric illness in women that are 1236 and 2677 heterozygous carrier (heterozygous and mutant homozygous) compared to healthy control (men and women) population and four-fold higher risk in comparison only to healthy women population. Mutant allele carriers for 1236 and 2677 polymorphisms that are 35 years and below in patients population have almost three-fold higher risk for development of psychiatric illness.

The role of electroconvulsive therapy in the treatment of bipolar disorder

2017 ◽  
Author(s):  
Roumen Milev
Keyword(s):  
Bipolar Disorder ◽  
Electroconvulsive Therapy ◽  
Case Reports ◽  
Bipolar Disorders ◽  
Seizure Threshold ◽  
Randomized Control Trials ◽  
Mixed States ◽  
Everyday Clinical Practice ◽  
Randomized Control

This chapter examines the use of electroconvulsive therapy (ECT) for treatment of patients with bipolar disorders. It briefly reviews the basics of ECT, stimulus parameters, placement of electrodes, and seizure threshold. The data for efficacy and tolerability of ECT for bipolar disorder, including mania, depression, mixed states, and across the lifespan is reviewed. Although there is a paucity of good-quality randomized studies, all available data, including case reports and naturalistic observations, support the use of ECT in this population, and reinforce the widespread use of ECT in everyday clinical practice. Good-quality randomized control trials are urgently needed to address numerous unanswered questions, in order to improve efficacy and reduce side-effect burden of one of the best treatments for bipolar disorder.

Alternative treatment strategies for lithium in bipolar disorder

1993 ◽  
Vol 5 (3) ◽  
pp. 55-59
Author(s):  
P.F. Bouvy
Keyword(s):  
Bipolar Disorder ◽  
Valproic Acid ◽  
Adverse Effects ◽  
Alternative Treatment ◽  
Calcium Antagonists ◽  
Treatment Strategies ◽  
Bipolar Disorders ◽  
Preventive Treatment ◽  
Acute Mania

SummaryIndications for lithium in the treatment of bipolar disorders are acute mania, depression and preventive treatment. In the case of insufficient efficacy or adverse effects the first alternative for lithium in acute mania is carbamazepine. However, the role of carbamazepine in preventive treatment is still uncertain. Well designed prospective research is hardly done. Clearly positive reports on the efficacy of carbamazepine concern specific lithium-resistant groups such as the ‘rapid-cyclers’. Valproic acid has been found effective in a few studies in bipolar disorders, especially in acute mania. Clonazepam is sometimes mentioned as a possible alternative, however recent research seriously questions the efficacy of clonazepam in bipolar disorders. Calcium-antagonists, especially verapamil, may have some efficacy in the treatment of acute mania, their role is still very uncertain.

Environmental Risk and Protective Factors in Bipolar Disorder

2015 ◽  
pp. 131-141
Author(s):  
Sheri L. Johnson ◽  
Anda Gershon ◽  
Kaja Johnson
Keyword(s):  
Bipolar Disorder ◽  
Social Environment ◽  
Race And Ethnicity ◽  
Treatment Patterns ◽  
Methodological Issues ◽  
Future Directions ◽  
Integrative Research ◽  
The Social ◽  
Support Family

In this chapter, we consider the role of the social environment as a predictor of symptoms within bipolar disorder. We begin with a discussion of some conceptual and methodological issues that must be considered in such lines of work. We then highlight some of the strongest research available concerning the role of social support, family predictors, marital variables, traumatic events, life events, culture, race, and ethnicity as predictors of outcomes within bipolar disorder. Taken together, the literature provides rich and compelling evidence that the social environment is of extreme importance for understanding symptoms and treatment patterns within bipolar disorder. We end with a discussion of important future directions for research, including the need for more integrative research on a fuller range of social and biological predictors.

Impact of cognitive-psychoeducational interventions in bipolar patients and their relatives

2006 ◽  
Vol 21 (2) ◽  
pp. 81-86 ◽  
Author(s):  
Britta Bernhard ◽  
Annette Schaub ◽  
Petra Kümmler ◽  
Sandra Dittmann ◽  
Emanuel Severus ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Group Intervention ◽  
Bipolar Disorders ◽  
Warning Signs ◽  
Psychoeducational Group ◽  
Before And After ◽  
Expressed Emotions ◽  
Bipolar Patients ◽  
Psychoeducational Interventions

AbstractBackground.In recent years, several controlled studies could show that psychoeducational interventions have been effective for relapse prevention in bipolar disorders. We therefore established a cognitive-psychoeducational group intervention with 14 sessions providing information about the illness, early warning signs, cognitive and behavioural strategies for stress management and social rhythm. Additionally we offered a group intervention for the patients' relatives. The objective of this study was to describe the outcome associated with our psychoeducational intervention in bipolar patients and their relatives.Methods.Sixty-two bipolar patients attended 14 sessions (à 90 min) of cognitive-psychoeducational group therapy. Patients' knowledge of bipolar disorder and their satisfaction with the treatment were assessed using self-developed questionnaires before and after the group intervention. Additionally, 49 relatives of bipolar patients received two psychoeducational workshops of 4 hours each. We assessed demographic variables, burden, high expressed emotion and depressive symptoms of the relatives before and after the two workshops and at 1-year follow-up.Results.Patients significantly improved their knowledge of bipolar disorder. They also have benefited from the discussions and the exchange of useful coping strategies. Burden and high expressed emotions showed no significant reductions at post-assessment, however they were significantly reduced at 1-year follow-up. Relatives also felt significantly better informed about the illness.Conclusions.These findings show that psychoeducational interventions in bipolar patients and their relatives improve patients' and their relatives' knowledge of the illness and the burden of the disorder as well as high expressed emotions are reduced in relatives at 1-year follow-up.

The Role of Cognitive Behaviour Therapy in Bipolar Disorder

1996 ◽  
Vol 24 (3) ◽  
pp. 195-208 ◽  
Author(s):  
Jan Scott
Keyword(s):  
Bipolar Disorder ◽  
Cognitive Behaviour Therapy ◽  
Outcome Data ◽  
Psychological Interventions ◽  
Psychosocial Issues ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
And Control ◽  
Risk Of Relapse

There is increasing support for the use of systematic psychological interventions in combination with pharmacotherapy in the treatment of bipolar disorder (BD). A “manualised” approach, such as cognitive behaviour therapy (CBT), can be used to facilitate adjustment to the disorder, increase the acceptability of prescribed medications and reduce morbidity. This paper outlines psychosocial issues of relevance to individuals with BD and a model to engage individuals in therapy is described. A brief overview is given of some of the interventions that may help sufferers identify and control the acute symptoms of BD, reduce the risk of relapse and improve how they cope with the disorder and its treatment. The available outcome data on the use of CBT and the need for research are also noted.

On Future Directions in Pathology

1982 ◽  
Vol 40 ◽  
pp. 274-277
Author(s):  
Benjamin F. Trump ◽  
Irene K. Berezesky ◽  
Raymond T. Jones
Keyword(s):  
Electron Microscopy ◽  
Transmission Electron Microscopy ◽  
Clinical Pathology ◽  
Future Directions ◽  
Diagnostic Pathology ◽  
The Past ◽  
Transmission Electron ◽  
Organ Systems ◽  
The Many

The role of electron microscopy and associated techniques is assured in diagnostic pathology. At the present time, most of the progress has been made on tissues examined by transmission electron microscopy (TEM) and correlated with light microscopy (LM) and by cytochemistry using both plastic and paraffin-embedded materials. As mentioned elsewhere in this symposium, this has revolutionized many fields of pathology including diagnostic, anatomic and clinical pathology. It began with the kidney; however, it has now been extended to most other organ systems and to tumor diagnosis in general. The results of the past few years tend to indicate the future directions and needs of this expanding field. Now, in addition to routine EM, pathologists have access to the many newly developed methods and instruments mentioned below which should aid considerably not only in diagnostic pathology but in investigative pathology as well.

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