scholarly journals Considerations on assisted resilience and individualized therapy in bipolar affective disorder, with a clinical case exemplification

2015 ◽  
Vol 88 (4) ◽  
pp. 462-467 ◽  
Author(s):  
Alexandra Bolos

Morbidity, mortality and economic consequences of bipolar affective disorder are very important to be evaluated because many of the costs entailed by this psychiatric disorder come from indirect costs due to inadequate diagnosis and treatment and from the characteristics of the affective symptoms itself. Psychotherapy focuses on diagnosis and the newest pharmacotherapy determines a decreasing of the morbidity of the disorder and also of its social and economic burden . However, more studies are necessary, with more heterogeneous patients, to find more predictors regarding the psychosocial consequences and to find more information about the prognosis of the bipolar disorder.In this context, in this paper we discuss the role of assisted resilience and the individualization of the therapy of bipolar affective disorder, especially that the resilience must be seen as a continuum and can be used anytime and in any situation, according to the theory of Geanellos. This idea is reflected in a case presentation of a patient with the diagnosis of bipolar disorder.

2020 ◽  
Vol 13 (2) ◽  
pp. 144-146
Author(s):  
Rossitza K. Iakimova ◽  
Maya Y. Stoimenova-Popova ◽  
Petranka G. Chumpalova ◽  
Milena S. Pandova ◽  
Maria B. Stoyanova

Summary Frequent mood changes are found in premenstrual dysphoric disorder (PMDD) as well as in bipolar affective disorder (BAD). The differential diagnosis is difficult because both conditions share some other common symptoms. We present a case study of a woman with premenstrual dysphoric disorder misdiagnosed as bipolar disorder. As a result, the patient was prescribed lithium and remained symptomatic for a prolonged period. She recovered only after initiation of treatment with a selective serotonin reuptake inhibitor, which is the treatment of choice in the management of PMDD. In such cases, the importance of affective symptoms evaluation is underscored in the context of the menstrual cycle, as well as in recognizing them for the correct diagnosis and treatment.


2021 ◽  
Vol 34 (6) ◽  
pp. e100663
Author(s):  
Surbhi Batra ◽  
Sumit Kumar ◽  
Lokesh Singh Shekhawat

Neurocysticercosis is the most common neuro-parasitosis caused by the larval stage of Taenia solium. The most common manifestations include seizures and hydrocephalus. Psychiatric abnormalities are relatively rare but depressive symptoms are frequent in patients with neurocysticercosis. However, mania as a presentation is relatively rare. Pregnancy and the postpartum period are relatively vulnerable times and they can lead to reactivation of existing neurocysterci lesions. We are discussing the case of a 23-year-old female patient with neurocysticercosis leading to the reactivation of lesions in the peripartum and postpartum period leading to bipolar affective disorder. Improvement in the patient was seen with a combination of antipsychotics, antihelmintics, antiepileptics and steroids, along with improved radiological signs of neurocysterci lesions. Although neurocysticercosis is a common illness, its prevalence presenting as a manic episode is merely 2.6% and, hence, missed easily. Therefore, it is important to rule out organic aetiology in patients even with a classic presentation of bipolar affective disorder and those having any other neurological symptoms and signs.


1994 ◽  
Vol 165 (6) ◽  
pp. 827-829 ◽  
Author(s):  
R. Littlejohn ◽  
F. Leslie ◽  
J. Cookson

BackgroundThe efficacy of depot antipsychotic drugs in the prophylaxis of bipolar affective disorder was investigated.MethodLife charts were constructed for 18 outpatients with bipolar disorder receiving prophylactic treatment with depot medication. The durations of affective episodes were compared during periods on or off medication.ResultsThe subjects suffered fewer relapses and spent significantly less time in hospital (P = 0.001) for treatment of manic, depressive and mixed affective illness during treatment with depot antipsychotics.ConclusionsDepot antipsychotic medication may be a useful prophylactic treatment for certain patients with bipolar affective disorder.British Journal of Psychiatry (1994), 165, 827–829


2016 ◽  
Vol 33 (S1) ◽  
pp. S504-S504
Author(s):  
A. Ballesteros ◽  
A. Petcu ◽  
B. Cortés ◽  
L. Montes ◽  
F. Inchausti ◽  
...  

IntroductionRecent studies suggest that Borderline Personality Disorder (BPD) could be regarded as an affective disorder within the Bipolar Affective Disorder (BP) spectrum. This is supported by evidence suggesting a clinical/neurobiological overlap between these two disorders. The Temperament and Character Inventory Revised (TCI-R) may help differentiate between the two disorders and orientate the clinical approach, considering the evidence of the medium-term temporal stability of TCI-R in a clinical population.ObjectiveWe present a clinical case diagnosed with BD which underwent testing using TCI-R. TCI-R orientated towards a secondary diagnosis of BPD and the case further received a course of Dialectical Behavior Therapy (DBT) which led to clinical improvement. We therefore study the usefulness of TCI-R in this clinical setting.AimsTo study whether TCI-R may help differentiate between BD and BPD in mood stabilized patients.MethodOur patient is a 52-year-old married male diagnosed with BD. Considering his clinical features of impulsivity/instability of behaviors and pathological interpersonal relationships, patient was started on individual DBT (fortnightly, 4 months). Psychotropic treatment (paroxetine 30 mg/day, lithium 1000 mg/day, aripiprazole 15 mg/day) was not modified.ResultsTCI-R scores: harm avoidance (100%), novelty seeking (53%), reward dependence (20%), persistence (18%), self-directedness (1%), cooperativeness (2%) and self-transcendence (48%). After 4 months of therapy, the patient improved in distress tolerance, acceptance, behavioral activation and assertiveness.ConclusionsTCI-R is an inventory for personality traits in which character scores differ markedly between PD and non-PD patients. It is a useful tool in BPD patients orientating the clinician in the differential diagnosis and the treatment approach.Disclosure of interestThe authors have not supplied their declaration of competing interest.


Author(s):  
Tom Burns ◽  
Mike Firn

This chapter deals with the other major psychotic illness, bipolar affective disorder. Bipolar disorder poses a difficult question for outreach workers, as patients are often well recovered between episodes—so should persisting outreach be provided? We report very good results in severe bipolar disorder where continuity of care has paid off. The chapter also deals with theories of causation and classification. The section on treatment identifies the importance of early admission in hypomania, the use of mood stabilizers, and the value of identifying and agreeing on relapse signatures. It also confirms the value of working hard to strengthen the therapeutic relationship and of psychosocial interventions such as psycho-education. Long-term work with these patients brings home just how persistent and disabling the depressive phases can be.


QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A M Omar ◽  
A N Elbatrawy ◽  
W M Sabry ◽  
H A Elkholy ◽  
W A Farrag

Abstract Background Bipolar disorder is one of the world’s 10 most disabling conditions, taking away years of healthy functioning from individuals, all bipolar disorders are chronically recurring illnesses associated with substantial morbidity and mortality. Impulsivity considered an integral part of bipolar disorder. Operationalized as a predisposition to action without reflection or regard for consequences. Potential consequences of this increased impulsivity include substance abuse, suicidal attempts, and other serious behavioral problems. Aim of the Study The aim of the current study was to measure impulsivity in both BD euthymic patients and in healthy first-degree relatives of BD patients. And to assess the functional implications of impulsiveness, on psychosocial functioning and in bipolar disorder patients, their first-degree relatives. Patients and Methods A convenient sample of 50 patients; diagnosed with bipolar affective disorder according to DSM-IV diagnostic criteria were selected from the general adult psychiatry clinics and a convenient sample of 50 healthy first degree relatives of BD patients. Results We concluded by the end of this study that both cases and relatives have high overall impulsivity, and cases have higher impulsivity in comparison to relatives. Conclusion We suggest that impulsivity may be a potentially valuable candidate endophenotype for bipolar disorder.


2010 ◽  
Vol 12 (5) ◽  
pp. 568-578 ◽  
Author(s):  
Justin L C Bilszta ◽  
Denny Meyer ◽  
Anne E Buist

2019 ◽  
Vol 215 (01) ◽  
pp. 383-385 ◽  
Author(s):  
Isabel Valli ◽  
Chiara Fabbri ◽  
Allan H. Young

SummarySchizophrenia and bipolar disorder are genetically related and their clinical features overlap. Schizophrenia is conceptualised as a neurodevelopmental disorder but the evidence for bipolar disorder is less clear. Cluster-analytic approaches reveal different cognitive profiles within bipolar disorder, possibly reflective of differing neurodevelopmental loads, which are also suggested by recent genetic and neuroimaging studies. Such studies suggest the potential utility of further clinical subcategories in bipolar disorder based on neurodevelopmental load.Declaration of interestNone.


1993 ◽  
Vol 38 (9) ◽  
pp. 587-589 ◽  
Author(s):  
Stephen P. Tyrer ◽  
Andrew D. Brittlebank

Patients with longstanding recurrent behavioural disturbance, unstable interpersonal relationships and periodic affective symptoms are often diagnosed as having a cluster B personality disturbance using DSM-III-R criteria. Two women are described who were diagnosed as having a personality disorder on several admissions to hospital, but in whom closer inquiry revealed evidence of bipolar affective disorder. Since treatment with lithium and adjunctive mood-stabilizing drugs neither patient has required further admissions to hospital within the past five years.


2005 ◽  
Vol 186 (2) ◽  
pp. 126-131 ◽  
Author(s):  
Tuhina Lloyd ◽  
Noel Kennedy ◽  
Paul Fearon ◽  
James Kirkbride ◽  
Rosemarie Mallett ◽  
...  

BackgroundThere has been a relative dearth of epidemiological research into bipolar affective disorder. Furthermore, incidence studies of bipolar disorder have been predominantly retrospective and most only included hospital admission cases.AimsTo determine the incidence of operationally defined bipolar disorder in three areas of the UK and to investigate any differences in gender and ethnicity.MethodAll patients who contacted mental health services with first-episode psychosis or non-psychotic mania between September 1997 and August 1999 were identified and diagnosed according to ICD–10 criteria. Incidence rates of bipolar affective disorder were standardised for age and stratified by gender and ethnic group across the three areas.ResultsThe incidence rate per 100 000 per year in south-east London was over twice that in Nottingham and Bristol. There was no significant difference in the rates of disorder in men and women. Incidence rates of bipolar disorder in the combined Black and minority ethnic groups in all three areas were significantly higher than those of the comparison White groups.ConclusionsThe incidence of bipolar disorder was higher in south-east London than in the other two areas, and was higher among Black and minority ethnic groups than in the White population.


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