Bipolar Disorders and Their Clinical Management, Part II: Diagnosis, Differential Diagnosis, and Treatment

2019 ◽  
Author(s):  
Bernadette DeMuri-Maletic ◽  
Vladimir Maletic
Keyword(s):  
Quality Of Life ◽  
Bipolar Disorder ◽  
Differential Diagnosis ◽  
Bipolar Disorders ◽  
Psychosocial Interventions ◽  
Diagnosis And Treatment ◽  
Treatment Quality ◽  
Treatment Modalities ◽  
The Impact

Bipolar disorder is a biologically and phenotypically diverse disorder and its diagnosis and treatment provides a significant challenge to even the most seasoned clinician. We provide an update on the diagnosis and differential diagnosis of bipolar disorder, reflecting recent changes in DSM-5. Our review provides a succinct summary of the treatment literature, encompassing pharmacologic and psychosocial interventions for bipolar depression, mania/hypomania, mixed states, and prevention of disease recurrence. We provide a brief critical review of emerging treatment modalities, including those used in treatment resistance. Challenges involved in maintaining adherence are further discussed. Additionally, we review common treatment adverse effects and provide recommendations for proper side effect monitoring. There is evidence of significant functional impairment in patients with bipolar disorder and we conclude with a discussion of the impact of impairment on prognosis and quality of life. This review contains 7 tables and 45 references. Key Words: bipolar disorders, differential diagnosis, maintenance pharmacotherapy, prognosis, psychosocial interventions, treatment, quality of life

Bipolar Disorders and Their Clinical Management, Part II: Diagnosis, Differential Diagnosis, and Treatment

2019 ◽  
Author(s):  
Bernadette DeMuri-Maletic ◽  
Vladimir Maletic
Keyword(s):  
Quality Of Life ◽  
Bipolar Disorder ◽  
Differential Diagnosis ◽  
Bipolar Disorders ◽  
Psychosocial Interventions ◽  
Diagnosis And Treatment ◽  
Treatment Quality ◽  
Treatment Modalities ◽  
The Impact

Bipolar disorder is a biologically and phenotypically diverse disorder and its diagnosis and treatment provides a significant challenge to even the most seasoned clinician. We provide an update on the diagnosis and differential diagnosis of bipolar disorder, reflecting recent changes in DSM-5. Our review provides a succinct summary of the treatment literature, encompassing pharmacologic and psychosocial interventions for bipolar depression, mania/hypomania, mixed states, and prevention of disease recurrence. We provide a brief critical review of emerging treatment modalities, including those used in treatment resistance. Challenges involved in maintaining adherence are further discussed. Additionally, we review common treatment adverse effects and provide recommendations for proper side effect monitoring. There is evidence of significant functional impairment in patients with bipolar disorder and we conclude with a discussion of the impact of impairment on prognosis and quality of life. This review contains 4 figures, 8 tables, and 45 references. Key Words: bipolar disorders, differential diagnosis, maintenance pharmacotherapy, prognosis, psychosocial interventions, treatment, quality of life

Bipolar Disorders and Their Clinical Management, Part II: Diagnosis, Differential Diagnosis, and Treatment

2019 ◽  
Author(s):  
Bernadette DeMuri-Maletic ◽  
Vladimir Maletic
Keyword(s):  
Quality Of Life ◽  
Bipolar Disorder ◽  
Differential Diagnosis ◽  
Bipolar Disorders ◽  
Psychosocial Interventions ◽  
Diagnosis And Treatment ◽  
Treatment Quality ◽  
Treatment Modalities ◽  
The Impact

Bipolar disorder is a biologically and phenotypically diverse disorder and its diagnosis and treatment provides a significant challenge to even the most seasoned clinician. We provide an update on the diagnosis and differential diagnosis of bipolar disorder, reflecting recent changes in DSM-5. Our review provides a succinct summary of the treatment literature, encompassing pharmacologic and psychosocial interventions for bipolar depression, mania/hypomania, mixed states, and prevention of disease recurrence. We provide a brief critical review of emerging treatment modalities, including those used in treatment resistance. Challenges involved in maintaining adherence are further discussed. Additionally, we review common treatment adverse effects and provide recommendations for proper side effect monitoring. There is evidence of significant functional impairment in patients with bipolar disorder and we conclude with a discussion of the impact of impairment on prognosis and quality of life. This review contains 4 figures, 7 tables, and 45 references. Key Words: bipolar disorders, differential diagnosis, maintenance pharmacotherapy, prognosis, psychosocial interventions, treatment, quality of life

Bipolar Disorders and Their Clinical Management, Part II: Diagnosis, Differential Diagnosis, and Treatment

2019 ◽  
Author(s):  
Bernadette DeMuri-Maletic ◽  
Vladimir Maletic
Keyword(s):  
Quality Of Life ◽  
Bipolar Disorder ◽  
Differential Diagnosis ◽  
Bipolar Disorders ◽  
Psychosocial Interventions ◽  
Diagnosis And Treatment ◽  
Treatment Quality ◽  
Treatment Modalities ◽  
The Impact

Bipolar disorder is a biologically and phenotypically diverse disorder and its diagnosis and treatment provides a significant challenge to even the most seasoned clinician. We provide an update on the diagnosis and differential diagnosis of bipolar disorder, reflecting recent changes in DSM-5. Our review provides a succinct summary of the treatment literature, encompassing pharmacologic and psychosocial interventions for bipolar depression, mania/hypomania, mixed states, and prevention of disease recurrence. We provide a brief critical review of emerging treatment modalities, including those used in treatment resistance. Challenges involved in maintaining adherence are further discussed. Additionally, we review common treatment adverse effects and provide recommendations for proper side effect monitoring. There is evidence of significant functional impairment in patients with bipolar disorder and we conclude with a discussion of the impact of impairment on prognosis and quality of life. This review contains 4 figures, 7 tables, and 45 references. Key Words: bipolar disorders, differential diagnosis, maintenance pharmacotherapy, prognosis, psychosocial interventions, treatment, quality of life

Psychoeducation in Bipolar Disorder: A Clinical Perspective

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
L.C. Castro ◽  
T. Rodrigues ◽  
J. Pereira ◽  
I. Coelho ◽  
H. Maia ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Bipolar Disorders ◽  
Psychosocial Interventions ◽  
Clinical Perspective ◽  
Prodromal Symptoms ◽  
Disorder Treatment ◽  
Bipolar Patients ◽  
The Impact ◽  
Relapse Rates

Background:Bipolar disorder is a chronic, recurrent and debilitating mood disorder with a major impact on several aspects of everyday life. Although pharmacotherapy plays a central role in bipolar disorder treatment, psychosocial interventions are essential to a more complete and successful treatment.Aims:To present a psychoeducation program for bipolar patients runned in a Portuguese psychiatric hospital - Hospital de Magalhães Lemos, Oporto. To review the impact of psychoeducative measures on bipolar patients.Methods:A psychoeducative program for bipolar patients was developed and adapted, based on the Barcelona Bipolar Disorders Program"s experience. The psychoeducative program was applied to bipolar patients as an adjuvant of maintenance treatment.Results:Fifteen sessions were runned during 15 weeks. Twelve patients were recruited to integrate the psychoeducative group. The sessions addressed several topics including information about the illness, early detection of prodromal symptoms and symptoms management, stress management and the importance of maintaining routines.Conclusions:The best treatment available for patients with bipolar disorder includes, along with the pharmacological treatment, psychosocial interventions aimed to target issues as early identification of prodromal symptoms, coping skills, medication adherence and understanding of the disorder. This broader approach of bipolar disorder treatment has proved to be efficient in reducing relapse rates, and improving patients’ feelings of self-efficacy and quality of life.

Quality of life in bipolar disorders compared to schizophrenia

2011 ◽  
Vol 26 (S2) ◽  
pp. 231-231
Author(s):  
L. Zouari ◽  
I. Abida ◽  
M. Walha ◽  
J. Masmoudi ◽  
J. Ben Thabet ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bipolar Disorder ◽  
Short Form ◽  
Age At Onset ◽  
Bipolar Disorders ◽  
Subscale Score ◽  
Sf 36 ◽  
Schizophrenic Patients ◽  
Bipolar Patients

IntroductionThe classic opinion of a favorable prognosis of bipolar disorders, compared to schizophrenia, is refuted by modern conceptions.ObjectivesThe aim of this study was to assess the quality of life (QOL) in bipolar patients compared to schizophrenic patients’, and to identify clinical and sociodemographic variables statistically associated to a poor QOL in bipolar disorder patients.MethodsOne hundred and twenty outpatients, 50 with bipolar disorder and 70 with schizophrenia, according to DSM-IV-TR criteria, were included in the study. The QOL has been assessed, in all patients, using the «36 item Short-Form Health Survey» (SF-36).ResultsThirty-six percent of the bipolar patients had a poor QOL, versus 37% among the schizophrenic patients. The bipolar patients had the score of the standardized vitality subscale significantly lower than schizophrenic patients’ (p = 0.036); the latter had the standardized general health subscale score significantly lower (p = 0.03). There were no other statistically significant differences. The multivariate analyses showed three variables significantly correlated to a poor QOL in bipolar patients: age at the time of the study ≥ 40 years (p = 0.01), professional irregularity or inactivity (p = 0.005), age at onset ≥ 25 years (p = 0.004).ConclusionOur survey of the QOL in bipolar patients showed that it did not differ globally from the schizophrenic patients’, with the SF-36 scale. Results reported in the literature are not in agreement. Further longitudinal studies on several months, with other assessments, would permit to verify the validity of our results.

Quality of Life Following Management of Localized Prostate Cancer

2018 ◽  
Author(s):  
Louis A Aliperti ◽  
Martin G Sanda ◽  
Christopher P Filson
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Expectant Management ◽  
Diagnosis And Treatment ◽  
Urinary Tract Symptoms ◽  
Related Quality ◽  
Health Related ◽  
The Impact

With a long survivorship phase after diagnosis and treatment of prostate cancer, consideration of the impact of treatment on health-related quality of life (HRQOL) is critical. For men considering treatment of prostate cancer, the domains that are impacted include urinary, sexual, and bowel-related qualities of life. This review identifies aspects of tools measuring HRQOL and covers instruments used to measure quality of life following a diagnosis and treatment of prostate cancer. We review the impact associated with radical prostatectomy, radiation and brachytherapy, and observation on men diagnosed with prostate cancer and compare the effects that each management strategy has on sexual and urinary function. This review contains 3 figures, 5 tables, 44 references. Key Words: erectile dysfunction, expectant management, lower urinary tract symptoms, prostate cancer, radical prostatectomy, radiation therapy, quality of life, urinary incontinence

Depressive and Bipolar Disorders

2017 ◽  
Author(s):  
Antoine Douaihy ◽  
Matthew Conlon ◽  
Maria Ferrara
Keyword(s):  
Quality Of Life ◽  
Antiretroviral Therapy ◽  
Sexual Behaviors ◽  
Depressive Disorders ◽  
Bipolar Disorders ◽  
Poor Quality ◽  
Persons Living With Hiv ◽  
The Impact ◽  
Hiv Aids

Depressive disorders are highly prevalent among persons living with HIV/AIDS. Depressive disorders significantly negatively affects adherence to antiretroviral therapy and HIV viral suppression and is associated with poor quality of life and major impairment in overall functioning. This chapter reviews the prevalence, risk factors, assessment and diagnosis of depressive and bipolar disorders. It also examines the impact of depression on sexual behaviors, adherence to antiretroviral therapy, quality of life, and mortality. This chapter also includes a comprehensive discussion of treatment approaches and considerations for HIV-infected individuals with depressive disorders. Furthermore, it reviews the bipolar disorder spectrum in HIV/AIDS as well as other psychiatric disorders co-occurring with depressive disorders.

scholarly journals A Critical Review of the Impact of Sarcoma on Psychosocial Wellbeing

Sarcoma ◽  
2019 ◽  
Vol 2019 ◽  
pp. 1-18 ◽  
Author(s):  
Lesley Storey ◽  
Lorna A. Fern ◽  
Ana Martins ◽  
Mary Wells ◽  
Lindsey Bennister ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Psychosocial Impact ◽  
Diagnosis And Treatment ◽  
Future Research ◽  
Clear Understanding ◽  
Psychosocial Wellbeing ◽  
Patient Reported ◽  
The Impact

Background. Previous reviews of outcomes in specific sarcoma populations suggest patients have poor quality of life. In most of these reviews, there is a predominant focus on physical function rather than psychosocial outcome. The aim of this review was to describe the psychosocial impact of diagnosis and treatment on patients with all types of sarcoma. Methods. Searches were conducted through six electronic databases for publications of any study design using a validated patient-reported outcome measure reporting the psychosocial impact in this population. Results. Eighty-two studies fulfilled the inclusion criteria. Most (65%) were assessed of being of reasonable quality. The most common aspect of psychosocial wellbeing measured was quality of life (80%). Due to the heterogeneity of methods, outcomes, and populations, it was not possible to make definitive conclusions. It seems there is an improvement in the physical aspects of quality of life over time but not in psychosocial function or mental health. There was no change in mental health scores, but patients reported an improvement in adjusting to normal life. There are no differences according to the type of surgery patients receive, and psychosocial outcomes tend to be poorer than the general population. There is no consistency in identifying the factors that predict/influence psychosocial wellbeing. Conclusion. The published literature does not provide a clear understanding of the impact of sarcoma diagnosis and treatment on psychosocial wellbeing. Instead, the review demonstrates a need for well-designed studies in this area and a more consistent approach to the measurement of patient-reported outcomes, which include psychosocial domains. Recommendations for future research have been proposed.

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