Search results for ‘Subject term:"bipolar disorder"’ Sort:
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Diagnosing alcohol and cannabis use disorders in adolescents with bipolar disorder: a preliminary investigation
- Authors:
- BLACK Jessica J., et al
- Journal article citation:
- Journal of Dual Diagnosis, 8(1), January 2012, pp.13-18.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The aim of this study was to examine the accuracy of diagnosing substance use disorders in manic adolescents with bipolar disorder, by comparing diagnoses derived in 2 different ways and at 2 different times. Initial diagnoses were obtained through administering the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime version semi-structured interview to 80 adolescents (12 to 21 years old) with co-occurring bipolar and substance use disorders. These were then compared to a best estimate diagnosis derived from a consensus conference using all available information (including data obtained from a second diagnostic interview using the Child Semi-Structured Assessment for the Genetics of Alcoholism, Adolescent version). The article reports on the data analysis and the results. The study found relatively low diagnostic agreement across the initial and the best estimate diagnoses for both alcohol and cannabis use disorders. The authors discuss the findings, concluding that the significant discrepancies in diagnoses indicate that a single interview alone may not be accurate for diagnosing substance use disorders in adolescents with bipolar disorder.
Psychiatric comorbidity in older adults with bipolar disorder
- Authors:
- SAJATOVIC Martha, BLOW Frederick C., IGNACIO Rosalinda V.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 21(6), June 2006, pp.582-587.
- Publisher:
- Wiley
Comorbidity patterns and correlates among older adults with bipolar disorder (BPD) are not well understood. The aim of this analysis was to examine the prevalence of comorbid PTSD and other anxiety disorders, substance abuse and dementia in a population of 16,330 geriatric patients with BPD in a Veterans Health Administration administrative database. Patients were identified from case registry files during Federal Fiscal Year 2001(FY01). Comorbidity groups were compared on selected clinical characteristics, inpatient and outpatient health resource use, and costs of care. Four thousand six hundred and sixty-eight geriatric veterans with BPD were comorbid for either substance abuse, PTSD and other anxiety disorder, or dementia (28.6% of all veterans with BPD age 60 or older). Mean age of all veterans in the four comorbidity groups was 70.0 years (±SD 7.2 years). Substance abuse was seen in 1,460 (8.9%) of elderly veterans with BPD, while PTSD was seen in 875 (5.4%), other anxiety disorders in 1592 (9.7%), and dementia in 741 (4.5%) of elderly veterans. Individuals with substance abuse in this elderly bipolar population are more likely to be younger, minority, unmarried and homeless compared to elderly bipolar populations with anxiety disorders or dementia. Inpatient use was greatest among geriatric veterans with BPD and dementia compared to veterans with BPD and other comorbid conditions. Clinical characteristics, health resource use and healthcare costs differ among geriatric patients with BPD and comorbid anxiety, substance abuse or dementia. Additional research is needed to better understand presentation of illness and modifiable factors that may influence outcomes.
Bipolar disorder and substance abuse: two disorders or one?
- Author:
- SWANN Alan C.
- Journal article citation:
- Journal of Dual Diagnosis, 1(3), 2005, pp.9-23.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The aim was to review evidence about mechanisms and consequences of relationships between bipolar and substance use disorders. Articles were identified using a MEDLINE search linking (1) bipolar disorder to substance use disorders, alcoholism, and specific drugs, (2) bipolar disorder and substance abuse to treatment strategies, and (3) bipolar disorder or substance abuse to behavioral sensitization, impulsivity, and suicide. We attempted to select only the most relevant refereed articles. In addition to articles found in the search, key references cited in the articles were used. Substance use disorders and bipolar disorders are associated with mutually increased risk. Patients with the combination are more impulsive and are at greater risk for suicidal or violent behavior than are subjects with either illness alone. Compared to subjects with bipolar disorder who do not have a substance use disorder, those with combined disorders have earlier onset of illness, more frequent hospitalizations, and are more likely to experience mixed episodes. Both disorders must be addressed specifically for treatment to be effective. Treatment options are expanding, but few have been adequately studied. The nature of the apparent link between bipolar disorder and substance use disorders suggests that they share common mechanisms. Candidate mechanisms include abnormal regulation of the initiation of behavior leading to abnormal reward sensitivity and increased impulsivity, and increased susceptibility to behavioral sensitization.(Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580)
Comparison of the internal state scale to clinician-administered assessments in patients with bipolar disorder and alcohol abuse or dependence
- Authors:
- SRISINROONGRUANG Rattapol, et al
- Journal article citation:
- Journal of Dual Diagnosis, 1(3), 2005, pp.61-69.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Self-report measures require less clinician time to administer than clinician-rated assessments. The Internal State Scale (ISS) is a well-validated self-report measure that assesses symptoms of mania and depression in patients with bipolar disorder (BPD). However, the ISS has never been specifically evaluated in patients with BPD and comorbid substance misuse. Substances can induce mood symptoms complicating diagnosis and mood state assessment. The ISS was compared with the Hamilton Rating Scale for Depression (HRSD), Young Mania Rating Scale (YMRS), and Brief Psychiatric Rating Scale (BPRS) in 21 patients with BPD and alcohol abuse/dependence at baseline and for up to 16 weeks postbaseline. In addition, ISS-determined mood state was compared to mood state from a structured diagnostic interview. Significant baseline correlations were observed between the ISS depression subscale and HRSD, ISS activation subscale and YMRS, and ISS perceived conflict subscale and BPRS. Significant correlations of baseline to exit change scores were found between the ISS activation and YMRS, but not ISS depression and HRSD, or ISS perceived conflict and BPRS. All participants had a mixed mood state by structured diagnostic interview. The ISS diagnosed the manic/hypomanic portion of this mood state in 76% of participants but found depression in only 38%. As in BPD patients without substance abuse, the ISS generally showed correlations with clinician-rated scales at baseline, with less strong correlations observed on change scores. The ISS diagnosis of mania or hypomania appeared to correspond more highly than depression with the findings from a structured diagnostic interview.(Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580)
The early detection and proper treatment of bipolar disorder: implications for social work practice with substance-abusing clients
- Authors:
- LADSON Darnell, KORNEGAY Bradley, LESANE Shakara
- Journal article citation:
- Journal of Human Behavior in the Social Environment, 24(5), 2014, pp.547-556.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The article describes the history of bipolar disorder diagnostics and the emerging trends of earlier detection and treatment. It explores the link between bipolar disorder and frequent co-occurring disorders, including substance abuse. There are discussions regarding the need for early detection of mood disorders in these individuals and the impact that treatment of mental health issues have on substance abuse prevention in this population. The practice implications for medical, substance abuse, and mental health professionals are examined. (Publisher abstract)
Co-morbid bipolar and alcohol use disorders: a treatment-focused review
- Authors:
- PRISCIANDAROA James J., MYRICK D. Hugh
- Journal article citation:
- Journal of Dual Diagnosis, 6(2), April 2010, pp.171-188.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Treatment of bipolar disorders or alcohol misuse is quite difficult. However, these are commonly combined, making diagnosis and treatment increasingly complex, and are often associated with poor outcomes. This article concisely reviews the diagnosis, epidemiology, consequences, and neurobiological similarities of these two conditions among individuals with dual diagnoses, and reviews the pharmacological and psychosocial treatment of bipolar and alcohol use disorders both alone and in combination. The article highlights how dual diagnosis is often complicated by the fact that intoxication and withdrawal states can mimic psychiatric illness, and, furthermore, the neuroadaptive changes associated with the chronic use of alcohol may cause alterations in neurotransmission, thereby inducing a psychiatric illness. In closing, evidence for the effectiveness of treatments for individuals with dual diagnoses (i.e., divalproex, atypical antipsychotics, naltrexone, cognitive-behavioural therapy, and integrated group therapy) is discussed, and areas for future treatment development and evaluation are identified.
Links between drug and alcohol misuse and psychiatric disorders
- Author:
- LITTLEJOHN Christopher
- Journal article citation:
- Nursing Times, 4.1.05, 2005, pp.34-37.
- Publisher:
- Nursing Times
Substance use is common in a wide range of psychiatric disorders, which can increase the risks of use developing into a substance use disorder. Conversely, substance use disorders are frequently accompanied by psychiatric symptoms. In some people these indicate formal psychiatric disorder. Whatever the causes, comorbidity may complicate treatment and resolution of both disorders, often presenting as a vicious circle that is difficult to break.
Psychosis and schizophrenia pathway
- Author:
- NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
- Publisher:
- National Institute for Health and Care Excellence
- Publication year:
- 2014
- Place of publication:
- London
A summary view of the NICE guidance on psychosis and schizophrenia in the form of a care pathway. It covers psychosis and schizophrenia in children and young people; psychosis and schizophrenia in adults; psychosis with coexisting substance misuse; bipolar disorder and psychotic depression. (Original abstract)
Psychosis with coexisting substance misuse: the NICE guideline on assessment and management in adults and young people
- Author:
- NATIONAL COLLABORATING CENTRE FOR MENTAL HEALTH
- Publisher:
- Royal College of Psychiatrists; British Psychological Society
- Publication year:
- 2011
- Pagination:
- 326p., CD ROM
- Place of publication:
- London
The printed version of the full evidence-based clinical guideline on psychosis with coexisting substance misuse (Clinical Guideline 120), commissioned by the National Institute for Health and Clinical Excellence (NICE). Developed by a multidisciplinary team the guidelines aim to provide advice on providing and planning high-quality care for people with psychosis and coexisting substance misuse while also emphasising the importance of the experience of care for people with psychosis and coexisting substance misuse and their families, carers or significant others. The first three chapters provide a general introduction to guidelines and the topic of psychosis with coexisting substance misuse, and to the methods used to develop this guideline. Chapters 4 to 9 provide the evidence that underpins the recommendations. These cover assessment and care pathways; service delivery models (including integrated services and inpatient care); psychological and psychosocial interventions; pharmacological and physical interventions; and young people with psychosis and coexisting substance misuse. A chapter also cover the experiences of service users, their carers and their families, including personal accounts and a review of the qualitative literature. The final chapter provides a summary of recommendations. The accompanying CD-ROM provides information about the clinical studies included and excluded and further details of the methodology. The guidance is relevant for those providing primary, community, secondary, tertiary and other healthcare professionals working directly with adults and young people with psychosis and coexisting substance misuse.
Clinical handbook of co-existing mental health and drug and alcohol problems
- Editors:
- BAKER Amanda, VELLEMAN Richard, (eds.)
- Publisher:
- Routledge
- Publication year:
- 2007
- Pagination:
- 402p.
- Place of publication:
- London
Co-existing mental health and drug and alcohol problems occur frequently in primary care and clinical settings. Despite this, health professionals rarely receive training in how to detect, assess and formulate interventions for co-existing problems and few clinical guidelines exist. Leading clinicians from the UK, the US and Australia provide practical descriptions of assessments and interventions for co-existing problems. These will enable professionals working with co-existing problems to understand best practice and ensure that people with co-existing problems receive optimal treatment. A range of overarching approaches are covered, including: working within a cognitive behavioural framework; provision of consultation-liaison services, training and supervision; individual, group and family interventions; and working with rurally isolated populations. The contributors also provide detailed descriptions of assessments and treatments for a range of disorders when accompanied by drug and alcohol problems, including anxiety, depression, schizophrenia, bipolar disorder and learning difficulties.