By Robert P. Reiser
The earlier 10 years have obvious a dramatic raise of curiosity in psychosocial remedies of bipolar sickness. there's now great empirical facts suggesting the effectiveness of such remedies. despite the fact that, this amassed details has no longer but been transferred into scientific perform in lots of settings. assistance is now handy. This compact quantity brings to the practitioner a entire, evidence-based method of the remedy of bipolar ailment that's useful, simply available, and will be conveniently utilized in medical perform. This practitioner's consultant starts by way of describing the most positive aspects of bipolar disease and issues for differential prognosis in accordance with DSM-IV and ICD-10 standards. Following this, present theories and types are defined, besides choice timber for comparing the easiest remedies. the amount then publications the reader via a scientific, built-in method of therapy, in response to the easiest of contemporary examine. The authors describe a based directive remedy that also is collaborative and buyer situated. distinctive issues, together with handling suicide probability, substance misuse, and medicine non adherence, are addressed. the amount is rounded off through the inclusion of clinically orientated instruments and pattern kinds.
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Extra resources for Bipolar Disorder
The authors recommend preventive treatment after a single manic episode, especially if there is a family history of bipolar disorder. Due to low response rates (less than 50%), for nonresponders and individuals unable to tolerate the side effects of lithium, other mood stabilizers including carbamazepine, valproic acid, and lamotrigine may be considered. Although some of the atypical antipsychotics have demonstrated antimanic efficacy and possible effects on depression, use of these compounds for long-term prophylaxis must take into account a number of serious side effects, including, among others, weight gain and risk of diabetes.
Is there a pattern of recent instability suggesting that standard outpatient treatment will not be sufficient for the patient to remain stable? Does the patient have sufficient social supports available at this point? , multiple hospitalizations or emergency room visits in the past month) Does the patient present an acute suicide risk that cannot be managed in outpatient care? Will the patient be able to comply with the requirements of outpatient treatment in terms of showing up for regularly scheduled appointments?
Treatment goals should be personally meaningful to the patient. Too often, clinicians focus primarily on a reduction in psychiatric symptoms as a primary goal of treatment. In our experience, it is important to develop the “big picture” in terms of the patient’s values, interests, and objectives in life in order to incorporate these into meaningful treatment goals that reflect level of functioning. While “becoming less depressed” is an important symptomatic goal, it is hardly motivating in terms of a meaningful life goal.