Bipolar Research
Published on Apr 21, 2016
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PRESENTATION OUTLINE
What is Bipolar Disorder?
Bipolar disorder is a chronic and recurrent brain disorder that affects a person’s mood, energy, functioning and quality of life. It is characterized by alternating episodes of depression and mania that vary in severity.
Episodes of mania and depression can last days, weeks, or months with periods of no symptoms in between.
Episodes of mania and depression can last days, weeks, or months with periods of no symptoms in between.
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Manic Symptoms
- high self esteem
- little need for sleep
- increased rate of speech
- flight of ideas
- increased interest in goals
- psychomotor agitation
- partakes in high risk activities
To be considered a manic episode the person must have at least three of the symptoms and the episode must last for a minimum of one week.
Hypomanic episodes are less severe and last for at least four days.
Hypomanic episodes are less severe and last for at least four days.
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Depressive Symptoms
- unusual eating habits
- unusual sleep habits
- feelings of sadness, worthlessness and hopelessness
- thoughts of death or suicide
- inability to concentrate
A depressive episode is characterized by at least five of these symptoms and must last for a minimum of two weeks.
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Prevalence & Incidence
and who is affected?
The incidence for adults affected by bipolar in the U.S. is 2.6%. The lifetime prevalence is 3.9%.
The most common age of onset is during late teenage years or early adulthood.
People of all races, ethnicities, genders and socioeconomic backgrounds are affected equally.
The most common age of onset is during late teenage years or early adulthood.
People of all races, ethnicities, genders and socioeconomic backgrounds are affected equally.
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Suicide & Bipolar Disorder
Bipolar disorder has a very high rate of relapse and recurrence. The extreme fluctuation in moods is difficult to cope with and can cause a person to attempt suicide.
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Underdiagnosis in African Americans
Research has found that bipolar disorder is very often under diagnosed in the african american population. There are many reasons for this including: a general mistrust of healthcare workers, a tendency for rely more heavily on family and community than healthcare workers, cultural barriers and lack of health insurance.
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Comorbid Psychiatric Disorders
- alcohol or substance abuse
- Attention deficit hyperactivity disorder
- anxiety
- borderline personality disorder
People who are diagnosed with bipolar disorder are very likely to suffer from an additional psychiatric disorder. The presence of comorbid psychiatric disorders worsens prognosis and also makes it difficult to differentiate between diagnoses.
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Diagnosis Issues
Bipolar is frequently over diagnosed and misdiagnosed due to its similarity to other disorders. Major depressive disorder is the most common misdiagnosis.
Some people also seek out a bipolar diagnosis to receive disability compensation.
Women are often misdiagnosed with major depressive disorder and men with schizophrenia.
Some people also seek out a bipolar diagnosis to receive disability compensation.
Women are often misdiagnosed with major depressive disorder and men with schizophrenia.
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Cause
- combination of genetic and environmental factors
- people with first degree relative 7X more likely
- 50% of bipolar offspring have a psychiatric disorder
External stressors or periods of high stress can trigger the disorder or worsen the symptoms. Substance abuse may also trigger the disorder.
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New Research
Recent research has identified three symptoms that are powerful predictors of bipolar disorder in children who have at least one parent who is bipolar.
The three strongest predictors were anxiety and depression, emotional lability, and low-level manic symptoms.
Children positive for all risk factors had a 49% chance of developing the disorder.
The three strongest predictors were anxiety and depression, emotional lability, and low-level manic symptoms.
Children positive for all risk factors had a 49% chance of developing the disorder.
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Treatment
- mood stabilizers
- antidepressants
- antipsychotics
- psychotherapy
- psychoeducation
The main goal of treatment is to address imminent episodes then to prevent further episodes of mania and depression. This is usually achieved by a combination of psychopharmacological treatments and psychotherapy.
Education on the topic is greatly beneficial to the person and their family and results in greater compliance with treatment.
Education on the topic is greatly beneficial to the person and their family and results in greater compliance with treatment.
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Treatment issues
Management is not usually possible with only one medication. 30-50% of people do not respond to initial treatment, therefore It often takes a trial period to determine the best treatment for an individual.
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Poor Prognosis
- poor job history
- substance abuse
- psychotic features
- depressive features between episodes
- patterns of depression-mania- euthymia
- male sex
These signs predict a worse outcome for a person who has bipolar disorder.
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Positive Prognosis
- short duration of manic episodes
- late age of onset
- few thoughts of suicide
- few psychotic features
- few medical problems
These signs make for a better prognosis in a person who has bipolar disorder.
