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Clinical Research Updates

Multidisciplinary Management of Bipolar Disorder

Accelerating Diagnosis, Achieving Remission, and Encouraging Adherence

Clinical Tools

Mood Disorder Questionnaire (MDQ)

A commonly used, sensitive, and specific screening questionnaire for bipolar disorder. A score of 7 or more across 3 criteria suggests the presence of bipolar disorder (Hirschfeld RM, et al. Am J Psychiatry. 2000;157(11):1873-1875).

Generalized Anxiety Disorder 7-item scale (GAD-7)

This 7-item questionnaire measures anxiety levels. With each question scored 0-3, the total score of 0-21 indicates the severity of anxiety. A score of 21 suggests the presence of severe anxiety (Spitzer RL, et al. Arch Intern Med. 2006;166(10):1092-1097).

World Health Organization Five Well-being Index (WHO-5)

A measurement of mental well-being over the previous two weeks, this 5-item questionnaire results in a raw score of 0-25. A percentage score is then obtained by multiplying the raw score by 4 (Henkel V, et al. BMJ. 2003;326(7382):200-201).

Guideline Update: NSAIDs and Other Complementary Treatments for Episodic Migraine Prevention in Adults (2012). 

American Academy of Neurology and the American Headache Society.

Guideline Update: Pharmacologic Treatment for Episodic Migraine Prevention in Adults (2012).

American Academy of Neurology and the American Headache Society.

The Migraine Disability Assessment Test

The MIDAS questionnaire was put together to help you measure the impage your headaches have on your life. The information on this questionnaire is also helpful for your primary care provider to determine the level of pain and disability caused by your headaches and to find the best treatment for you.

Guidelines

Diagnostic and Statistical Manual of Mental Disorders (Fifth edition).

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (Fifth edition). 2013: Arlington, VA, American Psychiatric Publishing.

Clinical Practice Guidelines for Management of Bipolar Disorder in Adults.

Department of Veterans Affairs. Clinical Practice Guideline for Management of Bipolar Disorder in Adults. 2010: Washington, DC, Department of Veterans Affairs, Department of Defense. 

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2013. 

Yatham LN, et al. Bipolar Disord. 2013;15(1):1-44. 

Patient Resource

Depression and Bipolar Support Alliance

The Depression and Bipolar Support Alliance (DBSA) offers resources for patients, materials for clinicians, information on mental health research as well as listings of patient support groups across the United States

Suggested Readings

Bipolar disorders: a review.

Price AL, Marzani-Nissen GR. Am Fam Physician. 2012;85(5):483-493.

Clinical differences between bipolar and unipolar depression. 

Forty L, et al. Br J Psychiatry. 2008;192(5):388-389.

The Canadian Network for Mood and Anxiety Treatments (CANMAT) task force recommendations for the management of patients with mood disorders and comorbid metabolic disorders.

McIntyre RS, et al. Ann Clin Psychiatry. 2012;24(1):69-81.

Strategies for monitoring outcomes in patients with bipolar disorder.

Ketter TA. Prim Care Companion J Clin Psychiatry. 2010;12(suppl 1):10-16.

Mixed specifier for bipolar mania and depression: highlights of DSM-5 changes and implications for diagnosis and treatment in primary care.

Hu J, et al. Prim Care Companion CNS Disord. 2014;16(2).

The neurobiology of the switch process in bipolar disorder: a review.

Salvadore G, et al. J Clin Psychiatry. 2010;71(11):1488-1501.

The functional neuroanatomy of bipolar disorder: a consensus model. 

Strakowski SM, et al. Bipolar Disord. 2012;14(4):313-325.

The International Society for Bipolar Disorders (ISBD) task force report on antidepressant use in bipolar disorders.

Pacchiarotti I, et al. Am J Psychiatry. 2013;170(11):1249-1262.

Lurasidone monotherapy in the treatment of bipolar I depression: a randomized, double-blind, placebo-controlled study.

Loebel A, et al. Am J Psychiatry. 2014;171(2):160-168.

Lurasidone as adjunctive therapy with lithium or valproate for the treatment of bipolar I depression: a randomized, double-blind, placebo-controlled study.

Loebel A, et al. Am J Psychiatry. 2014;171(2):169-177

Quetiapine monotherapy for bipolar depression.

Thase ME. Neuropsychiatr Dis Treat. 2008;4(1):11-21.

Efficacy of quetiapine monotherapy in bipolar I and II depression: a double-blind, placebo-controlled study (the BOLDER II study).

Thase ME, et al. J Clin Psychopharmacol. 2006;26(6):600-609.

A randomized, double-blind, placebo-controlled trial of quetiapine in the treatment of bipolar I or II depression.

Calabrese JR, et al. Am J Psychiatry. 2005;162(7):1351-1360.

Efficacy of olanzapine and olanzapine-fluoxetine combination in the treatment of bipolar I depression.

Tohen M, et al. Arch Gen Psychiatry. 2003;60(11):1079-1088.

Interactive Presentation

Multidisciplinary Management of Bipolar Disorder

Michael Thase, MD, W. Clay Jackson, MD, Susan Adams, PhD, RN, FAANP


Activity
Multidisciplinary Management of Bipolar Disorder

Accelerating Diagnosis, Achieving Remission, and Encouraging Adherence

Relevant Resources

Reducing the Burden of Bipolar Depression

Improved Diagnostic and Management Strategies

Improving Outcomes in Bipolar Depression

Overcoming Diagnostic Challenges, Targeting Remission, and Optimizing Cardiometabolic Health

Comprehensive Management of Bipolar Depression

New Approaches to Optimizing Patient Outcomes

A Focus on Bipolar Depression

Overcoming Diagnostic Barriers and Optimizing Long-Term Patient Outcomes

Mixed Features in Depressive Episodes

Managing Patients Across the Disease Spectrum

Agitation and Psychiatric Disease

Best Practices for Emergency Care

Clinical Issues in Bipolar Depression

Consensus and Controversies Across the Spectrum of Patient Presentations

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HOME '/var/www'
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Context properties
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Action CInlineAction (view)
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Context properties
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Route resources/view
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Context ResourcesController
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Action CInlineAction (view)
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View data
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Driver mysql
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Query Count Total (s) Avg. (s) Min. (s) Max. (s)
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SELECT r.id, COUNT(r.id) relevance FROM resources r join `resource_topics` rtj on rtj.`resource_id`=r.id WHERE rtj.`topic_id` in (SELECT topic_id from `resource_topics` rt where rt.`resource_id`=:rid AND rt.topic_id>0) AND r.id <> :rid AND r.status = 'active' Group by r.id order by relevance DESC, r.`createDate` DESC
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1 0.001260 0.001260 0.001260 0.001260
select id, status from activities where FIND_IN_SET(:shortAddress, shortAddress)
2 0.001223 0.000611 0.000277 0.000946
SHOW COLUMNS FROM `users`
1 0.001206 0.001206 0.001206 0.001206
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1 0.000998 0.000998 0.000998 0.000998
SELECT * FROM `users` `t` WHERE session=:session LIMIT 1
2 0.000940 0.000470 0.000446 0.000494
select id from resources where FIND_IN_SET(:shortAddress, shortAddress)
2 0.000858 0.000429 0.000258 0.000600
SELECT * FROM `resources` `t` WHERE `t`.`id` IN (166, 56, 43, 37, 20, 19, 15, 6)
1 0.000636 0.000636 0.000636 0.000636
SELECT * FROM `resources` `t` WHERE `t`.`id`=27 LIMIT 1
1 0.000484 0.000484 0.000484 0.000484
SHOW CREATE TABLE `activities`
1 0.000394 0.000394 0.000394 0.000394
SHOW CREATE TABLE `resources`
1 0.000344 0.000344 0.000344 0.000344
SHOW CREATE TABLE `users`
1 0.000317 0.000317 0.000317 0.000317
SHOW CREATE TABLE `resource_videos`
1 0.000315 0.000315 0.000315 0.000315
SHOW CREATE TABLE `interactions`
1 0.000312 0.000312 0.000312 0.000312
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1 0.000266 0.000266 0.000266 0.000266
# Query Time (s)
0
select id, status from activities where FIND_IN_SET(:shortAddress, shortAddress)
0.000946
1
select id from resources where FIND_IN_SET(:shortAddress, shortAddress)
0.000600
2
select id, status from activities where FIND_IN_SET(:shortAddress, shortAddress)
0.000277
3
select id from resources where FIND_IN_SET(:shortAddress, shortAddress)
0.000258
4
SHOW COLUMNS FROM `resources`
0.001675
5
SHOW CREATE TABLE `resources`
0.000344
6
SELECT * FROM `resources` `t` WHERE `t`.`id`=27 LIMIT 1
0.000484
7
SHOW COLUMNS FROM `resource_videos`
0.000998
8
SHOW CREATE TABLE `resource_videos`
0.000315
9
SELECT `videos`.`id` AS `t1_c0`, `videos`.`vzaar_id` AS `t1_c1`, `videos`.`title` AS `t1_c2`, `videos`.`description` AS `t1_c3`, `videos`.`resource_id` AS `t1_c4`, `videos`.`type` AS `t1_c5` FROM `resource_videos` `videos` WHERE (`videos`.`resource_id`=:ypl0)
0.000266
10
SHOW COLUMNS FROM `interactions`
0.001008
11
SHOW CREATE TABLE `interactions`
0.000312
12
SHOW COLUMNS FROM `activities`
0.001260
13
SHOW CREATE TABLE `activities`
0.000394
14
SHOW COLUMNS FROM `users`
0.001206
15
SHOW CREATE TABLE `users`
0.000317
16
SELECT * FROM `users` `t` WHERE session=:session LIMIT 1
0.000494
17
INSERT INTO `users` (`role`, `sendEmails`, `sendSms`, `source`, `session`, `lastLogin`, `phone`, `createDate`) VALUES (:yp0, :yp1, :yp2, :yp3, :yp4, :yp5, :yp6, :yp7)
0.004134
18
SELECT * FROM `users` `t` WHERE session=:session LIMIT 1
0.000446
19
UPDATE `users` SET `lastLogin`=:yp0 WHERE `users`.`id`=2539482
0.003002
20
SELECT `activities`.`id` AS `t1_c0`, `activities`.`group_id` AS `t1_c1`, `activities`.`resource_id` AS `t1_c2`, `activities`.`title` AS `t1_c3`, `activities`.`type` AS `t1_c4`, `activities`.`facultyNames` AS `t1_c5`, `activities`.`shortDescription` AS `t1_c6`, `activities`.`fullDescription` AS `t1_c7`, `activities`.`creditAmount` AS `t1_c8`, `activities`.`shortAddress` AS `t1_c9`, `activities`.`creditType` AS `t1_c10`, `activities`.`startDate` AS `t1_c11`, `activities`.`finishDate` AS `t1_c12`, `activities`.`sponsors` AS `t1_c13`, `activities`.`status` AS `t1_c14`, `activities`.`createDate` AS `t1_c15`, `activities`.`image` AS `t1_c16`, `activities`.`image_featured` AS `t1_c17`, `activities`.`archived` AS `t1_c18`, `activities`.`managers_list` AS `t1_c19`, `activities`.`is_send_pp_email` AS `t1_c20`, `activities`.`muvi_sync_date` AS `t1_c21`, `activities`.`expert_questions` AS `t1_c22` FROM `activities` `activities` WHERE (`activities`.`resource_id`=:ypl0)
0.001719
21
SELECT r.id, COUNT(r.id) relevance FROM resources r join `resource_topics` rtj on rtj.`resource_id`=r.id WHERE rtj.`topic_id` in (SELECT topic_id from `resource_topics` rt where rt.`resource_id`=:rid AND rt.topic_id>0) AND r.id <> :rid AND r.status = 'active' Group by r.id order by relevance DESC, r.`createDate` DESC
0.003633
22
SELECT * FROM `resources` `t` WHERE `t`.`id` IN (166, 56, 43, 37, 20, 19, 15, 6)
0.000636
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