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Practice Guideline for the Treatment of Patients With Bipolar Disorder - Update |
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Written by HealthyPlace.com Staff Writer
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Oct 13, 2008 |
A + A - RESET
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Page 1 of 6 Introduction
APA's Practice Guideline for the Treatment of Patients With Bipolar Disorder, 2nd Edition, was published in April 2002 (1). Since that time, a number of controlled treatment studies on aspects of bipolar disorder have been completed and published or are in press, including studies of second-generation (atypical) antipsychotics as monotherapy and as adjunctive treatment (with more traditional mood stabilizers) for the acute treatment of mania, studies of antiepileptic agents for the acute treatment of mania, trials for three medications for the acute treatment of bipolar depression, four monotherapy and one combination therapy relapse prevention studies, and studies of psychosocial interventions for maintenance. The evidence from these studies supports a substantially expanded set of options for clinicians who treat patients with bipolar disorder. This guideline watch briefly reviews the most important of the studies. The majority of the studies were industry supported.
The American Psychiatric Association (APA) practice guidelines are developed by expert work groups using an explicit methodology that includes rigorous review of available evidence, broad peer review of iterative drafts, and formal approval by the APA Assembly and Board of Trustees. APA practice guidelines are intended to assist psychiatrists in clinical decision making. They are not intended to be a standard of care. The ultimate judgment regarding a particular clinical procedure or treatment plan must be made by the psychiatrist in light of the clinical data presented by the patient and the diagnostic and treatment options available. Guideline watches summarize significant developments in practice since publication of an APA practice guideline. Watches may be authored and reviewed by experts associated with the original guideline development effort and are approved for publication by APA's Executive Committee on Practice Guidelines. Thus, watches represent opinion of the authors and approval of the Executive Committee but not policy of the APA. This guideline watch was published in November 2005. Copyright © 2005. American Psychiatric Association. All rights reserved. Suggested citation: Hirschfeld RMA: Guideline Watch: Practice Guideline for the Treatment of Patients With Bipolar Disorder. Arlington, VA: American Psychiatric Association. Available online at http://www.psych.org/psych_pract/treatg/pg/prac_guide.cfm.
Psychiatric Management
Recently completed epidemiological studies have estimated the lifetime prevalence of bipolar I and II disorders in the general population to be 3.7%–3.9% (2, 3). The prevalence in samples of patients presenting with depression is much higher, ranging from 21% (4) to 26% (5) in primary care settings and from 28% (6) to 49% (7) in psychiatric clinics. Use of a screening instrument, such as the Mood Disorder Questionnaire, can substantially improve recognition of patients with bipolar disorder, particularly among depressed patients (8).
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Last Updated( Feb 23, 2009 )
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reviewed by: Harry Croft, MD
Psychiatrist, HealthyPlace.com Medical Director
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