COMPLIMENTARY CME
Bipolar Disorder:
Self-Assessment Questions
Family physicians are playing an increasingly important role in
management of bipolar disorder and other mood disorders. It is now recognized
that 20% to 30% of patients presenting to primary care physicians with
depression or anxiety actually have bipolar disorder. Differentiating bipolar
disorder from other common mood disorders is critical in determining appropriate
treatment. Previous issues in this series discussed the use of screening tools,
such as the Mood Disorder Questionnaire, in identifying patients with bipolar
disorder, summarized current guidelines, described options for treatment, and
provided case reports illustrating effective diagnostic and therapeutic
approaches to bipolar disorder.
Primary care physicians are in a unique position to ensure
that patients with bipolar disorder receive appropriate care, whether they
provide it themselves or refer the patient to a mental health specialist, and to
coordinate and monitor patients' mental and physical health care. A
collaborative, shared-care approach to the management of bipolar disorder offers
potential benefits to both patients and health care providers. The
self-assessment questions in this issue are intended to increase primary care
physicians' awareness and understanding of bipolar disorder, leading to more
effective treatment and better outcomes for their patients.
Learning Objectives
After reading this article, the reader
should be able to:
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COMPLIMENTARY CME
Treating Bipolar Depression
in the Family Practice Setting
Bipolar II disorder is a condition within the bipolar spectrum
characterized by hypomania and major depression. Patients typically visit their
family physician for depression rather than for hypomanic behavior.
In this issue, J. Sloan Manning, MD, and Roy H. Perlis, MD, combine their
expertise in family practice and psychiatry, respectively, to discuss the main
issues surrounding treatment of these patients in a family practice setting. The
following discussion is an edited version of the transcript of the interview.
Gail Molnar Pfeifer, RN, contributed to preparation of the manuscript.
Learning Objectives
After reading this article, the reader
should be able to:
- Identify current options for treating depression in a patient with bipolar
disorder.
- Discuss considerations in selecting first-line therapy for bipolar
depression, how to initiate treatment, and how to modify the treatment regimen
to optimize patient response.
- Review the role of antidepressants in patients with bipolar depression.
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COMPLIMENTARY CME
Screening for Bipolar
Depression in the Family Practice Setting
Bipolar II disorder is perhaps the most common of the disorders that
constitute the bipolar disorder spectrum. Episodes of depression typically occur
more frequently than episodes of hypomania, and are more often the reason for
seeking treatment. As a result, patients are often misdiagnosed as having unipolar depression or major depressive disorder, which can lead to
inappropriate and ineffective treatment. In this interview, Dr J. Sloan Manning,
MD, and Hagop
S. Akiskal, MD, discuss the use of the Temperament
Evaluation of the Memphis, Pisa, Paris, and San Diego Autoquestionnaire
(TEMPS-A) and other screening tools in identifying patients with bipolar depression.
Learning Objectives
After reading this article, the reader
should be able to:
-
Explain the importance of elucidating temperament to determine a
diagnosis of bipolar depression.
-
Describe the use of the TEMPS-A questionnaire in screening for bipolar
depression in a family practice setting.
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COMPLIMENTARY CME
Bipolar Disorder:
Self-Assessment Questions
Bipolar spectrum disorders are prevalent in primary care settings and may be a
source of complicated, clinically frustrating presentations of depression. Current estimates are that 20% to 30% of depressed patients in primary
care have bipolar disorder..
This series of self-assessment questions is intended to
stimulate awareness of bipolar spectrum illness and focus on the principles of
differential diagnosis and treatment necessary for these patients.
Learning Objectives
After reading this article, the reader
should be able to:
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COMPLIMENTARY CME
Achieving Treatment Goals
in Bipolar Disorder: A Collaborative Care Approach
Bipolar disorder and other mood disorders are frequently treated in the primary
care setting. In this article, J.
Sloan Manning, MD, discusses the pivotal role primary care physicians can play
in treating bipolar disorder and the available options for treating bipolar
disorder and its psychiatric comorbidities.
Learning Objectives
After reading this article, the reader
should be able to:
-
List treatment goals for patients with bipolar disorder
-
Explain the shared-care approach to treatment of bipolar
disorder
-
Describe the basic principles of treatment of bipolar
disorder and the types of drugs used to treat bipolar mania, depression, and
psychiatric comorbidities
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COMPLIMENTARY CME
Case Reports in Bipolar
Disorder
If
bipolar disorder is suspected, the Mood Disorder
Questionnaire (MDQ) is a good way to start the differential diagnosis process.
Case studies provide sample MDQs completed by different types of patients to
illustrate the strengths and weaknesses of the test in the clinical setting.
Learning Objectives
After reading this article, the reader
should be able to:
-
Interpret responses on the Mood Disorder Questionnaire (MDQ)
-
Discuss the strengths and limitations of the MDQ in screening
for bipolar disorder in the clinical setting
-
Explain how results on the MDQ can be used to guide initial
treatment
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COMPLIMENTARY CME
Screening for Bipolar Disorder in a Primary
Care Setting
Bipolar disorder is frequently undiagnosed or misdiagnosed. This can result in
serious clinical consequences In this interview, J. Sloan Manning, MD, describes
the different types of bipolar disorder, clues to making the diagnosis, and the
tools available for screening for the disorder in the primary care setting.
Learning Objectives
After reading this article, the reader should be able to:
-
Describe the different types of bipolar disorder
-
Differentiate between unipolar depression and bipolar
disorder
-
Identify patients with bipolar disorder using a validated
diagnostic screening tool and other clinical information
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