Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Introduction
- 1 Bipolar disorder in historical perspective
- 2 The bipolar spectrum
- 3 Defining and measuring Bipolar II Disorder
- 4 Bipolar II Disorder in context: epidemiology, disability and economic burden
- 5 Is Bipolar II Disorder increasing in prevalence?
- 6 The neurobiology of Bipolar II Disorder
- 7 The role of antidepressants in managing Bipolar II Disorder
- 8 The use of SSRIs as mood stabilisers for Bipolar II Disorder
- 9 Mood stabilisers in the treatment of Bipolar II Disorder
- 10 The use of atypical antipsychotic drugs in Bipolar II Disorder
- 11 The role of fish oil in managing Bipolar II Disorder
- 12 The role of psychological interventions in managing Bipolar II Disorder
- 13 The role of wellbeing plans in managing Bipolar II Disorder
- 14 Survival strategies for managing and prospering with Bipolar II Disorder
- 15 A clinical model for managing Bipolar II Disorder
- 16 Management commentary
- 17 Management commentary
- 18 Management commentary
- 19 Management commentary
- 20 Management commentary
- 21 Management commentary
- 22 Management commentary
- 23 Management commentary
- 24 Management commentary
- 25 Management commentary
- 26 Management commentary: What would Hippocrates do?
- 27 Management commentary
- 28 Rounding up and tying down
- Appendix 1 Black Dog Institute Self-test for Bipolar Disorder: The Mood Swings Questionnaire
- Index
- References
2 - The bipolar spectrum
Published online by Cambridge University Press: 13 August 2009
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Edited by
Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Introduction
- 1 Bipolar disorder in historical perspective
- 2 The bipolar spectrum
- 3 Defining and measuring Bipolar II Disorder
- 4 Bipolar II Disorder in context: epidemiology, disability and economic burden
- 5 Is Bipolar II Disorder increasing in prevalence?
- 6 The neurobiology of Bipolar II Disorder
- 7 The role of antidepressants in managing Bipolar II Disorder
- 8 The use of SSRIs as mood stabilisers for Bipolar II Disorder
- 9 Mood stabilisers in the treatment of Bipolar II Disorder
- 10 The use of atypical antipsychotic drugs in Bipolar II Disorder
- 11 The role of fish oil in managing Bipolar II Disorder
- 12 The role of psychological interventions in managing Bipolar II Disorder
- 13 The role of wellbeing plans in managing Bipolar II Disorder
- 14 Survival strategies for managing and prospering with Bipolar II Disorder
- 15 A clinical model for managing Bipolar II Disorder
- 16 Management commentary
- 17 Management commentary
- 18 Management commentary
- 19 Management commentary
- 20 Management commentary
- 21 Management commentary
- 22 Management commentary
- 23 Management commentary
- 24 Management commentary
- 25 Management commentary
- 26 Management commentary: What would Hippocrates do?
- 27 Management commentary
- 28 Rounding up and tying down
- Appendix 1 Black Dog Institute Self-test for Bipolar Disorder: The Mood Swings Questionnaire
- Index
- References
Summary
Introduction
An experienced host prepares to serve a ceremonial fowl. The guests look on with anticipation. The knife is sharpened. After he identifies the gap between thigh and body, the carving proceeds neatly. This image is often invoked in discussions of diagnostic systems, speaking of ‘carving nature at its joints’. But what if the entity in question does not have joints? This is the essence of the bipolar spectrum perspective.
Most diagnostic systems – and many clinicians – categorise illnesses as discrete entities. This monograph has a similar orientation. In focusing on Bipolar II Disorder (BP II), it assumes that this is a distinct condition or entity and able to be distinguished from other putatively categorical mood disorders (particularly Bipolar I Disorder (BP I) and unipolar depression). But what if BP II is not an entity but rather a point on a continuous spectrum of mood disorders? This chapter examines such a proposition.
At least eight recent reviews have been written on the bipolar spectrum concept – including a chapter by the chairman of the International Society for Bipolar Disorder (ISBD) Diagnostic Guidelines Task Force (Ghaemi et al., 2006); and a review with recommendations for changes to the DSM–IV, prepared for that Task Force by this author and colleagues (Phelps et al., 2007); as well as six other cogent overviews (Katzow et al., 2003; Dunner, 2003; Moller and Curtis, 2004; Angst and Cassano, 2005; Mondimore, 2005; Skeppar and Adolfsson, 2006).
- Type
- Chapter
- Information
- Bipolar II DisorderModelling, Measuring and Managing, pp. 15 - 45Publisher: Cambridge University PressPrint publication year: 2008
References
, and (2002). ‘Cade's disease’ and beyond: Misdiagnosis, antidepressant use, and a proposed definition for Bipolar Spectrum Disorder. Canadian Journal of Psychiatry, 47, 125–34.CrossRefGoogle Scholar
International Society for Bipolar Disorders (2006). Diagnostic Guidelines Task Force Report. Bipolar Disorders Special Issue, in review.
Phelps, J. (2006). Mood Swings without Mania: Bipolar II. http://www.PsychEducation.org, accessed 12/1/06.
(2006). Why Am I Still Depressed? Recognising and Managing the Ups and Downs of Bipolar II and Soft Bipolar Disorders. New York: McGraw-Hill.Google Scholar
and (2006). Recurrent Major Depressive Disorder and Bipolar II: evidence that they lie on a dimensional spectrum. Journal of Affective Disorders, 92, 45–54.CrossRefGoogle ScholarPubMed
and (1987). Criteria for the ‘soft’ bipolar spectrum: treatment implications. Psychopharmacological Bulletin, 23, 68–73.Google ScholarPubMed
and (1999). The evolving bipolar spectrum. Prototypes I, II, III, and IV. Psychiatric Clinics of North America, 22, 517–34.CrossRefGoogle ScholarPubMed
and (2003). Antidepressant monotherapy for Bipolar Type II major depression. Bipolar Disorders, 5, 388–95.CrossRefGoogle ScholarPubMed
and (2005). The mood spectrum: improving the diagnosis of bipolar disorder. Bipolar Disorders, 7 (Suppl. 4), S4–12.CrossRefGoogle Scholar
, , et al. (2003). Toward a re-definition of sub-threshold bipolarity: epidemiology and proposed criteria for Bipolar-II, minor bipolar disorders and hypomania. Journal of Affective Disorders, 73, 133–46.CrossRefGoogle Scholar
(2003). Bipolar II Disorder and major depressive disorder: continuity or discontinuity?World Journal of Biological Psychiatry, 4, 166–71.CrossRefGoogle ScholarPubMed
and (2005). Are treatment emergent suicidality and decreased response to antidepressants in younger patients due to bipolar disorder being misdiagnosed as unipolar depression?Medical Hypotheses, 65, 39–43.CrossRefGoogle ScholarPubMed
, , et al. (2004). The mood spectrum in unipolar and bipolar disorder: arguments for a unitary approach. American Journal of Psychiatry, 161, 1264–9.CrossRefGoogle ScholarPubMed
(2003). Clinical consequences of under-recognized bipolar spectrum disorder. Bipolar Disorders, 5, 456–63.CrossRefGoogle ScholarPubMed
and (2005). Antidepressant-associated chronic irritable dysphoria (acid) in bipolar disorder: A case series. Journal of Affective Disorders, 84, 267–72.CrossRefGoogle Scholar
, , (2006). Clinical correlates associated with treatment-emergent mania. Poster presentation, American Psychiatric Association, Toronto.Google Scholar
, , et al. (2006). Summary of the International Society for Bipolar Disorders Diagnostic Guidelines Task Force Report. Bipolar Disorders, in review.Google Scholar
, and (2002). ‘Cade's disease’ and beyond: Misdiagnosis, antidepressant use, and a proposed definition for bipolar spectrum disorder. Canadian Journal of Psychiatry, 47, 125–34.CrossRefGoogle Scholar
, , et al. (2005). Sensitivity and specificity of a new bipolar spectrum diagnostic scale. Journal of Affective Disorders, 84, 273–7.CrossRefGoogle Scholar
Ghaemi, S. N., Saggese, B. A. and Goodwin, F. K. (2006). Diagnosis of Bipolar Depression. In Bipolar Depression, ed. and . Washington, DC: American Psychiatric Publishing.Google Scholar
, , , and (2004). Antidepressants for bipolar depression: a systematic review of randomized, controlled trials. American Journal of Psychiatry, 161, 1537–47.CrossRefGoogle ScholarPubMed
and (2003). Antidepressant-induced mania: an overview of current controversies. Bipolar Disorders, 5, 407–20.CrossRefGoogle ScholarPubMed
(2005). Prevalence and effects of mood disorders on role performance in the United States. Presented at the annual meeting of the International Society for Bipolar Disorders, Pittsburgh, PA.Google Scholar
, and (2003). The bipolar spectrum: a clinical perspective. Bipolar Disorders, 5, 436–42.CrossRefGoogle ScholarPubMed
, , et al. (2006). Risk of switch in mood polarity to hypomania or mania in patients with bipolar depression during acute and continuation trials of venlafaxine, sertraline, and bupropion as adjuncts to mood stabilizers. American Journal of Psychiatry, 163, 232–9.CrossRefGoogle ScholarPubMed
and (2006). Affective instability as rapid cycling: theoretical and clinical implications for borderline personality and bipolar spectrum disorders. Bipolar Disorders, 8, 1–14.CrossRefGoogle ScholarPubMed
, , and (2006). Diagnostic guidelines for Bipolar I depression: A probabilistic approach. Bipolar Disorders, in review.Google Scholar
(2005). Unipolar depression/bipolar depression: connections and controversies. International Review of Psychiatry, 17, 39–47.CrossRefGoogle ScholarPubMed
and (2004). The bipolar spectrum: Diagnostic and pharmacologic considerations. Expert Review of Neurotherapeutics, 4 (Suppl. 2), S3–8.CrossRefGoogle ScholarPubMed
, , and (2006). SSRIs as mood stabilizers for Bipolar II Disorder? A proof of concept study. Journal of Affective Disorders, 92, 205–14.CrossRefGoogle ScholarPubMed
Phelps, J. (2005a). Using the MDQ in Primary Care: Predictive value of the test results. http://www.psycheducation.org/PCP/mdqSensSpec.htm, accessed 12/7/2006.
(2005b). Agitated dysphoria after late-onset loss of response to antidepressants: a case report. Journal of Affective Disorders, 86, 277–80.CrossRefGoogle Scholar
Phelps, J. (2006). Depression is not a moral weakness. http://www.psycheducation.org/mechanism/MechanismIntro.htm, accessed 12/7/06.
, , and (2006). Validity and utility of the Bipolar Spectrum. Bipolar Disorders, in review.Google Scholar
and (2006). Improving the diagnosis of bipolar disorder: predictive value of screening tests. Journal of Affective Disorders, 92, 141–8.CrossRefGoogle Scholar
, , , and (1981). Prophylactic lithium carbonate with and without imipramine for Bipolar I patients. A double-blind study. Archives of General Psychiatry, 38, 902–7.CrossRefGoogle ScholarPubMed
and (2006). Bipolar II and the bipolar spectrum. Nordic Journal of Psychiatry, 60, 7–26.CrossRefGoogle ScholarPubMed
and (1979). Tricyclics modulate frequency of mood cycles. Chronobiologia, 6, 377–85.Google ScholarPubMed
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