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Stabilization in the treatment of mania, depression and mixed states

Published online by Cambridge University Press:  18 September 2015

D.J. Kupfer ,
E. Frank ,
V.J. Grochocinski ,
J.F. Luther ,
P.R. Houck ,
H.A. Swartz  and
A.G. Mailinger
D.J. Kupfer*
Affiliation:
University of Pittsburgh School of Medicine, Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, U.S.A.
E. Frank
Affiliation:
University of Pittsburgh School of Medicine, Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, U.S.A.
V.J. Grochocinski
Affiliation:
University of Pittsburgh School of Medicine, Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, U.S.A.
J.F. Luther
Affiliation:
University of Pittsburgh School of Medicine, Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, U.S.A.
P.R. Houck
Affiliation:
University of Pittsburgh School of Medicine, Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, U.S.A.
H.A. Swartz
Affiliation:
University of Pittsburgh School of Medicine, Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, U.S.A.
A.G. Mailinger
Affiliation:
University of Pittsburgh School of Medicine, Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, U.S.A.
*
Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic 3811 O'Hara Street, Pittsburgh PA 15213, United StatesTel 412-624-2353, Fax 412-624-8015, E-mail [email protected]
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Abstract

While one major need for improved therapeutic approaches in bipolar disease is the development of long-term treatment strategies, a systematic approach during the acute phase of bipolar disorder is also required. In our own studies we have arbitrarily divided the initial treatment of subjects by the predominant polarity for which they are treated acutely: manic, depressed, or mixed/cycling.1 In this larger investigation of over 150 patients with bipolar disorder, we now demonstrated again that the time to initial stabilization is generally the shortest with a manic episode and the longest with a mixed/cycling episode with the depressed episode in the middle (although almost as long as the mixed/cycling episode). These findings indicate the difficulty of treating both the depressed phase and mixed/cycling episodes in bipolar disorder. It is also noteworthy that gender does not have a significant effect on time to stabilization. Such findings in the acute phase have profound implications in designing and carrying out long-term therapeutic strategies for this disorder.

Keywords

stabilizationmanicdepressedmixed/cyclingsurvival analysisgender
Type
Articles
Information
Acta Neuropsychiatrica , Volume 12 , Issue 3 , September 2000 , pp. 110 - 114
Copyright
Copyright © Scandinavian College of Neuropsychopharmacology 2000

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References

1.Hlastala, SA, Frank, E, Mallinger, AG.Thase, ME. Ritenour, AM. Kupfer, DJ. Bipolar depression: An underestimated treatment challenge. Depr Anxiety 1997:5:73–83.3.0.CO;2-6>CrossRefGoogle ScholarPubMed
2.Keller, MB. Lavori, PW. Coryell, W. Andreasen, NC. Endicott, J. Clayton, PJ. Klerman, GL. Hirschfeld, RMA. Differential outcome of pure manic, mixed/cycling. and pure depressive episodes in patients with bipolar illness. JAMA 1986:255:3138–3142.CrossRefGoogle ScholarPubMed
3.Prien, RF, Rush, AJ. National Institute of Mental Health workshop report on the treatment of bipolar disorder. Biol Psychiatry 1996:40:215–220.CrossRefGoogle ScholarPubMed
4.Potior, WZ. Bipolar depression: Specific treatments. J Clin Psychiatry 1998:59:30–36.Google Scholar
5.Frank, E. Swartz, HA. Kupfer, DJ. Interpersonal and social rhythm therapy: Managing the chaos of bipolar disorder. Biol Psychiatry, in press.Google Scholar
6.Frank, E. Swartz, HA. Mallinger, AG. Thase, ME. Weaver, EV. Kupfer, DJ. Adjunctive psychotherapy for bipolar disorder: Effects of changing treatment modality. J Abnorm Psychol 1999:108:579–587.CrossRefGoogle ScholarPubMed
7.Hamilton, M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960:23:56–62.CrossRefGoogle ScholarPubMed
8.Bech, P. Bolwig, TG. Kramp, P. Rafaelsen, OJ. The Bech-Rafaelsen Mania Scale and the Hamilton Depression Scale. Acta Psychiatr Scand 1979:59:420–430.CrossRefGoogle ScholarPubMed
9.Endicott, J. Spitzer, RL. A diagnostic interview:The Schedule for Affective Disorders and Schizophrenia. Arch Gen Psychiatry 1978:35:837–844.CrossRefGoogle ScholarPubMed
10.Spitzer, RL. Endicott, J. Robbins, E. Research diagnostic criteria: Rationale and reliability. Arch Gen Psychiatry 1978:35:773–782.CrossRefGoogle ScholarPubMed
11.Thase, ME. Carpenter, L. Kupfer, DJ. Frank, E. Clinical significance of reversed vegetative subtypes of recurrent major depression. Psychopharmacol Bull 1991:27:17–22.Google ScholarPubMed
12.Maliinger, AG. Frank, E. Barwell, MM. Thase, ME. Kupier, DJ. Effectiveness of traditional antidepressants is suboptimal in the depressed phase of bipolar disorder. Proceedings of the Annual Meeting: New Clinical Drug Evaluation Unit Program. 1999.Google Scholar
13.Himmelhoch, JM. Thase, ME. Mallinger, ACJ. Houck, P. Tranylcypromine versus imipramine in anergic bipolar depression. Am J Psychiatry 1991:148:910–916.Google ScholarPubMed
14.Thase, ME. Mailinger, AG. McKnight, D. Himmelhoch, JM. Treatment of imipramine-resistant recurrent depression. IV: A double-blind, crossover study of tranylcypromine for anergic bipolar depression. Am J Psychiatry 1992:149:195–198.Google Scholar
15.Frank, E (ed). Gender and Its Effects on Psychopathology. Washington. DC. American Psychiatric Press. Inc., 2000.Google Scholar
16.Frank, E. Interpersonal and social rhythm therapy prevents depressive symptomatology in bipolar I patients (Abstract). Bipolar Disorders 1999:1 (Suppl 1):13.Google Scholar