Handbook of Bipolar Disorder: Diagnosis and Therapeutic Approaches PDF

Preface

Bipolar disorder is one of the most frequent psychiatric diseases and together with other bipolar spectrum disorders, affects three to five percent of the population. If untreated or improperly treated, patients with bipolar disorder face a lower life expectancy and an altogether lower quality of life. Recent data on diagnosis and epidemiology reveal that, apart from Bipolar I and Bipolar II, further diseases of the bipolar spectrum that are of broad clinical relevance can be diagnosed. Recent data indicate that if patients remain untreated, as is all too often the case, they have a higher morbidity and mortality even if psychiatric causes such as suicidality are excluded.

The underlying biology of bipolar disorder recently revealed new insights into neuropeptides and signal transduction. The importance of intracellular mechanisms has further been substantiated by molecular biology techniques. Brain imaging is a link to everyday clinical practice since it demonstrates where changes are located in patients. Using the technique of newer brain imaging methodology, it is possible to uncover small and functionally important changes, which together with molecular genetics—now termed molecular neuroimaging—shape a promising new field of research.

There is a huge amount of literature available on new treatments for bipolar disorder in various clinical states. These situations include mania, bipolar depression, mixed state, rapid cycling, and also the long-term perspective with the goal of mood stabilization. The treatment of patients with schizoaffective disorder and the treatment of bipolar disorder in children, as well as those in late life, add another important perspective to specific treatment procedures.

In the past, only lithium and antiepileptics of the first generation and mood stabilizers were available, while now there are a number of new antiepileptic medications as well as atypical antipsychotics on the market. Despite sometimes being in a quite deteriorated state, a large number of manic patients still receive typical neuroleptics, mostly in a depot fashion. However, this practice has been questioned recently with the newer compounds available. Antidepressants are used in bipolar disorder together with atypical antipsychotics and mood stabilizers, and there is a question of when to use and of how long to use this group of medications. New treatment options include the group of atypical antipsychotics and mood stabilizers, probably together as a combination therapy.

Besides pharmacotherapeutic approaches, psychotherapeutic interventions such as social role therapy or social rhythm therapy have also been studied for bipolar disorder in a controlled design.

This book provides an accessible and expert summary of state-of-the-art knowledge in various currently relevant issues regarding diagnosis and treatment of bipolar disorder, with a special emphasis on novel treatment applications. The existing theories are reviewed and clinically relevant applications given. The book is structured in four main parts; diagnosis and epidemiology, biology, treatment in typical clinical situations, and treatment approaches by the different methodology used. This enables the reader to focus either on diagnostic procedures, underlying biology, or most importantly the treatment perspectives.

The chapters have been written by authorities in various aspects of psychiatric research and aim to reach an audience comprising physicians and basic scientists in various psychiatric specialties as well as doctors in neurology and hope to be of importance for public health considerations. The book should be of particular interest also for policy makers who seek a comprehensive and current source of basic spectra and treatment implications of this disorder. Such a volume should, from our point of view, prove to be attractive for individuals as well as libraries around the world.