Bipolar I Disorder

Diagnostic criteria

Bipolar I disorder most often starts with depression( 75 %

of the time in women and 67% in men) and is a recurring
disorder.
Most patients experience both depressive and manic
episodes
The manic episodes typically have a rapid onset(hours or
days) but may evolve over a few weeks.
An untreated manic episode lasts about 3 months;
therefore
Clinicians should not discontinue giving drugs before that

Prognosis
Patients with bipolar I disorder have a poorer prognosis
than do patients with major depressive disorder.
40-50% may have a second manic episode within 2
years of the first episode.
50-60% achieve significant control of their symptoms
with LITHIUM

Treatment
Treatment of patients with mood disorders should be
directed toward several golad.
1st, the patients safety must be guaranteed
2nd, a complete diagnostic evaluation of the patient is
necessary
3rd, a treatment plan that addresses not only the
immediate sypmtoms but also the patients prospective
well being should initiated.

Hospitalization
The first and most critical decision a physician must
make is whether to hospitalize a patient or attempt
outpatient treatment.
Risk of Suicide or homicide- clear indications for
hospitalization

Psychosocial Therapy
Three types of short-term psychotherapies
1. Cognitive therapy- The goal is to alleviate depressive
episodes and prevent their recurrence by helping
patients identify and test negative cognitons; Develop
alternative, flexible and postive ways of thinking; and
rehearse new cognitive and behavioral responses
2. Interpersonal therapy-