Lesem MD, Tran-Johnson TK, Riesenberg RA, Feifel D, Allen MH, Fishman R, et al. DIFFERENTIAL DIAGNOSIS. Differential Diagnosis of Bipolar disorder Differential Diagnosis: Bipolar disorder “There are a variety of illnesses that are similar to bipolar disorder, but with less severe upswings,” says NIMH’s Dr. Francis J. McMahon. Frye MA, Nassan M, Jenkins GD, Kung S, Veldic M, Palmer BA, et al. Tkachev D, Mimmack ML, Ryan MM, Wayland M, Freeman T, Jones PB, et al. Mania-like behavior induced by disruption of CLOCK. American Psychiatric Association.
Background: Patients with bipolar disorder spend approximately half of their lives symptomatic and the majority of that time suffering from symptoms of depression, which complicates the accurate diagnosis of bipolar disorder. 2011;Online ahead of print. Relationship of prior antidepressant exposure to long-term prospective outcome in bipolar I disorder outpatients. Epub 2008 Aug 12.Narayan AJ, Chen M, Martinez PP, Gold PW, Klimes-Dougan B.Aggress Behav.
Doctors have come a long way in fully understanding different moods in bipolar disorder and in making an accurate diagnosis. Confounding syndromes of delirium and dementia often present difficulties in accurate diagnosis. Lifetime prevalence of BD appears uniform across cultures and similar between men and women.In as many as 10% of patients with BD, the illness develops after the age of 50.The evaluation of manic symptoms or episodes in an older adult requires a thorough differential diagnosis to accurately determine the cause and to guide appropriate treatment (In patients with MMSE scores of less than 15, the diagnosis of mania is especially problematic, particularly in distinguishing mania from dementia, delirium, or agitated depression.Unfortunately, the literature is lacking regarding the clinical presentation of geriatric bipolar depression and how or whether it may be distinguished from bipolar depression in a younger population.Most of what we know about the treatment of BD comes from randomized, controlled clinical trials in adult or mixed-age populations.
COVID-19 is an emerging, rapidly evolving situation. Dubovsky S. The real risk for suicide in mental disorders.
Does stage of illness impact treatment response in bipolar disorder?
Antidepressants for the acute treatment of bipolar depression: a systematic review and meta-analysis.
Available at Marcotte D. Use of topiramate, a new anti-epileptic as a mood stabilizer. multi-ethnic genome wide association study of bipolar disorder. Available at Hamrin V, Iennaco JD. Available at Zhang D, Cheng L, Qian Y, Alliey-Rodriguez N, Kelsoe JR, Greenwood T, et al. Neuropsychopharmacology. Risk factors for secondary substance use disorders in people with childhood and adolescent-onset bipolar disorder: opportunities for prevention. Mania or major depression with anxious features should be considered when a patient is known to have had prior mood disorders. Barnett JH, Huang J, Perlis RH, Young MM, Rosenbaum JF, Nierenberg AA, et al. Assessment of the effect of age at onset on linkage to bipolar disorder: evidence on chromosomes 18p and 21q.
The diagnosis of bipolar disorder, or manic-depressive illness (MDI), is based on the patient’s history and clinical course.Other conditions to be considered include the following:Medications (eg, antidepressants can propel a patient into mania; other medications may include baclofen, bromide, bromocriptine, captopril, cimetidine, corticosteroids, cyclosporine, disulfiram, hydralazine, isoniazid, levodopa, methylphenidate, metrizamide, procarbazine, procyclidine)Substance abuse disorders (eg, with alcohol, amphetamines, cocaine, hallucinogens, opiates)Bowden C, Singh V. Long-term management of bipolar disorder.
Angst J, Gamma A, Bowden CL, Azorin JM, Perugi G, Vieta E, et al.
Ekholm JM, Kieseppä T, Hiekkalinna T, Partonen T, Paunio T, Perola M, et al. Volavka J. However, as with gabapentin, topiramate and levetiracetam have failed in industry-supported studies of acute mania. A randomized add-on trial of an N-methyl-D-aspartate antagonist in treatment-resistant bipolar depression. Tohen M, Chengappa KN, Suppes T, Zarate CA Jr, Calabrese JR, Bowden CL, et al.
Instead, the diagnosis is based upon a medical and psychiatric history and a physical and mental status examination. Post RM, Speer AM, Hough CJ, Xing G. Neurobiology of bipolar illness: implications for future study and therapeutics. Bartzokis G. Neuroglialpharmacology: myelination as a shared mechanism of action of psychotropic treatments. Grozeva D, Kirov G, Ivanov D, Jones IR, Jones L, Green EK, et al. Bradford DW, Kim MM, Braxton LE, Marx CE, Butterfield M, Elbogen EB. Because of the absence of duration criteria for mania in DSM-III-R, the differential diagnosis within the bipolar disorders is largely based on severity and duration of depression.
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