Bipolar spectrum: consequences for the development of services

Author/s
Mark Agius
Citation
Issue 3 Summer 2013
CEPiP.2013;1:351-353
Abstract

There is a strong case for providing specialist services and structured clinics to manage bipolar disorder and mixed affective states, particularly to reduce suicide risk. Because mood can be very changeable in this disorder, especially in mixed affective states and rapid cycling bipolar disorder, the service must be responsive, implying that fixed occasional outpatient appointments might not constitute adequate management. A flexible approach is needed with a service that is tailored to the individual.

Keywords: bipolar disorders, suicide risk, design of services

Cite as: Cutting Edge Psychiatry in Practice 2013, 3(1):351-353; https://doi.org/10.65031/tcbq1547

References

  1. NICE Bipolar Illness Guidelines, 2006.           
  2. Rihmer Z Akiskal H: Do antidepressants t[h]reat[en] depressives? Towards a clinically judicious formulation of the antidepressant-suicidality FDA advisory in light of declining national suicide statistics from many countries. J Affect Disord 2006; 94:3-13. https://doi.org/10.1016/j.jad.2006.04.003
  3. Masand P, Mago R Review: in people with bipolar disorder, short term antidepressants improve clinical response, although tricyclics risk inducing mania. Evid Based Ment Health. 2005 ;8:35. https://doi.org/10.1136/ebmh.8.2.35
  4. Akiskal HS, Benazzi F, Perugi G, Rihmer Z: Agitated ‘unipolar’ depression re-conceptualised as a depressive mixed state; implications for the antidepressant-suicide controversy. J.Affect.Disord 2005, 85;245-258. https://doi.org/10.1016/j.jad.2004.12.004
  5. Ho J, Singh S, Agius M, Zaman R. Mixed affective states: a study within a community mental health team with treatment recommendations. Psychiatr Danub. 2011;23 Suppl 1:S25-8 https://doi.org/10.1016/s0924-9338(11)71899-5
  6. Agius M, Bugler R, Tavormina G, Zaman R.The bipolar spectrum: do we need a single algorithm for affective disorders? Psychiatr Danub. 2010 ;22:450-1. 353 https://doi.org/10.1016/s0924-9338(09)70839-9