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Overview
Although depression is the most common presentation of bipolar disorder, correct diagnosis presents a formidable challenge. Bipolar Depression introduces a model for diagnosis that allows the clinician to distinguish between bipolar and unipolar depression, addressing problems of misdiagnosis and overdiagnosis, as well as differentiate attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder. The contributors first review neurobiology and genetics, bipolar depression in children, and considerations regarding suicide, then offer critiques of specific treatment approaches.
This valuable volume focuses on the use of lithium and antiepileptic drugs, featuring a review of the most recent research on the former, for which higher doses are shown to be effective; antidepressants, offering a discussion of the randomized clinical trial literature and observational studies; and antipsychotics, evaluating the difference between first- and second-generation medications. Other chapters assess novel approaches to treatment such as atypical neuroleptics, electroconvulsive therapy, transcranial magnetic stimulation, and ketogenic diet; as well as psychological interventions, focusing on the inclusion of cognitive-behavioral therapy or interpersonal social rhythm therapy. Together, these chapters constitute a summary of the most recent research that opens new doors in recognizing differences between bipolar and unipolar forms of depression while offering key insights into the management of this illness.
American Psychiatric Publishing
Synopsis
Although depression is the most common presentation of bipolar disorder, correct diagnosis generally requires a history of mania and thus presents a formidable challenge. This book provides clinicians with the necessary guidance to distinguish this illness and pursue an appropriate therapeutic course. It brings together a team of clinical investigators who offer cutting-edge research on the topic and address the most critical concerns regarding its treatment.
Bipolar Depression first introduces a hierarchical model for diagnosis to allow the clinician to distinguish between bipolar and unipolar depression, addressing problems of misdiagnosis and overdiagnosis as well as differentiating attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder. Early chapters review the neurobiology and genetics of this highly heritable condition, presenting studies of neurotransmitter function and brain imaging studies and documenting the susceptibility of specific chromosomes as loci for bipolar disorder. Other chapters address the particular issues of bipolar depression in children, for whom a diagnosis is especially problematic, and suicide, focusing on the need for assessment during both acute and maintenance treatment with interventions appropriate to a patient's symptoms and history. Bipolar Depression offers critiques of specific treatment approaches: Β Lithium and antiepileptic drugs: featuring a review of the most recent research on the use of lithium, in which higher doses are shown to be effective, plus coverage of lamotrigine, valproic acid, carbamazepine, oxcarbazepine, and topiramate.Β Antidepressants: offering new perspectives on a complex field, including a discussion of the randomized clinical trial literature and observational studies on their use, and citing cautions regarding side effects.Β Antipsychotics: evaluating the difference between first- and second-generation medications and discussing their role in controlling acute depressions.Β Novel approaches to treatment: including the use of atypical neuroleptics, electroconvulsive therapy, transcranial magnetic stimulation, vagus nerve stimulation, ketogenic diet, omega-3 fatty acids, myo-inositol, and dopamine agonists.Β Psychological interventions: focusing on the inclusion of cognitive-behavioral therapy or interpersonal social rhythm therapy for nonmelancholic depressions in patients who had previously received psychoeducation.
Despite the past decade's advances in practice and research, there remains much room for progress in understanding and treating bipolar depression. This book blazes a trail toward that goal, opening new doors in recognizing differences between bipolar and unipolar forms of depression while offering both researchers and clinicians key insights into this troubling illness.
Editorials
From The Critics
Reviewer: Jeffrey Rado, MD(Rush University Medical Center)Description: This is a clinical guide covering the diagnosis, biology, and treatment of bipolar depression. Additional sections cover genetics and childhood bipolar depression.
Purpose: Although there is no preface, ostensibly the goal of this book is to provide clinicians with a practical and comprehensive update on bipolar depression.
Audience: The audience likely is psychiatry residents and psychology students as well as practicing psychiatrists. It is probably too detailed and focused to appeal to primary care providers or medical students.
Features: The book is divided into four sections covering diagnostic issues, biological factors, treatment, and special topics (suicide and childhood bipolar depression). It is clearly written without a lot of jargon. A large amount of research data, particularly the genetic studies, is summarized in depth yet very clearly, so a nongeneticist can understand this area of research. Each chapter is broken down into well organized section headings.
Assessment: This is an excellent, easy to read review of this topic. I would have liked more graphs, charts or other visual aids, however. There could have been more coverage of the use of antipsychotics in bipolar depression. A strength of the guide is that it is heavily evidence-based. Rarely are anecdotes or the personal opinion of the authors presented. Rather, the focus is on what the studies actually can tell us. There is a lot of helpful information and advice on how to make the sometimes tricky diagnosis of bipolar depression in both adults and children.