Reiser / Thompson / Johnson Bipolar Disorder

2. Auflage 2017
ISBN: 978-1-61334-410-1
Verlag: Hogrefe Publishing
Format: EPUB
Kopierschutz: 6 - ePub Watermark

E-Book, Englisch, 124 Seiten

Reihe: Advances in Psychotherapy - Evidence-Based Practice

An extensively updated new edition of the acclaimed guide to

treatment of bipolar disorder, incorporating the latest research on

psychosocial treatments and clear medication management

guidelines.

This extensively updated new edition of the acclaimed book in the

Advances in Psychotherapy series integrates empirical research from

the last 10 years to provide clear and up-to-date guidance on the

assessment and effective treatment of bipolar disorder. The expert

authors, a team of psychotherapists and medical practitioners,

begin by describing the main features of bipolar disorder based on

DSM-5 and ICD-10 criteria. Current theories and models are

described, along with decision trees for evaluating the best

treatment options. They then outline a systematic, integrated, and

empirically supported treatment approach involving structured,

directive therapy that is collaborative and client-centered as well as

clear medication management guidelines. Special considerations,

including managing suicide risk, substance misuse, and medication

nonadherence, are also addressed. This compact, stand-alone

resource aims to help psychotherapists, psychologists, medical and

psychiatric practitioners, and nurses deliver the highest standards of

care for people with bipolar disorder.

Zielgruppe

Clinical psychologists, psychiatrists, psychotherapists, and
counselors, as well as students.

Autoren/Hrsg.

Reiser, Robert P.

Thompson, Larry W.

Johnson, Sheri L.

Suppes, Trisha

Fachgebiete

• Sozialwissenschaften Psychologie Psychotherapie / Klinische Psychologie Verhaltenstherapie
• Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Medizinische Fachgebiete Psychiatrie, Sozialpsychiatrie, Suchttherapie
• Sozialwissenschaften Psychologie Psychotherapie / Klinische Psychologie Psychopathologie

Leseproben

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Description
Many people who are diagnosed with bipolar disorder are initially referred for medication treatment, with little consideration of psychosocial treatments. Many therapists worry about their capacity to treat bipolar disorder, as they are keenly aware of potential risks and (correctly) accept that medications are the first line of treatment. Reluctance to treat this disorder has increased therapists’ doubts about treating bipolar disorder in private practice settings. When you consider how many facets of life and well-being are influenced by bipolar disorder, though, this would seem to be the perfect disorder to target for psychosocial treatment. Indeed, our own personal experiences suggest that, armed with some humility and some appreciation for the severity of the challenges, along with a well-stocked toolkit, helping people with bipolar disorder gain back a sense of control, promoting understanding of the disorder and its triggers, and considering ways to rebuild life domains damaged by episodes, is an incredibly rewarding endeavor. This book attempts to give the practitioner a firm foundation and background to undertake this work. Because accurate diagnosis is a foundation for successful treatment, we begin by considering the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; APA, 2013), with fine-grained attention to differential diagnosis and the implications for clinical practice. Based on growing evidence of partial genetic overlap between schizophrenia and bipolar disorder, “Bipolar and related disorders” is now a separate chapter in the DSM-5. Some additional small changes were made in the criteria set, discussed below and throughout the book, based upon the best available evidence. 1.1 Terminology
Bipolar disorder (BD), previously known as manic depressive illness, is a mood disorder defined by manic symptoms of varying severity. Most people with BD will also experience depressive symptoms. Manic symptoms may involve changes in energy, impulsivity, behavior, and cognition. BD is usually characterized by an episodic course throughout the lifetime, resulting in significant impairment in social, interpersonal, and occupational functioning. Emil Kraepelin compiled an enduring set of observations regarding the presentation and course of illness for patients with manic-depressive illness (Kraepelin, 1921), and many of the manic symptoms he observed continue to be featured in diagnosis. The DSM-5 (APA, 2013) and the International Classification of Diseases of the World Health Organization (|2|Maier & Sandmann, 1993) are the major systems in use internationally (see online materials for comparison). In the DSM-5, bipolar disorders (BDs) are grouped into the following mutually exclusive categories depending upon the severity and duration of symptoms during the lifetime. Bipolar I disorder (BD I) is characterized by at least one manic episode during the lifetime. Manic episodes, in turn, are defined by manic symptoms of sufficient severity to cause marked impairment in social and occupational functioning, to result in a psychiatric hospitalization, or to involve psychosis. Bipolar II disorder (BD II) is characterized by at least one hypomanic episode, as well as one or more major depressive episodes, during the lifetime. Hypomanic episodes are defined by manic-type symptoms in which symptoms are not long in duration nor as severe to cause marked impairment in social or occupational functioning, to warrant psychiatric hospitalization, or to involve psychosis. Depression episodes may be associated with psychotic symptoms, though this is seen less frequently then in patients with BD I depression. Cyclothymic disorder is characterized by mood instability over a 2-year period (or one year in children and adolescents) with hypomanic and depressed symptoms that do not meet full criteria for a manic episode or a major depressive episode. Substance/medication-induced bipolar and related disorder is defined by mood symptoms that have been triggered by use of or withdrawal from substances. Bipolar and related disorder due to another medical condition is defined by manic type symptoms that appear to be consequent to a medical condition. Other specified bipolar and related disorders has replaced the Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR (4th ed.) (DSM-IV-TR; APA, 2000) category of “Not otherwise specified.” This category is now used to note four subcategories that do not meet full criteria for one of the above listed disorders: Short-duration hypomanic episodes (2–3 days) and major depressive episodes; hypomanic episodes with insufficient symptom count and major depressive episodes; hypomanic episode without a history of major depression episodes; and short-duration cyclothymia (less than 24 months). Unspecified bipolar and related disorders is intended for temporary use when insufficient information is available but it appears likely the person has some manic symptom history. Specifiers, which have changed significantly in DSM-5, are used to denote important elements about the presentation or course of illness. Most specifiers are used for BD I and BD II illnesses, with some applicable to the other bipolar diagnoses. Current specifiers include: With anxious distress (new to DSM-5) With mixed features (new to DSM-5, applies to manic/hypomanic or depressive episodes) With rapid cycling With melancholic features |3|With atypical features With psychotic features, which can be mood-congruent or mood-incongruent With catatonia With peripartum onset, which now includes peripartum as well as postpartum within 4 weeks of delivery With seasonal pattern (applies to depressive, hypomanic, and manic symptoms now) Further course specifiers: In partial remission or full remission Mild, moderate, or severe severity The specifiers have significantly changed in DSM-5 compared to DSM-IV-TR. The new mixed features specifier is an important change in DSM-5. In an improvement over DSM-IV-TR, symptoms like irritability, distractibility, and agitation that are common to mania and depression, are not used in the mixed feature specifier criteria. Mixed states are important to detect, as they are related to the higher likelihood of suicidal behavior. Increased energy during depressive periods could also foster impulsive behaviors. 1.2 Definition
Table 1 presents the criteria for a manic episode or a hypomanic episode as described in the DSM-5. Increased activity or energy was added as a cardinal symptom in DSM-5, in part because this may be more reliably reported than mood states. BD II criteria require the presence of at least one episode of major depression. Table 2 presents the criteria for a DSM-5 diagnosis of a major depressive episode. Although the diagnosis of BD I does not require the presence of an episode of major depression, the majority of people who experience manic episodes will experience at least one or more episodes of depression during their lifetime. Depressive and manic episodes can and do co-occur, and the mixed feature specifier is used when at least three symptoms of the opposite pole are present (see Table 3). Over time, the DSM has given increasing attention to bipolar spectrum disorders. Cyclothymic disorder was introduced in DSM-III, and BD II was introduced in DSM-IV. As with BD I, both are considered long-term conditions. Accurate detection of bipolar spectrum disorders may require observing fluctuations over time. BD II is not just a subthreshold or a “light” version of BD I. This condition is stable over time, and involves significant depressive episodes, levels of functional impairment, and...