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Bipolar Disorder: A Biopsychosocial Overview

Bipolar Disorder: A Biopsychosocial Overview. mdl.psych.northwestern.edu. Source: Touched by Fire, Jamison, 1996. Bipolar Disorder: Epidemiology. Elevated suicide, divorce, work impairment, substance use 6 th leading cause of disability worldwide (Murray & Lopez, 1996).

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Bipolar Disorder: A Biopsychosocial Overview

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  1. Bipolar Disorder: A Biopsychosocial Overview

  2. mdl.psych.northwestern.edu

  3. Source: Touched by Fire, Jamison, 1996

  4. Bipolar Disorder: Epidemiology • Elevated suicide, divorce, work impairment, substance use • 6th leading cause of disability worldwide(Murray & Lopez, 1996). • Accounts for nearly half the inpatient mental health care costs in the US (Kent et al., 1995).

  5. Roadmap: A series of Questions • Four Questions about Bipolar Disorder • What is it? • 2. What is its stigma? • 3. Is there a blood test? • 4. What are its treatments?

  6. Roadmap: A series of Questions • Four Questions about Bipolar Disorder • What is it? • 2. What is its stigma? • 3. Is there a blood test? • 4. What are its treatments?

  7. Mood disorder involving severe mood swings Depression Mania

  8. Severity ~ 2-4 percent of population has bipolar spectrum diagnosis

  9. Misdiagnosis of Bipolar Disorder 60 26 % of Patients Misdiagnosed 18 17 14 11 Unipolar Depression Anxiety Disorder Subst. Abuse Schiz Personality Disorder Schizo- Affective Hirschfeld, et al. J Clin Psychiatry 64: 161-174, 2003

  10. Age-of-Onset of Bipolar Disorder Pediatric Bipolar Disorder - 10-20% onset < 10 yo - Controversial (40-fold increase) - Difficult to differentiate from ADHD

  11. Roadmap: A series of Questions • Four Questions about Bipolar Disorder • What is it? • 2. What is its stigma? • 3. Is there a blood test? • 4. What are its treatments?

  12. Predicts worse course and social isolation • Limit social interactions • Social isolation in caregivers Grief for the Loss of the Healthy Self

  13. Roadmap: A series of Questions • Four Questions about Bipolar Disorder • What is it? • 2.What is its stigma? • 3. Is there a blood test? • 4. What are its treatments?

  14. PFC PFC Limbic Limbic - Common to many psychiatric disorders - Biology of positive emotion may yield cues more specific to bipolar

  15. ‘Wanting’ Circuit in the Brain Ventral Striatum Bipolar disorder characterized by a hypersensitivity in the wanting circuit

  16. Reward-Processing in Bipolar Disorder

  17. Reward-Related Brain Activity: MDD < Comparison Comparison MDD Forbes et al., 2009, Am J Psychiatry • Bipolar disorder and unipolar depression characterized by distinct profiles in the wanting or reward circuit • Biomarkers and treatment

  18. Roadmap: A series of Questions • Four Questions about Bipolar Disorder • What is it? • 2.What is its stigma? • 3. Is there a blood test? • 4. What are its treatments?

  19. Bipolar disorder may not be curable but it is livable

  20. Psychosocial Treatments for Bipolar Disorder Cognitive Behavioral Therapy Family-Focused Therapy IPSRT

  21. mdl.psych.northwestern.edu

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