Comparing treatment outcomes of bipolar patients between psychiatry residents and attending physicians.

Objective: The authors sought to compare the outcomes of patients treated by psychiatric residents and attending psychiatrists.

Method: Charts of 121 outpatients meeting criteria for bipolar spectrum disorder were analyzed. Residents treated 41, and attending physicians 80, of 121 patients.

A 20-month, double-blind, maintenance trial of lithium versus divalproex in rapid-cycling bipolar disorder.

Objective: The authors tested the hypothesis that divalproex would be more effective than lithium in the long-term management of patients with recently stabilized rapid-cycling bipolar disorder.

Method: A 20-month, double-blind, parallel-group comparison was carried out in recently hypomanic/manic patients who had experienced a persistent bimodal response to combined treatment with lithium and divalproex. Sixty patients were randomly assigned to lithium or divalproex monotherapy in a balanced design after stratification for illness type (bipolar I versus bipolar II disorder).

Gender differences in criminality: bipolar disorder with co-occurring substance abuse.

Outpatient interviews to collect criminal history data were conducted with 55 women and 77 men who had the dual diagnosis of rapid-cycling bipolar disorder with co-morbid substance abuse disorders (DD-RCBD), to ascertain gender-related similarities and differences. Fifty-three percent of women and 79 percent of men reported that they had been charged with a crime, and nearly half of those charged had been incarcerated. Men with DD-RCBD were more likely to have committed a felony and had a trend of committing more misdemeanors.

Bipolar disorders and the effectiveness of novel anticonvulsants.

The discovery that valproic acid is helpful in the management of patients with rapid-cycling bipolar disorder led to an explosion of research culminating in the third-generation anticonvulsants. Refractory depressive phases are frequent in bipolar disorders. No studies to date have shown that gabapentin is effective in bipolar mania or hypomania.