An ISBD perspective on the sociocultural challenges of managing bipolar disorder: A content analysis.

Objective: Clinical management of bipolar disorder patients might be affected by culture and is further dependent on the context of healthcare delivery. There is a need to understand how healthcare best can be delivered in various systems and cultures. The objective of this qualitative study was to gain knowledge about culture-specific values, beliefs and practices in the medical care provided to patients with bipolar disorders from a provider perspective in various areas of the world.

Are migraine and bipolar disorders comorbid phenomena?: findings from a pharmacoepidemiological study using the Norwegian Prescription Database.

Objectives: Clinical, epidemiological, and, recently, genome-wide linkage and genome-wide association studies suggest migraine and bipolar disorder are comorbid phenomena. The objective of this study was to determine whether there is also evidence that this comorbidity exists by virtue of there being a positive relationship between the prescription of medications used to treat migraine and mood-stabilizing agents using the National Norwegian Prescription Database.

Methods: Data allowing ascertainment of the concurrence of prescriptions for migraine and mood-stabilizing agents were gleaned from the Norwegian Prescription Database for calendar year 2006, covering the total population (N = 4,640,219).

Comorbidity of migraine with ADHD.

Objective: The purpose of this study was to investigate how often drugs used to treat migraine and ADHD are prescribed to the same patients to assess, indirectly, the comorbidity of these disorders.

Method: We used data from the Norwegian prescription database for 2006, including the total Norwegian population (N = 4,640,219).

Results: Antimigraine drugs were prescribed to 81,225 persons (1.

A pharmaco-epidemiological study of migraine and antidepressant medications: complete one year data from the Norwegian population.

Background: Migraine, depression and anxiety disorders have been associated with one another in several epidemiological studies. However, it is not known if or how these associations are reflected in the concurrent use of medications for migraine and depressive/anxiety disorders in the general population. The purpose of the present study was to identify groups of patients particularly likely to receive clinical treatment for both conditions.

An estimate of the minimum economic burden of bipolar I and II disorders in the United States: 2009.

Objective: To conduct an analysis yielding estimates of the direct and indirect costs accruing from bipolar I and II disorders in 2009. The last analysis of these costs pertained to 1991.

Methods: The analysis presented is based on recent epidemiological data, a measure of the increase in the cost of health care services and commodities between 1991 and December 31, 2009, a measure of the increase in the cost of living after partialing out of the costs of health care between 1991 and December 31, 2009 and adjustment for growth in the population of the United States between 1991 and 2009 to calculate the direct and indirect costs of bipolar I and II disorders.

Comorbidity of asthma with ADHD.

Objective: To assess how frequently drugs used to treat asthma and ADHD are prescribed to the same patients.

Method: The authors used data from the Norwegian Prescription Database for 2006, including the total Norwegian population (n = 4,640,219).

Results: Anti-asthma drugs were prescribed to 350,894 persons (7.

Migraine in affectively ill Mexican adolescents.

The objective of this cross-sectional study was to determine the prevalence of migraine headache among depressed Latino adolescents of Mexican American origin. This is, to the best of our knowledge, the first study of the prevalence of migraine among depressed adolescents of any ethnic/racial background. In a mental health clinic for the indigent, 132 consecutive Latino adolescents fulfilling the DSM-IV criteria for major depressive episode were compared with a sample of adolescents with other mental disorders.

Migraine headache in affectively ill latino adults of mexican american origin is associated with bipolarity.

Background: The objective of this cross-sectional study was to determine the prevalence of migraine headache among depressed Latino adults of Mexican American origin meeting the criteria for bipolar disorder (BPD) or major depressive disorder (MDD) relative to patients in a psychiatric comparison group.

Method: In a mental health clinic for the indigent, consecutively and systematically evaluated acutely depressed Latino adults received structured diagnostic psychiatric interviews based on modules extracted from the Structured Clinical Interview for DSM-IV. All were asked as part of routine assessment whether they had headaches "in the last week.

Is a family history of bipolar disorder a risk factor for migraine among affectively ill patients?

Aims: The aim was to determine whether having a family history of bipolar disorder (BPD) or unipolar major depressive disorder (MDD) is associated with an increased likelihood of having migraine headaches.

Methods: Latino adults received structured diagnostic interviews. Family history was determined by live interview of first-degree relatives or interview by proxy.

"Mixed hypomania" in children and adolescents: is it a pediatric bipolar phenotype with extreme diurnal variation between depression and hypomania?

Background: Although DSM-IV and the literature on pediatric bipolarity recognize mania and mixed phases neither recognizes states of "mixed hypomania." There has been preliminary presentation of the latter phenomenon in the adult bipolar literature. The authors herein describe this phenomenon in a consecutive clinical series of bipolar children and adolescents.

Treating depressive mixed States in bipolar disorders.

Although not recognized as a diagnostic entity in the DSM-IV-TR, mixed depression is a common clinical presentation. To treat depressive mixed states, clinicians in both Europe and the United States have developed valuable, yet different, therapeutic strategies. For example, the European model focuses on resolving patients' hypomanic symptoms, while the American model treats patients in depressive mixed episodes similarly to those who have bipolar II disorder.

Diagnosing depressive mixed states in bipolar disorders.

The presence of depressive mixed states among patients originally diagnosed with unipolar depression suggests that these patients may actually fall along the bipolar spectrum, which has significant treatment implications. To accurately detect mixed depression, physicians should systematically inquire about the presence of manic and hypomanic symptoms in a formal, structured manner when evaluating a depressed patient. This includes specifically asking patients about symptoms of irritability, racing or crowded thoughts, talkativeness, and psychomotor agitation.

Differential patterns of lifetime multiple anxiety disorder comorbidity between Latino adults with bipolar I and major depressive disorders.

Background: To determine the lifetime rates of panic disorder, obsessive-compulsive disorder (OCD), social phobia, and posttraumatic stress disorder (PTSD) among adult Latino patients with major depressive disorder (MDD) and bipolar disorder (BPD), and whether there are dose-response relationships between loading for comorbid anxiety disorders, the probability of having BPD, and attributes of severity of illness.

Methods: In a public sector clinic for the indigent located in a semiclosed rural community, 187 consecutively presenting affectively ill Latino patients were evaluated by use of the Structured Clinical Interview for DSM-IV. Polarity and the lifetime prevalence of panic disorder, OCD, social phobia, and PTSD were determined.

Pain complaints in latino adults of mexican origin with and without major depressive episode: a cross-sectional study.

Background: The aim of this retrospective, cross-sectional study was to determine the prevalence of 5 pain complaints among Latino adults of Mexican origin meeting the criteria for major depressive episode (MDE).

Method: In a mental health clinic for the indigent, consecutively evaluated Latino adults of Mexican origin received structured diagnostic psychiatric interviews based on modules extracted from the Structured Clinical Interview for DSM-IV Axis I Disorders-Clinical Version. All were specifically asked whether they had experienced headache, backache, abdominal pain, myalgia, or arthralgia "in the last week.

Mixed states: the most common outpatient presentation of bipolar depressed adolescents?

Background: The purpose of this study was to determine the rate of bipolar disorder in adolescent outpatients presenting with DSM-IV major depressive episode (MDE) and, among the bipolar group, to find out what proportion were in a mixed state.

Methods: 247 MDE Hispanic adolescents presenting to a community mental health clinic received structured screens for hypomania/mania by history. One hundred met the criteria for bipolar I or II disorder, depressed.

Pain complaints in adolescent patients with affective disorders versus adolescent psychiatric controls.

Objective: To ascertain the frequencies of 4 prospectively determined pain complaints among adolescents meeting the criteria for major depressive episode (MDE) relative to non-affectively ill controls.

Method: In a community mental health clinic for the indigent situated on the border of the United States and Mexico (Rio Grande City, Tex.), adolescents (age range, 12-17 years) who consecutively presented to the clinic from August 2001 to November 2003 received structured psychiatric diagnostic screens for depression and mania using the modules from the DSM-IV.

High rate of unrecognized bipolar mixed states among destitute Hispanic adolescents referred for "major depressive disorder".

Objective: To ascertain the rate of bipolarity among adolescent Hispanic youths referred for the treatment of "major depressive disorder" (MDD) in a community mental health clinic (CMHC) in which the threshold for referral was moderate to severe impairment.

Methods: The patients were 49 consecutively presenting Hispanic adolescents (33 girls and 16 boys with a range of 12-17 years), many of whom had histories of unruly, hostile and/or assaultive behavior; indeed, 1 out of 3 had been referred to the CMHC from the "First-Time Offenders Program." Upon evaluation at the CMHC triage unit, all were diagnosed as MDD rendered by a licensed paramedical mental health professional managing this unit.

Preschool-onset mania: incidence, phenomenology and family history.

Objective: To ascertain the incidence of mania among preschool children presenting in a community mental health clinic over a 24-month period, to describe the signs and symptoms of the children meeting criteria for mania and present their family histories based on systematic diagnostic interview.

Methods: Forty children less than the age of 5 years presented between October 2001 and September 2003. Signs of mania were determined using a structured interview.

Occult mood disorders in 104 consecutively presenting children referred for the treatment of attention-deficit/hyperactivity disorder in a community mental health clinic.

Objective: To ascertain the prevalence of mood disorders among consecutively evaluated prepubertal children presenting for the treatment of attention-deficit/hyperactivity disorder (ADHD) in a community mental health clinic.

Method: 104 children received systematic assessments designed to identify individuals meeting the DSM-IV criteria for major depressive disorder (MDD), mania, and ADHD. "Standard" and "modified" criteria for mania were employed.

Pattern of response to divalproex, lithium, or placebo in four naturalistic subtypes of mania.

We investigated effects of antimanic treatments on specific aspects of mania, prediction of response, and the existence of naturalistic subgroups of patients with different treatment response in 179 inpatients randomized to antimanic treatment with lithium, divalproex, or placebo. Psychiatric symptom ratings were conducted by clinicians and nurses before and during treatment. Factor analysis using physician and nurse rating scales, followed by a cluster analysis, yielded anxious-depressive, psychotic, classic, and irritable subtypes.