Focus 5:3-13, Winter 2007
© 2007 American Psychiatric Association
Bipolar Disorder Clinical Synthesis: Where Does the Evidence Lead?
Gary S. Sachs, M.D.
Correspondence: Address correspondence to Gary S. Sachs, M.D.; email: Gsachs{at}partners.org
Bipolar disorder is a common condition diagnosed by the occurrence of pathological mood elevation but most often dominated by dysphoria states. Over the past 10 years, understanding of bipolar disorder and the number of evidence-based treatments have increased dramatically. This article offers strategies for improving diagnostic confidence and simple benchmarks that facilitate integrating principles of evidence-based medicine into the management of patients with bipolar disorder. Simple systematic assessment techniques such as focusing the evaluation to assess the most extreme episode of mood elevation and longitudinal factors such as age of onset and course of illness can avoid errors of omission and raise diagnostic confidence. An iterative measurement-based treatment model that aims to bring patients and their supports into the collaborative care process for progressively better outcomes is recommended.
CME Disclosure
Gary S. Sachs M.D., Director, Bipolar Clinic and Research Program, Massachusetts General Hospital; Associate Professor of Psychiatry, Harvard Medical School, Boston MA
Research support: Abbott Labs, GSK, Memory, Pfizer, Repligen, Wyeth; Advisory board: Abbott Labs, AstraZeneca, GSK, JDS, Lilly, Memory, Novartis, Pfizer, Repligen, Wyeth. Speakers bureau: Abbott Labs, AstraZeneca, GSK, Lilly; Equity (Spouse): Concordant Rater Systems.
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