from: American Psychiatric Publishing
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Type of bind: Paperback
Dewey Decimal Number: 616.895
EAN num: 9781585621712
ISBN number: 1585621714
Label: American Psychiatric Publishing
Manufacturer: American Psychiatric Publishing
Quantity: 1
Page Count: 277
Printing Date: May 03, 2006
Publishing house: American Psychiatric Publishing
Sale Popularity Level: 783899
Studio: American Psychiatric Publishing
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Product Description:
Although depression is the most common presentation of bipolar disorder, correct diagnosis generally requires a history of mania and thus presents a formidable challenge. This book provides clinicians with the necessary guidance to distinguish this illness and pursue an appropriate therapeutic course. It brings together a team of clinical investigators who offer cutting-edge research on the topic and address the most critical concerns regarding its treatment.
Bipolar Depression very first introduces a hierarchical model for diagnosis to allow the clinician to distinguish between bipolar and unipolar depression, addressing problems of misdiagnosis and overdiagnosis as well as differentiating attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder. Early chapters review the neurobiology and genetics of this highly heritable condition, presenting studies of neurotransmitter function and brain imaging studies and documenting the susceptibility of specific chromosomes as loci for bipolar disorder. Other chapters address the particular issues of bipolar depression in children, for whom a diagnosis is especially problematic, and suicide, focusing on the need for assessment during both acute and maintenance treatment with interventions appropriate to a patient's symptoms and history. Bipolar Depression offers critiques of specific treatment approaches:
- Lithium and antiepileptic drugs: featuring a review of the most recent research on the use of lithium, in which higher doses are shown to be effective, plus coverage of lamotrigine, valproic acid, carbamazepine, oxcarbazepine, and topiramate.
- Antidepressants: offering new perspectives on a complex field, including a discusion of the randomized clinical trial literature and observational studies on their use, and citing cautions regarding side effects.
- Antipsychotics: evaluating the difference between first- and second-generation medications and discussing their role in controlling acute depressions.
- Novel approaches to treatment: including the use of atypical neuroleptics, electroconvulsive therapy, transcranial magnetic stimulation, vagus nerve stimulation, ketogenic diet, omega-3 fatty acids, myo-inositol, and dopamine agonists.
- Psychological interventions: focusing on the inclusion of cognitive-behavioral therapy or interpersonal social rhythm therapy for nonmelancholic depressions in patients who had previously received psychoeducation.
Despite the past decade's advances in practice and research, there remains much room for progress in understanding and treating bipolar depression. This book blazes a trail toward that goal, opening new doors in recognizing differences between bipolar and unipolar forms of depression while offering both researchers and clinicians key insights into this troubling illness.
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Rated by buyers 
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I beg to differ with the star-conferring-and-star-revoking author of the previous review. One sentence, taken out of context, doe not sink this book. Dr. El-Mallakh does a fine job with this subject. And no, he does not consider whether my one-a-day Flintstones vitamins treat bipolar disorder. Thank goodness! He does not waste my time with such silliness!
Rated by buyers 
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REVIEW
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Ugh, when will I learn - APPI books have such good titles but they never deliver. The very first chapter, about diagnosis of bipolar depression gives some great perspective on the diagnosis and is the highlight of the book. The proposed bipolar spectrum and features of bipolar, as apposed to unipolar depression were worth buying the book for. The intersection of BPD and bipolar disorder, especially ultra-rapid cycling BPAD is a hot topic and was given little treatment here. The very first and second chapters are particularly strong on mixed affective states.
The third chapeter, about the genetics of bipolar disorder gives a list of candidate genes according to chromosome; not much interest to me. I'm not sure what a child psychiatrist would have thought of chapter 4 about pediatric bipolar depression. Chapter 5, the Suicide in Bipolar depression makes the same mistake that most suicide literature does, concentrating on static risk factors and mentioning nothing about cognitions.
Chapter 6 gave generic info about lithium and antiepileptic drugs in not much detail but I consider it writing off gabapentin to be a credible update on Sadock and Sadock's guraded endoresement of it. Chapter 7 about antidepressants sets out to "digest this literature for the reader, not to be comprehensive and ask the reader to do the digestive activity." That is a good idea and if it did that it would be much better than the other chapters in the book and every other APPI book I have read. The summary was reasonable, though.
Chapter 8 and 9 shared describing antipsychotic and BP depression and were very clumsily divided. Mallakh, the author of the 8th chapter and an editor of the book should have been resourceful enough to make his problem not the reader's problem. I suspect that there was more data on the atypicals than was reviewed here. The 9th chapter about novel treatments for BP depression is one place the book really falls down: having a page and a half about creatinine when there is NO data about it but you are going to study it is amateur hour indeed. Worse, if the reader wants to know about nimodepine, folate, ascorbate, buproprion, modafinil or stacks of others, the reader can get stuffed, because there is nothing in the book about them!
Chapter 10... hang on, I'll just decrease the review star count from three to one... states "in most bipolar [depressed]patients, there is no cognitive change." By "cognitions," the authors refer to Beck's triad cognitions and the like, not memory/concentration/executive function cognitions and the like. I'll point out that that's on page 219, because you won't believe I quoted that correctly!
SUMMARY
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Manic Symptoms
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D. Distractibility, as opposed to inability to initiate concentration
I. Insomnia, decreased need
G. Grandiosity, increased self-esteem
F. Flight of ideas; subjective
A. Activities, goal directed increased
S. Speech, objectively talkative
T. Thoughtlessness, risk-taking behaviour
Mood. Euphoric/irritable.
Depressive Characteristics
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Atypical symptoms (need 3): increased sleep, leaden paralysis, rejection sensitivity, leaden paralysis, mood reactivity.
Psychosis, especially with guilt and agitation or retardation
Mixed state
Anxious/agitated depression
(Anergic depression)
(Irritability/anger attacks)
Course Characteristics
-----------------------
Onset of depression as a child or before age 20.
First episode depression psychotic
Recurrence
Postpartum
Rapid cycling
Brief duration of depressive episodes
Treatment Response
------------------
Nonresponse to antidepressants
Antidepressant mixed state, psychosis or suicidality
Tolerance
Rapid cycling
Proposed Bipolar Spectrum Disorder
----------------------------------
At least one major depressive episode and no spontaneous manic or hypomanic episodes.
2 and 1 or 1 and 2 from the following groups:
Family history of BPAD
BPAD III.
BPAD IV
More than 3 episodes of MDD
Major depressive episodes less than 3 months
Atypical MDD
Psychotic MDD
Onset MDD before 25
Postpartum MDD
Antidepressant poop out
Non response to 3 antidepressants
Miscellaneous
Family collateral of periodicity and dysfunction. MDQ. BDSAT (bypass stem questions).
Kraeplin/Benazzi (NOT IN THE BOOK BUT IN A LANCET ARTICLE THAT IS FAR MORE HELPFUL IN EXCLUDING A MIXED STATE IN SOMEONE WHO IS DEPRESSED)
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Domains (increase or decrease)
1. Mood
* Irritability ... Read More
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