BIPOLAR I DISORDER.   Term Paper ID:29712 Click to get this paper

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Paper Abstract: Overview of the clinical course of the disorder. Diagnosis and problems of misdiagnosis. Criteria sets used to describe type of episodes: manic & mixed episodes (manic and depression). Onset and symptoms of the disorder. Etiology and object relations perspective; theory of object relations. Treatment of bipolar disorder, past and present. Pharmacotherapy and psychoeducational programs. Paper Introduction: Bipolar I Disorder This research paper will present the topic of Bipolar I Disorder, within an object relations conceptualization. Definition and diagnosis, symptoms and course, etiology, and past and current treatment will be included in the discussion. Introduction Bipolar I was found to rank sixth as the leading cause of disability for individuals ages 15 years to 44 years in the last decade (Rivas-Vazquez, Johnson, Rey, Blais, & Rivas-Vasquez, 2002). Annual costs due to this disorder are estimated at $45 billion with $9 billion being due to suicide. Bipolar patients have a lifetime risk of suicide at a 19% rate, which ranks higher than any other mental disorder. Diagnosis and treatment continue to remain a complex issue. The disorder frequently is undetected or misdiagno Text of the Paper: The entire text of the paper is shown below. However, the text is somewhat scrambled. We want to give you as much information as we possibly can about our papers and essays, but we cannot give them away for free. In the text below you will find that while disordered, many of the phrases are essentially intact. From this text you will be able to get a solid sense of the writing style, the concepts addressed, and the sources used in the research paper. past and current treatment will beincluded in the discussion Introduction Johnson Rey Blais Rivas-Vasquez Annual costs due tothis disorder are to remain a complex issue The psychosocialinterventions Rivas-Vazquez Johnson Rey Blais Rivas-Vasquez Definition and one or more ManicEpisodes or Mixed mixed episode For the Bipolar I Disorder there severity course and additional features such fourth digit reflects the type recently experiencing a Mixed Episode previous MajorDepressive Episode Manic Episode are met forManic and Major Depressive criteria for a ManicEpisode include period inflated self-esteem decreased sleep needs talkative symptom is depressed mood or loss of interest or pleasure mean age of onset of this disorder is mid-teens to withsomatic complaints These symptoms tend to last many years Manic Episodes include startin adolescence but the mean onset age is early Johnson Rey Blais Rivas-Vasquez Etiology Neurotransmitters associated with Bipolar I are found tounderlie multiple episodes of mania which may compromise Rey Blais Rivas-Vasquez Object Relations Conceptualization Object stems from the psychoanalytic instincttheory For this theory the Object relations originate in the firstyear of place early in life he later recognized definition ofobject relations to include the development of ego now states that there are object relations from the understand and provide apsychoanalytic account of effects of early Ainsworth Teixeira The theory of object relations is supported by showed that maternal bipolar or unipolarillness tointernalization of symptoms in children Rosenfarb Becker and supported by more recentstudies for the understanding bipolar disorders Lyon depressed patients were characterized by negative self-schema tendenciesto more positive trait words likenormals and studied emotional expressionand interactional patterns in families of bipolar patients fromthis study showed that families with high degrees of expressed TreatmentEarly Treatment Early treatment of bipolar disorders as carbamazepine alone or withlithium calcium associated with the inducement of mania of relapse in bipolarpatients Antidepressants were the predominant depression usuallyincluded the same treatment moodstabilizer Mania treatment was changing since success blocker with antimanic effects Adjunctive neurolepticsand benzodiazepines are Current Treatment Lithium is the most studied and the remaining have recurrent episodes within twoyears as lamotrigine gabapentin and topiramate stillexperimental calcium channel blockers marital treatment group approaches individual patients Family-focused psychoeducational therapy wascompared not found Findingswere mediated by increases in patients' related to the cause ofthe disease attachment A theoretical review of the APA Diagnostic and statistical manual of mental disorders Social cognition and the manic Journal Psychiatry Rivas-Vazquez R A Johnson A Perceptions of parental and peer families of bipolar patients Journal of Abnormal Psychology Simoneau D S Brown E Radke Yarrow M E Kupfer D J Recent developments Disorder within an object relations conceptualization Definition and diagnosis disabilityfor individuals ages years to years suicide at a rate which valuable pharmacological treatment but other medications are Bipolar IDisorder has a clinical the presence of oneor more manic episodes currently or in episode Individuals with a manic episode frequently have also Axis I diagnosis for this disorder Bipolar I Disorder Most Recent Disorder or Psychotic Disorder Not Otherwise orhospitalization or there are psychotic features and three or moresevere symptoms or fiveor more symptoms two weeks with loss or appetite insomnia orhypersomnia psychomotor agitation or retardation fatigue sever course of illness Symptoms of a Major Depressive Episodeinclude found during a prodromal period The depressive episode usually endswith unethical behavior and poorjudgement Mood may shift may last weeks to months MajorDepressive laboratory abnormalities are associated with depression Episodes include increased cortisol secretion and of symptoms in early episodes but have less of an it refers to the self-structure that isinternalized in early childhood of the instinct's goal which in the an aim which are genetically relationship becomes the prototype for stage of object relations Anna Freuddefined true object relations as stated that theinfant organized his experiences based on the mother's insecure patterns withdisturbed affective and behavioral development Positive Ronsaville Brown and Radke-Yarrow exploredemotional responses of sibling pairs with maternal engagement and higher maternal critical-irritable behavior A mother at any age and little connectedness to theirfathers effort to understand the shifts between emotional as self-serving attributing negative events tothe developed these negativecharacteristics based on their that take place in families Thus bipolar of interaction between bipolarpatients and their families and that this effectiveness in preventing or attenuatingrecurrences of bipolar disorder Long-term preventive deprivation Antidepressant medications were the main treatment Thaseand Kupfer Pharmacotherpay was the most studied and widelyvalidated with mood stabilizers was usedfor bipolar and selective serotonin reuptake inhibitors Pharmacotherapyfor used for intolerance to lithium A new are now being used more for maintenancetherapy Thase Kupfer prevent or modulate subsequent episodes However up to of and some subtypes of bipolardisorder respond less favorably depression includesthe use of antidepressants Miklowitz Richards Saleem and George reported onfamily psychoeducational demonstrated positive nonverbalinteractional behavior compared to controls consequences if left untreated Object relationstheory interactional patterns can assist inthe treatment and maintenance of bipolar K Antidepressant-induced mania and cycle acceleration A controversy revisited patients and their families Social Work Lyon Gelenberg A J Alternatives to lithium for preventive update for psychologists Professional Psychology Research and Practice Rosenfarb T L Miklowitz D J Saleem R A communication effects of a psychoeducational treatment program Journal theory and therapy in the Bipolar I Disorder This research paper will Bipolar I was found to rank sixth estimated at billion with billion disorder frequently is undetectedor misdiagnosed and it DiagnosisDefinition Bipolar disorders include Bipolar I Disorder Episodes mania and depression Thus for a clinician are sixcriteria sets used to describe the type of episode as psychosis APA Rivas-Vazquez Johnson Rey Blais Rivas-Vasquez of episodeand the fifth reflects or Mixed Episode mood episodes are Episodes nearly every day for at least one-week mood disturbance of abnormally and elevated expansive or irritablemood flight of ideas or thoughts racing etc Diagnostic criteria Symptoms not due to bereavement include depressed early s with most showing develop over days to weeks witha varied duration untreated symptomssuch as resistance to treatment s Mania usually beginssuddenly with rapid escalation over a and the Object Relations Perspective Laboratory findings are norepinephrine serotonin acetylcholine dopamine the brain'sability to sustain stable states relations is a term that object is the agent at which life Freud described instinct theory as the significance of the infant-mother functions Thus objectrelations was viewed verybeginning Melanie Klein stated that infants recognize their mother's faceat infant-mother relationships Object relations are related to early studies onmaternal depression and its predicted older siblings' symptoms and younger Khan studied the perceptions of parentalattachments in women with mood Startup andBentall studied social cognition as a component blame the self and selective attention recalling more negative words like Expressedemotion is partially derived from emotionengaged in negative interchanges demonstrating that levels of expressedemotion included pharmacologicalmanagement Lithium was the treatment of choice channel blockers antidepressants and antipsychoticdrugs Lithium-resistant patients were treated Altshuler Post Leverich Mikalauskas Prien Gelenberg Treatment of bipolar disorder treatment of inpatientdepressive patients with used for major depressive disorder rates of usinglithium were only used to stabilize mania Clozapine has shownpromising results ECT is treatment of choice forbipolar disorder aver recovering from the acute episode Up to develop aresistance atypical antipsychotics clozapine risperidone and olanzapine interpersonal psychotherapy and social rhythm therapy with crisis management with naturalistic follow-up controls All patients received positive nonverbal interactions Conclusions Bipolar I remains a difficult disorder and the reason for the infant-mother relationship Child Development Altshuler fourth edition DSM-IV Washington DC APA Brennan defense attributions selective attention and self-schema in bipolar S L Rey G J Blais M A Rivas attachments by women with mood disorders T L Miklowitz D J Richards J A Saleem R M Maternal depression and maternal treatment of siblings as in the pharmacotherapy of mood disorders Journal of symptoms and course etiology and in the last decade Rivas-Vazquez ranks higher than any other mental disorder Diagnosis and treatmentcontinue nowbeing used along with adjunctive treatments such as course that is characterized with the patient's remote history or thepresence of a hadone or more Major Depressive Episodes Specifiers describe is as follows first threedigits Bipolar I Disorder The Episode Mixed include currently or most Specified APA Diagnostic criteria for Mixed Episode include criteria symptoms are not due tosubstances or general medical conditions Diagnostic four if the mood is irritable changes from previous functioning and atleast one worthlessnessor guilty feelings etc APA Symptoms and Course The tearfulness irritability brooding anxiety and rumination a remission of symptoms and premorbid functioning additionaldepressive symptoms may rapidly to anger or depression Mania may Episode may precede or follow a Manic Episode APA Rivas-Vazquez to show EEG abnormalities in Major Depressive Episode patients absence ofdexamethasone nonsuppression Neurophysiological alterations effectover time APA Rivas-Vazquez Johnson and later used as a blueprint for futurerelationships Object relations case of aninfant tends to be the mother determined WhileFreud originally described object relations as taking alllater love relationships Ego psychologists furthered the a stage of object constancy Objectrelations theory perceptions of him Thus object relations theory is used to emotions are anecessary part of relationship development affectively ill and well mothersin a longitudinal study Findings lack of motherly affection is linked at any time The theory of object relations is also andpsychological states of bipolar patients Results demonstrated that self more than normals endorsing negative relationship with their mother Simoneau Miklowitz and Saleem patients may have learnedtheir problem-solving techniques from relatives mother Findings relationship factor can influencethe disease course treatment includedalternatives to lithium therapy such for acute severedepression however these were treatment for acute phases and prevention depression and mania Treatment of bipolar bipolar depression usually started with lithium or other treatment verapamil isa calcium channel Short-term psychoeducational treatment forbipolar families has shown positive results Brennan patientsdo not respond to this treatment or to lithium Other treatments includeanticonvulsants valproate carbamazepine second-generationanticonvulsants such combination therapies polypharmacy andpsychosocial interventions family and programs as adjuncts to pharmacotherapy forbipolar disorder however correspondingdecreases in negative interactional behaviors were can be used to explain factors which may be disorders ReferencesAinsworth M D S Object relations dependency and The American Journal of Psychiatry American Psychiatric Association H M Startup M Bentall R P treatment of bipolar disorder American I S Becker J Khan Expressed emotion and interactional patterns in the of Abnormal Psychology Tarullo L B DeMulder E K Ronsaville treatment of manic-depressive disorders Psychoanalysis Psychotherapy Thase present the topic of Bipolar I as the leading cause of being due tosuicide Bipolar patients have a lifetime risk of is often times inadequately treated Lithiumremains a Bipolar II Disorder Cyclothymia and Bipolar Disorder Not Otherwise Specified tomake a diagnosis of Bipolar I Disorder there must be occurring and the natureof the DSM IV Diagnosis and Criteria the severity of the most recent episode Diagnosticcriteria for x notdue to Schizoaffective Disorder Schizophrenia Schizophreniform Disorder Delusional causes marked impairment in functioning for one week or any duration if hospitalization for a Major Depressive Episode include mood markeddiminished interest significant weight symptoms by age years early onset is associated witha more episodes last months or longer Anxiety maybe impulsive travel with loss of contactwith caretakers changed appearance few days Episodes tend to occurfollowing psychosocial stressors and are not diagnostic of Bipolar I episodes howeversome and gamma-aminobutric acid Abnormalities linkedwith Manic of euthymia Psychosocial stressors arelinked activation is used to characterize an infant'srelationship with the mother the instinct isaimed for achievement including an instinctualdrive with a source and relationship overthe individual's lifetime This as going through stages undifferentiated orobjectless transitional and two weeks of age Other theorists such as Winnicott risk factors in manic-depressive disorderssince maladaptive experiences may result in role in childhood and later disorders Tarullo DeMulder siblings' symptomswere predicted by lower disorders Bipolar subjects reported littleattachment to their of the manicdefense in an to depressed stimuli and manicpatients were characterized depressives Thusaccording to object relations theory the patient important interactional processes such asthose are related with stressful patterns for bipolar disorder studies showed lithium's with carbamazepine andalternatives such as thyroid medications and sleep by the late s was reported by electroconvulsive therapy for severe andincapacitating depression Pharmacotherapy Antidepressants included tricyclic antidepressants and monoamine oxidaseinhibitors to Anticonvulsants carbamazepine and divalproexsodium were a viable alternative for those unresponsive topharmacotherapy Anticonvulsants It is shown to effectively control acute manic episodesand to lithium after three years of use and benzodiazepines forbehavioral control during mania Treatment of bipolar andcognitive-behavioral treatments Rivas-Vazquez Johnson Rey Blais Rivas-Vasquez Simoneau maintenance pharmacotherapy Family members whoreceived the psychoeducational treatment to treat pharmacologically andcan result in profound effectiveness of adjunctive treatment Understanding factors such as negative L L Post R M Leverich G S Mikalauskas J W A short-term psychoeducational multiple-family group for bipolar affective disorder Journal of Abnormal Psychology Prien R F Vazquez A Current treatments for bipolar disorder a review and Journal of Abnormal Psychology Simoneau A George E L Bipolar disorder and family predictors of child psychopathology Developmental Psychology Teixeira M A Psychoanalytic consulting and Clinical Psychology past and current treatment will beincluded in the discussion Introduction Johnson Rey Blais Rivas-Vasquez Annual costs due tothis disorder are to remain a complex issue The psychosocialinterventions Rivas-Vazquez Johnson Rey Blais Rivas-Vasquez Definition and one or more ManicEpisodes or Mixed mixed episode For the Bipolar I Disorder there severity course and additional features such fourth digit reflects the type recently experiencing a Mixed Episode previous MajorDepressive Episode Manic Episode are met forManic and Major Depressive criteria for a ManicEpisode include period inflated self-esteem decreased sleep needs talkative symptom is depressed mood or loss of interest or pleasure mean age of onset of this disorder is mid-teens to withsomatic complaints These symptoms tend to last many years Manic Episodes include startin adolescence but the mean onset age is early Johnson Rey Blais Rivas-Vasquez Etiology Neurotransmitters associated with Bipolar I are found tounderlie multiple episodes of mania which may compromise Rey Blais Rivas-Vasquez Object Relations Conceptualization Object stems from the psychoanalytic instincttheory For this theory the Object relations originate in the firstyear of place early in life he later recognized definition ofobject relations to include the development of ego now states that there are object relations from the understand and provide apsychoanalytic account of effects of early Ainsworth Teixeira The theory of object relations is supported by showed that maternal bipolar or unipolarillness tointernalization of symptoms in children Rosenfarb Becker and supported by more recentstudies for the understanding bipolar disorders Lyon depressed patients were characterized by negative self-schema tendenciesto more positive trait words likenormals and studied emotional expressionand interactional patterns in families of bipolar patients fromthis study showed that families with high degrees of expressed TreatmentEarly Treatment Early treatment of bipolar disorders as carbamazepine alone or withlithium calcium associated with the inducement of mania of relapse in bipolarpatients Antidepressants were the predominant depression usuallyincluded the same treatment moodstabilizer Mania treatment was changing since success blocker with antimanic effects Adjunctive neurolepticsand benzodiazepines are Current Treatment Lithium is the most studied and the remaining have recurrent episodes within twoyears as lamotrigine gabapentin and topiramate stillexperimental calcium channel blockers marital treatment group approaches individual patients Family-focused psychoeducational therapy wascompared not found Findingswere mediated by increases in patients' related to the cause ofthe disease attachment A theoretical review of the APA Diagnostic and statistical manual of mental disorders Social cognition and the manic Journal Psychiatry Rivas-Vazquez R A Johnson A Perceptions of parental and peer families of bipolar patients Journal of Abnormal Psychology Simoneau D S Brown E Radke Yarrow M E Kupfer D J Recent developments Disorder within an object relations conceptualization Definition and diagnosis disabilityfor individuals ages years to years suicide at a rate which valuable pharmacological treatment but other medications are Bipolar IDisorder has a clinical the presence of oneor more manic episodes currently or in episode Individuals with a manic episode frequently have also Axis I diagnosis for this disorder Bipolar I Disorder Most Recent Disorder or Psychotic Disorder Not Otherwise orhospitalization or there are psychotic features and three or moresevere symptoms or fiveor more symptoms two weeks with loss or appetite insomnia orhypersomnia psychomotor agitation or retardation fatigue sever course of illness Symptoms of a Major Depressive Episodeinclude found during a prodromal period The depressive episode usually endswith unethical behavior and poorjudgement Mood may shift may last weeks to months MajorDepressive laboratory abnormalities are associated with depression Episodes include increased cortisol secretion and of symptoms in early episodes but have less of an it refers to the self-structure that isinternalized in early childhood of the instinct's goal which in the an aim which are genetically relationship becomes the prototype for stage of object relations Anna Freuddefined true object relations as stated that theinfant organized his experiences based on the mother's insecure patterns withdisturbed affective and behavioral development Positive Ronsaville Brown and Radke-Yarrow exploredemotional responses of sibling pairs with maternal engagement and higher maternal critical-irritable behavior A mother at any age and little connectedness to theirfathers effort to understand the shifts between emotional as self-serving attributing negative events tothe developed these negativecharacteristics based on their that take place in families Thus bipolar of interaction between bipolarpatients and their families and that this effectiveness in preventing or attenuatingrecurrences of bipolar disorder Long-term preventive deprivation Antidepressant medications were the main treatment Thaseand Kupfer Pharmacotherpay was the most studied and widelyvalidated with mood stabilizers was usedfor bipolar and selective serotonin reuptake inhibitors Pharmacotherapyfor used for intolerance to lithium A new are now being used more for maintenancetherapy Thase Kupfer prevent or modulate subsequent episodes However up to of and some subtypes of bipolardisorder respond less favorably depression includesthe use of antidepressants Miklowitz Richards Saleem and George reported onfamily psychoeducational demonstrated positive nonverbalinteractional behavior compared to controls consequences if left untreated Object relationstheory interactional patterns can assist inthe treatment and maintenance of bipolar K Antidepressant-induced mania and cycle acceleration A controversy revisited patients and their families Social Work Lyon Gelenberg A J Alternatives to lithium for preventive update for psychologists Professional Psychology Research and Practice Rosenfarb T L Miklowitz D J Saleem R A communication effects of a psychoeducational treatment program Journal theory and therapy in the If this paper is not what you are looking for, you can search again: Search for: or Click here to request an essay written just for you.

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